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CLS 701 > Day 4 - Proteins, Lipids > Flashcards

Day 4 - Proteins, Lipids Flashcards

1
Q

A 10-12 hour fast is required in a panel for these lipids (4):

A

Total cholesterol
HDL
LDL
Triglycerides

  • general rule: if serum looks clear after overnight refrigeration = normal triglycerides; if hazy/turbid = high triglycerides (above 3000 mg/dL), sample is lipemic
  • no need to fast if testing cholesterol only
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2
Q

What do LDL contain the highest concentration of compared to the other lipoproteins?

A

Cholesterol

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3
Q

Hyperviscosity syndrome is associated with an increase in which immunoglobulin type?

A

IgM

-Waldenstrom’s Macroglobulinemia

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4
Q

What protein is used to assess the health of the BBB in a CSF sample? What would an increase or decrease indicate?

A

Albumin

Albumin not normally present in CSF; not permeable to BBB. INCREASED albumin in CSF indicates damaged BBB.

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5
Q

A normal immunoglobulin increase in response to infections would be a monoclonal or polyclonal increase?

A

Polyclonal

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6
Q

What do HDL contain the highest concentration of compared to the other lipoproteins?

A

Protein

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7
Q

Low HDL or high HDL increases risk of coronary heart disease?

A

Low HDL

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8
Q

What is primary amyloidosis? Name a complication it can cause…

A

Abnormal proteins clump together, forming deposits in cellular matrix of organs

Lungs (respiratory failure)

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9
Q

During protein catabolism, the amino group is removed by ___. The ___ ion produced during protein breakdown is converted to ___

A

Deamination
-carbon skeleton enters metabolic pathways

Ammonium

Urea

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10
Q

The most abundant protein in the body is… The next highest is…

A

Albumin

Globulin

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11
Q

Proteins linked to lipids are called… Proteins linked to carbohydrates are called…

A

Lipoproteins

Glycoproteins

-both are conjugated proteins

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12
Q

A protein that can react as both an acid and a base is called…

A

Amphoteric

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13
Q

What is the isoelectric point (pI)?

A

pH of a solution at which the net charge of a protein becomes zero
-neutrally charged

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14
Q

What happens if a solution’s pH > pI of a given protein? Below?

A

Above = protein is negatively charged
-protein lose H+ into solution

Below = protein is positively charged

  • solution has high H+
  • protein absorbs H+ ions
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15
Q

Anode is ___ charged. Cathode is ___ charged

A

Positively
-anion (-) moves towards anode (+)

Negatively
-cation (+) moves towards cathode (-)

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16
Q

Amino acid metabolism disorders are collectively called…

A

Aminoacidopathies

-PKU one of the common ones

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17
Q

The gold standard total protein assay is called…

A

Kjeldahl method

  • protein precipitation followed by acid digestion
  • nitrogen converted to ammonium bisulfite, which is measured
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18
Q

Why are urine and CSF poor samples to use for the biuret reaction for total protein?

A

Protein concentration too low (0.01 g/dL)

-need > 1 g/dL

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19
Q

Describe the biuret reaction for total protein

A 
Cupric ions (Cu2+) complex with peptide bonds, producing a color change
-more protein = more peptide bonds = darker color
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20
Q

What is the A/G ratio?

A

Albumin / Globulin

  • total protein = albumin + globulin
  • total protein - albumin = globulin
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21
Q

Prealbumin is also called… What 2 proteins does it transport?

A

Transthyretin
-made in liver

Thyroid hormone (thyroxine)
Retinol

-transthyretin = TRANSports THYroxin and RETINol

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22
Q

The majority of urine protein is… Why is it excreted?

