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MLS 411 Clinical Chemistry I > Bishop Chapter 11 Amino Acids and Proteins > Flashcards

Bishop Chapter 11 Amino Acids and Proteins Flashcards

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1
Q

The two major groups of plasma proteins

A

Albumin and Globulins

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2
Q

Analysis of blood specimens will typically include what four protein measurements?

A

Total protein, albumin, globulins, and albumin-to-globulin ratio (A/G) ratio.

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3
Q

What is the alternative name for prealbumin?

A

Transthyretin

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4
Q

What is the reason for giving transthyretin the name prealbumin?

A

It migrates before albumin in classic serum protein electrophoresis (SPE).

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5
Q

Prealbumin acts as a transport protein for which thyroid hormone(s)?

A

Thyroxine and Triiodothyronine

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6
Q

Prealbumin forms a complex with which vitamin for transport?

A

Forms a complex with retinol-binding protein for transport of retinol (Vitamin A).

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7
Q

Prealbumin is rich with which amino acid?

A

Tryptophan

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8
Q

What would cause a decrease in serum prealbumin?

A

Hepatic damage due to decreased protein synthesis, during an acute-inflammatory response, or as a result of tissue necrosis.

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9
Q

How would poor nutritional status effect prealbumin?

A

Low prealbumin level

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10
Q

When would serum prealbumin be elevated?

A

Patients receiving steroid therapy, issues with alcohol abuse, or who are in chronic renal failure.

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11
Q

What protein is the most abundant in plasma?

A

Albumin

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12
Q

What is the rate at which albumin is synthesized?

A

9 to 12 g/day

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13
Q

What does albumin exist in other than in serum?

A

Extravascular (interstitial) space.

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14
Q

The total amount of extravascular albumin exceeds the total intravascular amount by how much?

A

30%

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15
Q

What is the transcapillary escape rate?

A

The rate at which intravascular albumin leaves the bloodstream per hour.

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16
Q

What is the clinical significance of albumin?

A

The transport of thyroid hormones, unconjugated bilirubin, fat-soluble hormones, iron, fatty acids, calcium, magnesium, and certain drugs such as aspirin.

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17
Q

Decreased blood concentrations of albumin are most commonly associated with what conditions?

A

Acute inflammatory response; liver disease; kidney disease.

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18
Q

What condition causes an increase excretion of albumin?

A

Nephrotic syndrome.

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19
Q

What is the clinical significance of high blood albumin?

A

Not clinically significant; can be the result of dehydration or excessive albumin infusion.

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20
Q

What is the main function of alpha1-Antitrypsin?

A

The inhibition of the protease, neutrophil elastase.

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21
Q

In which cells is neutrophil elastase released?

A

Leukocytes

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22
Q

How is the lack of alpha1-antitrypsin typically identified?

A

By the lack of alpha1-globulin band on serum protein electrophoresis.

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23
Q

What is the clinical significance of alpha1-fetoprotein?

A

Proposed that it protects the developing fetus from immunologic attack by the mother.

AFP can also be used as a tumor marker.

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24
Q

What is the primary function of haptoglobin?

A

To bind free hemoglobin to prevent the loss of its constituent, iron, into the urine.

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25
Q

Haptoglobin concentrations are primarily used to evaluate what condition?

A

Hemolytic anemia

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26
Q

If the haptoglobin concentration is normal and the reticulocyte count is increased, what is likely the cause of this?

A

Anemia is due to destruction of red blood cells in organs such as the spleen and liver.

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27
Q

If haptoglobin concentration are decreased without any sign of hemolytic anemia, what is the likely cause?

A

It is possible the liver is not producing adequate amounts of haptoglobin.

28
Q

Ceruloplasmin is primarily measured along with what to diagnose Wilson’s disease?

A

Blood and urine copper tests.

29
Q

What is Wilson’s disease?

A

An autosomal recessive inherited disorder associated with decreased concentrations of ceruloplasmin.

30
Q

Decreased concentrations of ceruloplasmin can cause what condition(s)?

A

Hepatic cirrhosis and neurologic damage.

31
Q

What is the clinical significance of transferrin?

A

Binds and transports iron to its storage sites (i.e. liver), where it is incorporated into apoferritin, which forms ferratin.

32
Q

Transferrin concentrations are routinely measured to determine what conditions?

A

Anemia, gauge iron metabolism, and to determine the iron-carrying capacity of the blood.

