Clinical Chemistries: Protein and Hepatobiliary Testing

Question 1

Are protein assays a liver function test?

Answer 1

Not specifically

Two of the three plasma proteins are produced by the liver

Question 2

What two plasma proteins are produced by the liver?

Answer 2

Albumin and Fibrinogen

Question 3

Are there other proteins produced by the liver

Answer 3

Yes, they are just in smaller amounts

Question 4

What are globulins produced by?

Answer 4

The immune system

Question 5

What are the functions of plasma proteins?

Answer 5

Help form structural matrix of all cells, organs, and tissues
Maintain osmotic pressure
Serve as enzymes, buffers, and hormones
Function in blood coagulation
Help with the body's defense system
Act as transport or carrier molecules

Question 6

Total Protein

Answer 6

The total amount of protein in serum

Question 7

What does total protein measure specifically?

Answer 7

Albumin, globulins, and many other proteins

Question 8

What is total protein useful in determining?

Answer 8

The hydration status of the patient

Question 9

Hyperproteinemia

Answer 9

Dehydrated patient

Question 10

Hypoproteinemia

Answer 10

Over-hydrated or other causes

Question 11

What protein tests can you run?

Answer 11

Total plasma protein
Total Protein
Albumin
Globulin
Fibrinogen

Question 12

Total plasma protein

Answer 12

Uses plasma and includes all 3 proteins
Can measure with PCV tube and refractometer or
GTT in the analyzer

Question 13

Albumin

Answer 13

Run in chemistry analyzer

Makes up 35-50% of total protein

Question 14

Globulin

Answer 14

Rarely done

Estimated by taking the difference between TP and ALB

Question 15

Fibrinogen

Answer 15

Run with 4 PCV tubes

After spinning, cook 2 in a warm water bath and take the difference on the refractometer

Question 16

Hypoalbuminemia

Answer 16

Low Albumin

Question 17

What are the causes of low albumin?

Answer 17

1. Liver disease
2. Kidney damage
3. Malnutrition
4. Intestinal disease
5. Bloodsucking parasites

Question 18

How does liver disease cause low albumin?

Answer 18

If the liver is not making adequate amounts

Question 19

How does kidney damage cause low albumin?

Answer 19

Proteins are leaking through a damaged glomerulus

Question 20

How does intestinal disease cause low albumin

Answer 20

Prevents the absorption of proteins

Question 21

High Albumin =

Answer 21

Usually dehydration

Question 22

Why is the albumin/globulin ratio important?

Answer 22

Because it is the first indication of a protein abnormality

Question 23

What is the albumin/globulin ratio analyzed in conjunction with?

Answer 23

The protein profile

Question 24

What alters the albumin/globulin ratio?

Answer 24

Most pathologic conditions

Question 25

What condition does not alter the albumin/globulin ratio and why?

Answer 25

Hemorrhage because everything is reduced in equal amounts

Question 26

Fibrinogen

Answer 26

Only when you have plasma

Produced by the liver

Question 27

What percent does fibrinogen make up in the total plasma protein?

Answer 27

3 to 6%

Question 28

What happens if fibrinogen is low?

Answer 28

Blood will not clot normally

Question 29

What causes high fibrinogen?

Answer 29

Inflammation or tissue damage

Question 30

What phase is clotting involved in

Answer 30

Mechanical phase

Platelets and smooth muscle contraction

Question 31

What phase is the clotting cascade apart of?

Answer 31

Chemical phase

Fibrinogen gets converted into insoluble fibrin