CMP Lab Flashcards
albumin
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.
ALT
liver enzyme, marker of hepatic injury
AST
liver enzyme, marker of hepatic injury, also found in heart tissue to a lesser extent
Alk Phos
marker of pathology in bile ducts of the liver, can be elevated without cell necrosis.
bilirubin
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.
kernicterus
brain damage caused by jaundice (indirect bilirubin buildup), can occur in babies, important to screen babies for jaundice.
BUN/creatinine
markers that allow us to calculate GFR. Elevated BUN/creatinine ratio = renal failure. BUN may be elevated in dehydration.
BUN = blood urea nitrogen
pseudohyponatremia
elevated triglycerides can give false lab readings for sodium
elevated trigs
increased risk for pancreatitis and CAD
intrinsic proteins
plasma proteins that are supposed to be there, synthesized by the liver and lymphocytes, serve a variety of functions
extrinsic proteins
plasma proteins that are present in much smaller amounts, released by dying cells, markers for diagnosis and prognosis
classification of plasma proteins
classified by solubility first - albumin vs globulins; then subclassified by electrophoretic mobility at ph 8.6 (type of globulin or albumin)
alpha 1 globulins
includes a1-antitrypsin
normal A/G ratio
1.2-1.4
alpha 2 globulins
includes a2-macroglobulin
phi globulins
includes fibrinogen
gamma globulins
includes all immunoglobulins, including IgG
serum protein electrophoresis (SPE)
used to determine levels of serum proteins when a patient has abnormal symptoms like unexplained hemolytic anemia, renal insuff, MM
functions of plasma proteins
- body fluid maintenance between tissues and blood (colloidal suspension, viscosity)
- bind many small hydrophobic molecules
- albumin is reservoir for calcium
- specialized carriers of small molecules
- buffering pH, next to Hgb in importance
- inactive precursor
- protection - ex: Immunoglobulins, complement factors, protease inhibitors
acute phase proteins
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
CRP
C reactive protein, activates complement factors, sensitive marker for inflammation caused by infection, trauma, cancer
hepcidin and ferritin
in iron regulation; increase of Hepcidin is responsible for anemia of chronic disease and increased ferritin may mask iron deficiency anemia
hyperproteinemia
usually due to dehydration, levels less than 8 g/dL, Albumin and globulin both are increased; A/G ratio remains the same
hypergammaglobulinemia
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).
