Blood Plasma

Question 1

What is the composition of blood plasma?

Answer 1

90% = water,
8% = plasma proteins,
1% = electrolytes,
1% = others (waste products, nutrients, hormones and vitamins)

Question 2

Describe the distribution of blood plasma proteins?

Answer 2

Proteins are found in colloidal dispersion.

Colloidal osmotic pressure of plasma proteins ~25mmHg

Question 3

What are the classifications of plasma proteins?

Answer 3

Albumin (most common), globulins, fibrinogens, others

Question 4

What are the characteristics of albumin?
* Amount in the blood
* Where it is formed
* Function

Answer 4

Amount: 4 - 4.5 g/dl (60% of blood plasma proteins)
Formation: In the liver
Function: Responsible for plasma osmotic/oncotic pressure

Osmotic pressure: The pressure that favors the reabsorption of extracellular fluid into capillaries and helps to keep water in the bloodstream

Question 5

What are the mechanisms for capillary exchange?

Answer 5

Hydrostatic pressure (Pc): Filtration force out of the cells
Oncotic pressure (πc): Reabsorption force into the cell

Question 6

What factors lead to a decreased albumin level?

Answer 6

In severe starvation or malabsorption (due to intestinal diseases)
In liver failure (decrease its formation)
In kidney disease (increase its loss in urine)
Decreased albumin levels might lead to edema

Question 7

What are the characteristics of globulins?
* Amount in the blood
* Types
* Where it is formed
* Function

Answer 7

Amount: 2.5 g/dl
Types: α globulins , β globulins & γ globulins
Formation: α + β globulins formed in the liver
γ globulins are antibodies formed by plasma cells
Function: α + β globulins are carrier proteins
γ globulins defend against infection

IgG is the most abundant globulin

Question 8

What are the types of antibodies?

Answer 8

GAMED
IgG, IgA, IgM, IgE, IgD

In multiple myeloma and malignant disease of the plasma cells levels of immunoglobulins increase

Question 9

What are the characteristics of globulins?
* Amount in the blood
* Where it is formed
* Function

Answer 9

Amount: 0.3 g/dl
Formation: Liver
Function: Blood clotting and blood viscosity

Question 10

List of plasma proteins and their functions (for reference)

Answer 10

Question 11

What is the albumin/globulin ratio?

Answer 11

A/G between 1.4 - 1.8% (generally 1.5%)

A/G ≈ 4.5/2.5

Question 12

What factors decrease the A/G ratio?

Answer 12

Liver disease
Kidney disease
Infection
Multiple myeloma

First two factor = decrease in albumin
Last two factors = increase in globulin

Question 13

What factors increase the A/G ratio?

Answer 13

AIDS
Hypogammaglobulinamia

Question 14

What are the ways that plasma can be used?

Answer 14

1) Transfusion
2) Fractionation
3) Exchange

Question 15

How is plasma transfusion conducted?

Answer 15

Plasma is separated from donated blood and frozen (Fresh Frozen Plasma - FFP).

FFP can be thawed and given as a transfusion

Question 16

When is plasma transfusion used?

Answer 16

People in trauma, serious accidents and undergoing major surgery experience a lot of bleeding.

Why is plasma transfusion needed?

Excess blood loss causes clotting factors to become depleted and transfusion of FFP and patient RBCs resolves this

Question 17

What is plasma fractionation?

Answer 17

Important components of plasma (such as plasma proteins) are separated to treat a specific medical problem pertaining to a lack of them

Question 18

What are the reasons for plasma fractionation?

Answer 18

Albumin used in ascites,
Clotting factors in hemophilia,
Immunoglobulins in immune deficiency disorders

Question 19

What is plasma exchange?

Answer 19

Blood is withdrawn, plasma is separated out, replace with a substitute (such as an albumin solution) and pumped back into the patient.

A machine called a separator conducts this process

Question 20

What is plasma exchange used to treat?

Answer 20

Thrombocytopenic purpura (TTP),
Multiple myeloma,
Waldenstrom macroglobulinaemia