A

Albumin

MW of 60,000 means it’s low enough to pass through glomerulus but too large for reabsorption

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23
Q

2 main functions of albumin

A

Binding substances in blood

  • carries hormones, drugs
  • acts as blood buffer

Control osmotic pressure of blood

  • maintains appropriate amount of fluids in tissues
  • low albumin = edema, fluid buildup in body sites
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24
Q

The condition of protein in urine is called… Too much low MW proteins appearing in the urine is due to a defect in reabsorption called…

A

Proteinuria

Tubular Proteinuria

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25
Q

The plasma protein B2 microglobulin (B2M) increases in the urine during…

A

Kidney disease

  • B2M should be reabsorbed
  • tested for renal tubular function
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26
Q

CRP is an example of a globulin protein. When does it increase? What does it do?

A

Increases during infections
-one of the first acute phase proteins to rise in infections

Binds to bacteria (opsonization), promoting complement binding
-leads to phagocytosis

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27
Q

In multiple myeloma, the patient produces an excess of this specific part of the antibody’s structure…

A

Light chain

-abnormal production of monoclonal immunoglobulins

28
Q

The light chain of antibodies are one of two types… Light chains appearing in the urine are called…

A

Lambda or kappa

Bence Jones proteins
-light chains have lower MW than full Ig structure

29
Q

Bence Jones proteins can be detected with this test…

A

Electrophoresis

-also specific immunoassays for light chains

30
Q

The majority of immunoglobulins are…

A

IgG (70%)

31
Q

How can we tell the difference between elevated Ig due to infection vs elevated Ig due to multiple myeloma?

A

Infections = polyclonal

MM = monoclonal
-paraproteins = abnormal protein
32
Q

Monoclonal immunoglobulin SPE looks like this…

A

Gamma, beta or alpha2 increase

-ie multiple myeloma (gamma increase)

33
Q

Nephrotic syndrome SPE looks like this…

A

Albumin lost, or very low
Alpha2 and beta increase
-retention of proteins like alpha2 macroglobulin
-albumin increase in urine

34
Q

Acute-phase reactant proteins SPE looks like this… These proteins show up during…

A

Albumin decrease
Alpha and beta increase
-CPR = beta band

Inflammation

35
Q

Liver disease SPE looks like this…

A

Albumin decrease

Gamma globulin increase

36
Q

Multiple sclerosis patients show this band in CSF protein electrophoresis… Why?

A

Oligoclonal bands

Due to myelin basic protein, demyelination

  • breakdown of myelin sheath in neurons
  • only thing in CSF protein electrophoresis to watch out for
37
Q

What are mott cells? What disease do they occur in?

A

Plasma cells with vacuoles

Multiple myeloma

38
Q

In multiple myeloma, patients have an increase in myeloma protein called ___, which corresponds to this globulin band on the SPE…

A

M protein

Gamma
-“M spike” = monoclonal spike

39
Q

What is the signature lab findings to diagnose multiple myeloma (2)?

A

M spike in serum or urine

CRAB

  • Calcium > 11 mg/dL
  • Renal creatinine > 2 mg/dL
  • Anemia hgb < 10 g/dL
  • Bone lytic lesions, osteoporosis
40
Q

What is MGUS?

A

Monoclonal gammopathy of uncertain significance

  • low levels of monoclonal paraprotein detected with increasing age
  • minor spike in SPE without multiple myeloma
  • mostly normal health, some evolve into MM
41
Q

Waldenstrom macroglobulinemia is associated with overproduction of… Serum viscosity is…

A

IgM
-> 3 g/dL

Very high
-can be 4x thicker than normal serum

42
Q

Difference between multiple myeloma and Waldenstrom’s Macroglobulinemia seen on a SPE is..

A

MM = high IgG heavy chain

Waldenstrom’s Macroglobulinemia = high IgM heavy chain

43
Q

Saturated vs unsaturated - which has the double bond? Which is a solid and which is a liquid at room temperature?

A

Unsaturated

Saturated = solid (ie butter)
Unsaturated = liquid (ie oil)
44
Q

Saturated vs unsaturated - animal or plant origin?

A

Saturated = animal

Unsaturated = plant

45
Q

What is the composition of a triglyceride?

A

3 fatty acids bound to glycerol

-hydrophobic

46
Q

What is the composition of a phospholipid?