33
Q

Transferrin concentrations are abnormally elevated in what condition(s)?

A

Iron deficiency anemia.

34
Q

Low transferrin concentrations can lead to what conditions?

A

Impair hemoglobin production which leads to anemia.

35
Q

What precipitates in tissue as a result of inappropriate accumulation and precipitation of iron?

A

Hemosiderin

36
Q

When does transferrin produce a low result?

A

Liver disease or not enough protein in the diet.

37
Q

Define atransferrinemia.

A

An autosomal recessive trait due to mutation of both transferrin genes, with a resulting absence of transferrin.

38
Q

How does iron deficiency effect the following analytes:

Total serum Iron, total iron-binding capacity, and transferrin saturation.

A

Total serum iron: DECREASED
Total iron-binding capacity: INCREASED
Transferrin saturation: DECREASED

39
Q

Lipoproteins are complexes of proteins and lipids whose function is to do what?

A

Transport cholesterol, triglycerides, and phospholipids in the bloodstream.

40
Q

What causes elevated serum levels for beta-2-microglobulin?

A

The result of impaired clearance by the kidney or overproduction of the protein that occurs in a number of inflammatory diseases.

41
Q

The complement system is a natural defense mechanism that does what?

A

Protects the human body from infections.

42
Q

What condition(s) are indicative of increased C3 and C4 levels?

A

Acute inflammatory disease and tissue inflammation.

43
Q

What condition(s) are indicative to decreased levels of complement C3?

A

Autoimmune disease, neonatal respiratory distress syndrome, bacteremia, tissue injury, and chronic hepatitis.

44
Q

What condition(s) are indicative of decrease complement C4 levels?

A

Disseminated intravascular coagulation (DIC), acute glomerulonephritis, chronic hepatitis, and SLE.

45
Q

What is the function of fibrinogen?

A

To form fibrin clot when activated by thrombin.

46
Q

Decreased levels of fibrinogen is indicative of what?

A

Extensive coagulation, during which fibrinogen is consumed.

47
Q

What condition(s) causes an elevated C-Reactive Protein (CRP)?

A

Atherosclerosis (fatty deposits accumulating in the inner lining of the arteries).

48
Q

hsCRP is most commonly used to detect what condition?

A

Cardiovascular Disease

49
Q

What is the most abundant class of antibodies found in both plasma and lymph?

A

IgG

50
Q

IgG antibodies act on what?

A

Bacteria, fungi, viruses, and foreign particles by agglutination, opsonization, and complement activation and by neutralizing toxins.

51
Q

IgG is increased in which conditions?

A

Liver disease, infections, IgG myeloma, parasitic disease, and rheumatic diseases.

52
Q

Decreased IgG levels are associated with what conditions?

A

Acquired immunodeficiency, hereditary deficiency, and non-IgG myeloma.

53
Q

Where does secretory IgA remain active?

A

In the digestive and respiratory tracts.

54
Q

In what condition(s) is serum IgA increased?

A

Liver disease, infections, and autoimmune diseases.

55
Q

Myoglobin is the primary oxygen-carrying protein found where?

A

In striated skeletal muscle and cardiac muscle.

56
Q

Cardiac troponins are considered the “gold standard” for diagnosis of what syndrome?

A

Acute Coronary Syndrome (ACS)

57
Q

Fetal fibronectin (fFN) is used to help predict what?

A

The short-term risk of premature delivery.

58
Q

Where is fFN produced?

A

At the boundary between the amniotic sac and the lining of the uterus.

59
Q

What types of samples are unacceptable for serum total protein testing?

A

Hemolyzed specimens.

60
Q

What total protein quantitation method measures the amount of nitrogen in the specimen?

A

Kjeldahl

61
Q

Why is the Kjeldahl method no longer used in clinical laboratories?

A

It is time consuming and relies on some assumptions that are not always true.

62
Q

What total protein quantitation method is most commonly used in clinical laboratories?

A

Biuret

63
Q

What is the principle of the Biuret reaction?

A

Based on the principle that in an alkaline medium and the presence of at least two peptide bonds, cupric ions (Cu2+) will complex with groups involved in the peptide bond to form a violet-colored chelate.

64
Q

During the Biuret reaction, at what absorbance is the colored chelate measured?

A

540 nm

65
Q

During the Biuret reaction, the absorbance is proportional to what?

A

The number of peptide bonds present which reflects the total protein concentration of the specimen.

MLS 411 Clinical Chemistry I (31 decks)

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