Lab 2 Serum protein

Question 1

What is plasma?

Answer 1

Noncellular component of anticoagulated whole blood

Plasma is essential for transporting nutrients and waste products in the body.

Question 2

What are plasma proteins?

Answer 2

All proteins of blood plasma and interstitial fluid

These proteins play key roles in maintaining osmotic pressure and immune function.

Question 3

Which plasma protein is the most abundant?

Answer 3

Albumin

Albumin helps regulate blood volume and pressure.

Question 4

What are other types of plasma proteins besides albumin?

Answer 4

Immunoglobulins, transport proteins, clotting proteins

These proteins are crucial for immune response and blood coagulation.

Question 5

Where are most plasma proteins synthesized and catabolized?

Answer 5

In the liver

The liver plays a vital role in protein metabolism.

Question 6

What primarily consists of total protein?

Answer 6

Albumin and globulins

The balance between these proteins is important for health.

Question 7

What causes alterations to serum total protein?

Answer 7

↑ or ↓ in volume of plasma water, ↑ or ↓ in concentration of protein in plasma

These changes can result from various physiological and pathological conditions.

Question 8

What is the reference range for total serum protein?

Answer 8

(65 - 85 g/L)

Values outside this range can indicate health issues.

Question 9

What does hypoproteinaemia indicate?

Answer 9

Haemodilution

This condition can result from excessive fluid intake or loss of proteins.

Question 10

What does hyperproteinaemia indicate?

Answer 10

Haemoconcentration

This condition can occur with dehydration or increased protein production.

Question 11

What are the methods for determining total protein?

Answer 11

• Direct photometric methods
• Biuret method
• Dye-binding methods
• Turbimetric and nephelometric methods

Each method has its specific applications and accuracy levels.

Question 12

What are the colourimetric methods for total globulin determination?

Answer 12

• Precipitation & biuret
• Specific dyes (e.g. Pyrogallol red) preferentially bind globulins

These methods are useful for quantifying globulin levels in serum.

Question 13

What is the formula for globulin levels?

Answer 13

Globulin = Total Protein – Albumin

This calculation is preferred for assessing globulin levels.

Question 14

What is electrophoresis used for?

Answer 14

To determine protein levels in blood

This method separates proteins based on their size and charge.

Question 15

What are immunochemical methods used for?

Answer 15

Total globulin determination

These methods can provide specific information about different globulin fractions.

Question 16

What is the most abundant plasma protein?

Answer 16

Albumin

Albumin constitutes about 60% of total plasma protein.

Question 17

What is the approximate molecular weight of albumin?

Answer 17

≈68kDa

This molecular weight helps in its functions and interactions in the plasma.

Question 18

What is the reference range for albumin levels in plasma?

Answer 18

(35-50 g/L)

This range is critical for diagnosing hypoalbuminaemia or hyperalbuminaemia.

Question 19

What percentage of albumin is present in plasma versus ECF?

Answer 19

≈40% in plasma and ≈60% in ECF

This distribution plays a role in fluid balance in the body.

Question 20

What is the half-life of albumin?

Answer 20

≈18-20 days

This half-life is important for understanding its turnover and effects in the body.

Question 21

What is the fastest migrating protein in SPEP?

Answer 21

Albumin

This characteristic is used in laboratory diagnostics.

Question 22

Where is albumin synthesized?

Answer 22

In the liver

Albumin accounts for 25% of total hepatic protein synthesis.

Question 23

What role does albumin play in transport?

Answer 23

Binds various ligands and acts as a transporter for them

Examples include amino acids, enzymes, bilirubin, hormones, Vitamin D, glucose.

Question 24

What percentage of the osmotic pressure of human plasma is albumin responsible for?

Answer 24

75-80%

This role is crucial for maintaining blood volume and body fluid distribution.

Question 25

What condition can hypoalbuminaemia lead to?

Answer 25

Oedema ## Footnote This occurs due to reduced oncotic pressure.

Question 26

What are some causes of hypoalbuminaemia?

Answer 26

* Liver cirrhosis * Nephrotic syndrome * Malnutrition * Burns * Analbuminaemia ## Footnote Each cause impairs albumin production or increases loss.

Question 27

What is a potential effect of hypoalbuminaemia related to infection?

Answer 27

Increased infection risk ## Footnote Albumin helps transport immune molecules, hence its deficiency can impair immune response.

Question 28

What condition can result from hypoalbuminaemia that affects lipid levels?

Answer 28

Hyperlipidaemia (in nephrotic syndrome) ## Footnote The liver compensates by producing more lipids in response to low albumin.

Question 29

What is one of the serious effects of hypoalbuminaemia on the body?

Answer 29

Shock ## Footnote This occurs due to fluid shifts and hypovolaemia.

Question 30

What can lead to delayed wound healing in the context of hypoproteinaemia?

Answer 30

Reduced albumin levels ## Footnote Albumin is essential for tissue repair.

Question 31

What is a cause of hyperalbuminaemia?

Answer 31

Fluid depletion/dehydration ## Footnote This condition results in a relative increase in albumin concentration.

Question 32

What dye-binding method is used for albumin determination?

Answer 32

Bromocresol Green ## Footnote This method is known to slightly overestimate albumin levels.

Question 33

What are the main proteins produced in the liver?

Answer 33

* Albumin * A and B globulins * A-1-Antitrypsin * Haptoglobulin * Transferrin * C-reactive Protein (CRP) ## Footnote These proteins play various roles in the body's physiology.

Question 34

What role do immunoglobulins play in the body?

Answer 34

Igs play a key role in defence mechanisms of the body ## Footnote Immunoglobulins are crucial for the immune response.

Question 35

How many types of immunoglobulins are there?

Answer 35

5 types: IgG, IgA, IgM, IgD, IgE ## Footnote Each type has distinct functions in the immune system.

