CMP Lab

Question 1

albumin

Answer 1

plasma protein synthesized by liver, ~69kDa, general marker of health, surgical mortality and used for life insurance data.

• Important for body fluid maintenance between tissues and blood - vital for starlings forces/oncotic/osmotic pressure in capillaries.
• Serves as a reservoir for calcium in plasma. (40% of calcium is bound to albumin. ~0.8 mg calcium/g albumin)
• Binds many small molecules including free FAs, unconjugated bilirubin, drugs.

Question 2

ALT

Answer 2

liver enzyme, marker of hepatic injury

Question 3

AST

Answer 3

liver enzyme, marker of hepatic injury, also found in heart tissue to a lesser extent

Question 4

Alk Phos

Answer 4

marker of pathology in bile ducts of the liver, can be elevated without cell necrosis.

Question 5

bilirubin

Answer 5

metabolic waste product from heme, lab report usually shows indirect (unconjugated), direct (conjugated) and total bilirubin. Indirect bilirubin shows hemolytic anemia, metabolic defect (Gilbert), or hepatocellular injury. Direct bilirubin shows biliary obstruction.
**Can use light therapy to convert from trans to cis bilirubin, increasing water solubility and ability to clear.

Question 6

kernicterus

Answer 6

brain damage caused by jaundice (indirect bilirubin buildup), can occur in babies, important to screen babies for jaundice.

Question 7

BUN/creatinine

Answer 7

markers that allow us to calculate GFR. Elevated BUN/creatinine ratio = renal failure. BUN may be elevated in dehydration.
BUN = blood urea nitrogen

Question 8

pseudohyponatremia

Answer 8

elevated triglycerides can give false lab readings for sodium

Question 9

elevated trigs

Answer 9

increased risk for pancreatitis and CAD

Question 10

intrinsic proteins

Answer 10

plasma proteins that are supposed to be there, synthesized by the liver and lymphocytes, serve a variety of functions

Question 11

extrinsic proteins

Answer 11

plasma proteins that are present in much smaller amounts, released by dying cells, markers for diagnosis and prognosis

Question 12

classification of plasma proteins

Answer 12

classified by solubility first - albumin vs globulins; then subclassified by electrophoretic mobility at ph 8.6 (type of globulin or albumin)

Question 13

alpha 1 globulins

Answer 13

includes a1-antitrypsin

Question 14

normal A/G ratio

Answer 14

1.2-1.4

Question 15

alpha 2 globulins

Answer 15

includes a2-macroglobulin

Question 16

phi globulins

Answer 16

includes fibrinogen

Question 17

gamma globulins

Answer 17

includes all immunoglobulins, including IgG

Question 18

serum protein electrophoresis (SPE)

Answer 18

used to determine levels of serum proteins when a patient has abnormal symptoms like unexplained hemolytic anemia, renal insuff, MM

Question 19

functions of plasma proteins

Answer 19

1. body fluid maintenance between tissues and blood (colloidal suspension, viscosity)
2. bind many small hydrophobic molecules
3. albumin is reservoir for calcium
4. specialized carriers of small molecules
5. buffering pH, next to Hgb in importance
6. inactive precursor
7. protection - ex: Immunoglobulins, complement factors, protease inhibitors

Question 20

acute phase proteins

Answer 20

proteins whose serum concentrations alter by at least 25% during acute or chronic inflammation. Cytokines are regulators of their expression. Can be positive (increased concentration) or negative (decreased concentration). Ex: CRP, hepcidin, ferritin

Question 21

CRP

Answer 21

C reactive protein, activates complement factors, sensitive marker for inflammation caused by infection, trauma, cancer

Question 22

hepcidin and ferritin

Answer 22

in iron regulation; increase of Hepcidin is responsible for anemia of chronic disease and increased ferritin may mask iron deficiency anemia

Question 23

hyperproteinemia

Answer 23

usually due to dehydration, levels less than 8 g/dL, Albumin and globulin both are increased; A/G ratio remains the same

Question 24

hypergammaglobulinemia

Answer 24

only Ig levels increased, A/G ratio decreases. Polyclonal leads to liver disease (IgA), autoimmune disease (IgM). Monoclonal usually due to MM (G>A>M>E>D).

Question 25

hypoproteinemia

Answer 25

decrease in total protein, A/G ratio same. Associated with edema. Causes: loss of blood, malnourishment, burns, hemodilution (H2O poisoning)

Question 26

hypoalbuminemia

Answer 26

decreased albumin, A/G ratio decreases. Associated with edema. Caused by severe liver disease, nephrotic syndrome

Question 27

hypogammaglobulinemia

Answer 27

low levels of gamma globulins, A/G ratio increases. Causes: decreased synthesis, corticosteroid use

Question 28

serum marker proteins

Answer 28

proteins (metabolites, miRNA) that are objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacological responses to a therapeutic intervention

Question 29

aldolase

Answer 29

serum marker protein for liver, skeletal muscle

Question 30

amylase/lipase

Answer 30

serum marker proteins for pancreas