EXAM III Proteins, COH, Lipids Flashcards
Normal glucose concentration of serum?
80-100 mg/dL
Requirements of an oral GTT
Fasting at least 10 hours
Done in morning
no eating, drinking, smoking or exercise
normal to high COH intake 3 days prior
Order of mobility of serum proteins during an electrophoresis
albumin(fastest)-a1-a2-beta-gamma
Why can the biuret method NOT be used for determining CSF or urine protein?
it lacks sensitivity to detect low levels of protein which are in those specimens
What does the biuret reagents specifically react with?
tripeptide
2 or more peptide chains
What is the reference method for total protein determination?
Kjeldahl
Which method for measuring albumin is most common in automated instruments?
Dye-binding
What SPE abnormality is seen in multiple myeloma?
In nephrotic syndrome?
Spike in gamma region
^ a2 and beta region, decrease albumin
Glucose in CSF is approximately ____ of the amount of glucose in the blood.
2/3
60-70%
In bacterial meningitis, what would be the expected results for CSF protein?
CSF glucose?
protein increased
glucose decreased
What anticoagulant is used to prevent glycolysis?
sodium fluoride
Increases blood glucose levels
inhibits glucose uptake by the tissues
increases glucose output by the liver
ACTH
growth hormone
Increases blood glucose levels
Increases glycogenolysis and gluconeogenesis
Glucagon
Increases blood glucose levels
Increasing gluconeogenesis and inhibiting glucose metabolism in peripheral tissue
Glucocorticoids
Decreases blood glucose levels
by decreasing glycogenolysis-only hormone that decreases
Insulin
Increases blood glucose levels
fight or flight
stimulates glycogenolysis
Epinephrine
What is the action of the enzyme glucose-6-phosphate dehydrogenase?
removes hydrogen from glucose-6-phosphate and gives it to NADP
What technique is used to ID patients with familial hyperlipoproteinemia?
electrphoresis
normal value for albumin
3.5-5.0 g/dL
normal value for globulin
2.5-3.5 g/dL
normal value for TP
6.0-8.5 g/dL
What phenom causes the gamma globulins to move toward the cathode in SPE, even though they are negatively charged?
EEO
electroendosmosis
What specific form of hgb is used to monitor patients with Type I diabetes mellitus?
A1c
How is globulin in serum routinely determined?
TP - albumin
Which fraction of lipprotein contains highest percentage of protein?
HDL
What is the order of migration of lipoproteins?
chylomicrons - prebeta - beta - alpha
What is the desirable TC level in serum
less than 200 mg/dL
Most likely explanation for a patient with lab results of elevated TC and TGD but normal lipoprotein pattern?
patient isn’t fasting
non fasting specimen
Which lipoprotein fraction is responsible for post-prandial lipemia?
chylomicrons
If plasma is used instead of serum for electrophoresis, what change will be observed?
Spike in beta gamma region
due to fibrinogen
What dyes can be used for the detection of albumin?
HABA
BCP
BCG
Methyl orange
Desirable level for HDL
greater than 40 mg/dL
normal two hour post-prandial glucose
less than 140 mg/dL
how long for plasma glucose to return to normal levels
3 hours
Name four blood constituents that can produce falsely decreases TC due to interference with the enzymatic cholesterol assay.
uric acid
ascorbic acid
bilirubin
glutathione
Electrphoretic classification of these lipoproteins
HDL
LDL
VLDL
HDL-alpha
LDL-beta
VLDL-prebeta
Which lipoprotein has protective effect against coronary heart disease?
HDL
Protein isolated from a lipoprotein which is also affiliated with certain lipoprotein
apoprotein
What is the main function of lipoproteins in the body?
transport body lipids throughout the bloodstream
elevated for 3hrs
start high, stays high, takes longer to return to normal glucose levels
diabetes mellitus
lower than normal after 3hrs
normal, then falls below fasting levels
hypoglycemia
elevated at 1hr
drops at 2 hr
returns to normal by 3 hr
normal GTT
Why is the performance of electrophoresis on CSF more difficult than SPE?
protein concentrations are too low
need to concentrate it 100x
Patients with borderline glucose levels are tested further with?
3hr OGTT
What is actually measured in the hexokinase method for glucose?
NADPH
Normal range for CSF glucose
40-70 mg/dL
What period of fasting is required for lipid panels?
12 hours
What is the reaction that takes place during the biuret procedure?
protein solutions treated with alkanolized cupric sulfur; cupric ions react with peptide bonds to form a violet color
What precautions must be taken prior to collecting a specimen for lipid analysis?
12 hour fasting
2 wk normal diet
no meds that affect lipids
defer for 2 months after surgery, illness or AMI
What is the most specfic method for determining plasma cholesterol?
cholesterol oxidase enzymatic reaction
What protein, when found in increased amounts, lowers the risk of coronary heart disease?
apolipoprotein A1
What is the only diagnostic purpose for ordering phospholipid measurements
Niemann Pick disease
RDS
What unusual electrophoretic serum protein pattern is seen in cirrhosis of the liver?
beta-gamma bridge
What would be the expected shape of a GTT curve if the patient has malabsorption syndrome? What test should be done instead?
flatline; no absorptions, no change in curve
IV GTT
What test may be used to assess the average plasma glucose level that a patient has maintained during a previous 2-3 month period?
Glycosulated hemoglobin
hgb A1c
The enzyme that causes the release of H2O2 when it reacts with glucose
glucose oxidase
What would happen to the glucose in a blood specimen if it was drawn in a clot tube and was left uncentrifuged at room temp?
serum glucose levels will be reduced at a rate of 7% an hour
Amount of glucose used in adult GTT?
75g
What reagent is used for color development in the Libermann-Burchard reaction?
acetic anhydride sulfuric acid
What adjustment is made to OGTT if hypoglycemia is suspected?
additional testing at 4 and 5 hours
B-lipoprotein(LDL) contain high % of?
pre-B-lipoprotein(VLDL) contain high % of?
LDL-cholesterol
VLDL-trigylcerides
How would a physician view the prognosis of a patient with an elevated HDL?
Good, not at high risk
possibly protected from arthrosclerosis
What is the most likely explanation of milky serum?
Increased chylomicrons
lipemic
What enzyme catalyzes the hydrolysis of triglycerides?
lipase - LPL
normal range for CSF protein?
15-45 mg/dL
What compund is used to stimulate the pancreas to produce insulin?
Tolbudamine
detects insulinomas
Ultracentrifugation separates lipoproteins into various categoried based on?
density
What stains can be used to stain the protein bands obtained from SPE?
Ponceau S Amido black 10B bromphenol blue lissamine green coommassie blue
what pH is routine SPE performed at?
8.6
What is gestational diabetes?
diabetic condition that occurs during pregnancy
secondary mellitus due to hormonal changes
What is meant by the term renal threshold?
value?
level of glucose in the blood above which glucose “spills over” into urine
160-180 mg/dL
What type of diabetes generally occurs in adults?
Type 2- non-insulin dependent
Name a test that can be used to determine the risk of RDS in newborns
phospholipid levels
L/S ration
less than 2; PG present