Question 36

In which conditions is the synthesis of gamma globulins increased?

Answer 36

* Chronic infections * Chronic liver diseases * Autoimmune diseases * Leukaemias * Lymphomas * Various other malignancies ## Footnote Increased gamma globulin levels can indicate underlying health issues.

Question 37

What is hypoalbuminaemia?

Answer 37

A condition characterized by low albumin levels in the blood ## Footnote It can lead to various health complications.

Question 38

What is hyperalbuminaemia?

Answer 38

A condition characterized by high albumin levels in the blood ## Footnote This can also indicate underlying health issues.

Question 39

What is Multiple Myeloma?

Answer 39

A cancer of the immune system involving β-lymphocyte proliferation (plasma cells) ## Footnote It is typically a disease of older patients.

Question 40

What is a characteristic of Multiple Myeloma in terms of immunoglobulin production?

Answer 40

Over-secretion of non-functional immunoglobulin (paraprotein) by cancerous clone ## Footnote This leads to the presence of monoclonal proteins in the serum.

Question 41

What are paraproteins?

Answer 41

Identical clones of a single plasma cell ## Footnote They are referred to as monoclonal because they originate from one clone.

Question 42

What family of neoplasms does Multiple Myeloma belong to?

Answer 42

Monoclonal gammaopathies ## Footnote This family includes various disorders related to abnormal plasma cells.

Question 43

What is a possible cause for low total protein but normal albumin and protein in urine?

Answer 43

Excretion issue - loss via kidneys -loss via GI tract (protein losing enteropathy) Synthesis issue - chronic liver disease may impair globulin production more than albumin - immunodeficiency causing low globulin levels ## Footnote This may indicate excessive protein loss via the kidneys.

Question 44

What condition is characterized by increased glomerular permeability leading to loss of globulins and other serum proteins rather than albumin?

Answer 44

Nephrotic syndrome ## Footnote Nephrotic syndrome results in significant proteinuria.

Question 45

What test can be used to identify which proteins are lost in nephrotic syndrome?

Answer 45

Urine protein electrophoresis test ## Footnote This test helps determine the specific proteins being excreted.

Question 46

What tests are performed to check for low globulin levels?

Answer 46

Serum protein electrophoresis ## Footnote This test evaluates the serum protein levels including globulins.

Question 47

What tests assess kidney function in the context of nephrotic syndrome?

Answer 47

Kidney function tests (creatinine, eGFR) ## Footnote These tests evaluate how well the kidneys are filtering blood.

Question 48

What is a possible cause for low total protein, low albumin, and trace protein in urine?

Answer 48

Malnutrition/Synthesis/Redistribution issue ## Footnote This may indicate problems with protein synthesis or absorption.

Question 49

What condition is indicated by decreased albumin levels due to the liver's inability to synthesize it?

Answer 49

Liver failure (severe cirrhosis/hepatitis) ## Footnote The liver's function is crucial for protein synthesis.

Question 50

What happens to total protein levels in liver failure?

Answer 50

Decreased total protein ## Footnote This occurs because the liver cannot synthesize any proteins, including immunoglobulins.

Question 51

What does the absence of proteinuria in liver failure suggest?

Answer 51

Kidney function may still be normal ## Footnote This indicates that the kidneys are not losing protein.

Question 52

What symptoms may suggest liver failure?

Answer 52

Jaundice, coagulopathy ## Footnote These symptoms indicate liver dysfunction.

Question 53

What are the 4 general causes of low albumin and low total protein?

Answer 53

1. Decreased protein production 2. Increased protein loss 3. Malnutrition 4. Redistribution ## Footnote This condition can lead to various health complications.

Question 54

How does nephrotic syndrome lead to oedema?

Answer 54

1. Damaged glomeruli allow excessive albumin to leak into the urine (proteinuria) 2. Low serum albumin reduces oncotic pressure causing fluid to leave capillaries into interstitial space, leading to oedema. ## Footnote This can cause swelling in various parts of the body.

Question 55

What is a condition characterized by protein loss through the gut rather than urine?

Answer 55

Protein-losing enteropathy (e.g., Crohn’s disease) ## Footnote This condition leads to malabsorption and related symptoms.

Question 56

What symptoms may accompany protein-losing enteropathy?

Answer 56

Diarrhoea, weight loss, vitamin deficiencies ## Footnote These symptoms are common in gastrointestinal disorders affecting absorption.

Question 57

Causes of decreased protein production

Answer 57

1. Liver disease (cirrhosis/hepatitis) 2. Malnutrition / malabsorption (e.g. Crohns disease) - inadequate dietary intake or poor absorption of proteins 3. Chronic inflammation (suppresses liver protein synthesis)

Question 58

Causes of increased protein loss

Answer 58

1. Nephrotic syndrome (glomerular damage causes protein loss in urine) 2. Protein losing enteropathy (e.g. IBD - protein loss from GI tract) 3. Severe burns / extensive skin damage (protein loss through damaged skin).

Question 59

Further tests to run to investigate the reason behind hypoproteinaemia

Answer 59

1. Liver function tests (AST, ALT, ALP, Bilirubin = to assess liver disease) 2. Urinalysis + urine protein-to-creatine ratio (to check for nephrotic syndrome) 3. Total protein electrophoresis (SPEP = to differentiate between different causes). 4. Nutritional assessment (iron studies/vitamin levels = to evaluate malnutrition)

Question 60

Further investigations to perform if an individual has oedema

Answer 60

1. Urine dipstick - to confirm proteinuria 2. Serum albumin - to check for hypoalbuminaemia 3. Serum creatinine + eGFR - to assess kidney function 4. Lipid profile - nephrotic syndrome causes hyperlipidaemia due to liver compensation for protein loss.