Disease Manifestation Flashcards
What is one type of Transport Protein?
Transthyretin (TTR) or Prealbumin
What is important about TTR?
Non-Glycosylated
55 kDa
transports 10% of hormones
Contains hormones T3 and T4
Where is Transthyretin produced?
Liver
Also made in the Central Nervous System
What is bound to Transthyretin with a size of 21 kDa?
Retinol Binding Protein (RBP)
Half life of 12 hours; Longer if renal failure
Vitamin A was transported from the kidneys to the liver. What transported it there?
Retinol Binding Protein
What levels are increased in Renal Disease?
RBP levels
Where do we normally see decreased levels of RBP?
Liver disease and Protein Malnutrition
A patient has a low concentration of both RBP and Vitamin A. What is this known as?
Zinc Deficiency
When does TTR tend to see a decrease?
In inflammation and malignancy
What is the most abundant Plasma Protein?
Albumin
Accounts for half of the overall Plasma Protein mass
How is Albumin produced, and where do we find it?
Made by the Liver
60% is found in the Extravascular Space
Synthesis is controlled by Colloidal Osmotic Pressure (COP)
What are the functions of Albumin?
Primary: Major contributor to COP
Secondary: pH buffer and transports compounds
What does the Colloidal Osmotic Pressure help do?
Retain fluid and Maintain Vascular Volume
What are the compounds that Albumin transports?
Free fatty acids
Bilirubin
Metallic Ions
Hormones
Drugs
Fire Burns Making Hot Death
What can cause an increased level of Albumin?
Hydration problems
Prolonged tourniquet use
What can result due to Hypoalbuminemia?
Analbuminemia
Inflammation
Hepatic Disease
Urinary Loss
Gastrointestinal Loss
Burn Injury
Edema and Ascites
Anytime I Hold U Gas Burns Extra
What can Edema and Ascites be used for?
An indicator of Albumin levels being out of proportion
What is the most abundant Plasma Protein in early embryonic life?
A-Fetoprotein (AFP)
What is the function of A-Fetoprotein (AFP) and where is it produced?
Transports the hormone Estradiol
Made by Fetal Yolk Sack and Liver
A patient has elevated levels of AFP. What can we expect to see in the patient?
Abdominal wall defects
General fetal distress
Neural Tube Defects (Spina Bifida/Anencephaly)
What do we expect to see with a mother that is pregnant with twins?
Higher levels of A-Fetoprotein (AFP)
What is a member of the Lipocalin family and binds to Lipophilic Substances?
A1 Acid Glycoprotein (AAG)
What is the role of A1 Acid Glycoprotein (AAG) and where is it produced?
Made in Liver
Binds to Lipophilic hormones and many basic drugs
Reduces bioavailability of drugs
What do we expect to see in a patient that has high levels of A1 Acid Glycoprotein (AAG)?
Increase in GI Inflammatory Disease and Malignant Neoplasms
What is responsible for inactivating Serine Proteases?
A1 Antitrypsin (AAT)
Highest concentration of all Protease inhibitors
Where is A1 Antitrypsin (AAT) made and what is it’s function?
Made in the Liver
Inhibits Leukocyte Elastase
Where do we see increases AND decreases in patients of AAT?
High level of Estrogen (Pregnancy)
Respiratory distress or Pancreatitis
What binds to free Hemoglobin?
Haptoglobin (Hp)
Where is Haptoglobin (Hp) made and what is it’s purpose?
Made in the Liver
Binding to Hb prevents Renal clearance of Hb and loss of iron
Protects Nitric Oxide in the blood
Hormones, Nonsteroidal Anti-Inflammatory drugs, and Inflammatory diseases are all causes of what?
Increased Haptoglobin
What is the major Plasma Proteinase Inhibitor?
A2 Macroglobulin (AMG)
Where is A2 Macroglobulin (AMG) made and what is it’s role?
Made in the Liver
Inhibits Enzymes (Serin, Cysteine, and Metal Ions)
Activated by Proteolytic Cleavage then binds to Proteases
Why is A2 Macroglobulin (AMG) not used as an APR for humans?
It stays fairly constant during an Acute Phase Reaction (APR)
Where do we tend to see an increase in AMG?
Nephrotic Syndrome
Diabetes
Increased Estrogen
What makes up 95% of the total Serum Copper?
Ceruloplasmin (Cp)
Blueish tint
Where is Ceruloplasmin made and what are it’s primary functions?
Made by Liver
Serves as a catalyst for Redox Reactions
Folding of Polypeptide chain
What is the cause of Iron accumulating in the blood?
Decreased amounts of Ceruloplasmin (Cp)
Where do we see an increased level of Cp in patients?
Sever infection, Inflammation, Tissue damage, and Pregnancy
What is Wilson Disease?
Increased copper levels deposited into the Liver, Brain, and Periphery of the Iris
What is Transferrin (TRF)?
Made by Liver
Found in B region of Serum on Electrophoresis strip
What is the function of Transferrin (TRF)
Transport protein for Iron
Makes up most of the Total Iron Binding Capacity
If Iron is not oxidized it cannot be bound
How much Transferrin bonds to Iron and what percentage?
One Transferrin to two Iron
20% - 50%
Where do we find surface receptors for Transferrin?
In EVERY cell
How can we utilize the concentrations of Transferrin (TRF)?
Diagnosis of Anemia and monitoring treatment
What do we find on the surface of Nucleated Cells?
B2 Microglobulin (BMG)
High number of Lymphocytes
Tumor marker
What is indicative of Impaired renal Clearance?
Elevated levels of B2 Microglbulin (BMG)
Why is BMG important for patients with HIV?
Monitoring can help indicate a large Lymphocyte Turnover
What is critical to the Coagulation System and is the largest Plasma Protein?
Fibrinogen
Assists in clot formation
How is Fibrinogen measured?
Functional Assays that evaluate clotting
What is the fastest and strongest Acute Phase Protein?
C Reactive Protein (CRP)
Levels rise with 6-12 hours
Where is C Reactive Protein made and what is it’s purpose?
Made in the Liver
Protects the body against infectious organisms
What happens when CRP is bound to bacteria and fungi?
Promotes the binding of Complement
Taken up by Phagocytes
Opsonization
When do we see increased levels of C Reactive Protein (CRP)?
Acute infection or Inflammation
>1 mg/dL
Normally very low
What is associated with Coronary Heart Disease and an increased risk of developing Type 2 Diabetes?
C Reactive Protein (CRP)
Rheumatoid Arthritis, Crohn’s Disease, and Systemic Lupus Erythematous are all what?
Assessed for Effectiveness of treatment by measuring CRP levels
When do we see CRP elevated?
Acute Rheumatic Fever
Bacterial and Viral infections
Myocardial Infarctions
Rheumatoid Arthritis
Gout
Cancer Spread
Aye Bro My Racks Got Cut
What is The Complement?
A complex system of at least 20 proteins
Part of the Immune System
Where is Complement produced and what is it’s purpose?
Made by the Liver and Monocytes
Classical Pathway
Alternative Pathway
How is the Classic Pathway activated?
Activated by Immunoglobulin and CRP
How is the Alternative Pathway activated?
Activated by Bacterial Lipopolysaccharides and Cobra Venom