A

Phosphate head and 2 fatty acids bound to glycerol

  • hydrophilic head, hydrophobic tail
  • form cell membranes (phospholipid bilayer)
47
Q

Is cholesterol hydrophobic or hydrophilic?

A

Both

  • hydrophilic head
  • hydrophobic tail
48
Q

What are the 4 classes of lipoproteins based on ultracentrifugation electrophoresis patterns?

A

Chylomicrons

VLDL

LDL

HDL

49
Q

What are apolipoproteins?

A

Protein free of lipids

  • available to bind lipids
  • ie apo A1 (HDL), apo B (VLDL, LDL)
  • Lp(a) is a variant of LDL
50
Q

Which lipoprotein is the lightest? Densest?

A

Chylomicrons

HDL

51
Q

Which lipoprotein has the highest percentage of protein? What is this protein?

A

HDL

Apo A1

52
Q

Which lipoprotein has the highest percentage of triglyceride?

A

Chylomicrons

53
Q

VLDL have a composition highest in…

A

Triglycerides

-second highest after chylomicrons

54
Q

Which lipoprotein has the highest percentage of cholesterol?

A

LDL

55
Q

Of the 4 classes of lipoproteins, which are apo A and which are apo B?

A

apo A = HDL
-apo A1 = HDL

apo B = chylomicron, VLDL, LDL

  • apo B-48 = chylomicrons
  • apo B-100 = VLDL, LDL

-apo A and apo B are surface proteins

56
Q

LDL and HDL - which is the “good” cholesterol?

A

HDL - higher in protein, free to absorb free cholesterol

  • HDL removes excess cholesterol from cells via reverse cholesterol pathway
  • LDL contains highest amount of cholesterol (60%)
57
Q

Of the 4 classes of lipoproteins, where are each made?

A

Intestines = chylomicrons

Liver = VLDL/LDL, HDL

58
Q

Once spun down, chylomicrons form this layer… Where is it located on the tube?

A

Cloudy layer, floating on top of serum

59
Q

How are LDLs made?

A

VLDL converts to LDL via the enzyme LPL (lipoprotein lipase)

60
Q

Difference between exogenous and endogenous pathways for lipoprotein metabolism

A

Exogenous = from diet, intestines

Endogenous = from liver

61
Q

What is dyslipidemia? What are the 2 categories of dyslipidemia?

A

Disease associated with abnormal lipid levels

Hyperlipoproteinemia - high cholesterol, triglycerol, or both
Hypolipoproteinemia

62
Q

For hypolipoproteinemia, is hypoalphalipoproteinemia or hypobetalipoproteinemia more dangerous?

A

Hypoalphalipoproteinemia (HDL)

  • increased risk for CHD
  • low HDL, so cannot get cholesterol out of cells
63
Q

What are the 2 main methods to test for total cholesterol?

A

Colorimetric - using strong acids

Enzymatic - cholesterol esterase, cholesterol oxidase, peroxidase

  • oxidase = measure oxygen consumed or hydrogen peroxide produced
  • peroxidase = look for color change
64
Q

What is the Friedewald equation to calculate LDL indirectly? What are the units?

A

LDL = Total Cholesterol - HDL - (Triglycerides/5)
-trig/5 is an estimate for VLDL cholesterol

mg/dL

65
Q

To be able to use the equation to calculate LDL, these two things must be true

A

12 Hour fast

Triglycerides < 400 mg/dL

66
Q

After lipoprotein electrophoresis, where are the following lipoproteins found on the gel: chylomicrons, VLDL, LDL, HDL

A

Chylomicrons - point of origin (remain in well)
-too big to move

VLDL - with pre-beta globulins

LDL - with beta globulins

HDL - with alpha globulins

-order seen on gel: chylo, beta, pre-beta, alpha

67
Q

Besides poor diet/nutrition, low albumin levels are also caused by damage to either of these two organs…

A

Liver
-cannot make albumin

Kidneys
-rapid loss of albumin in urine

CLS 701 (10 decks)

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