Major plasma proteins

Question 1

function of albumin

Answer 1

• maintain oncotic pressure b/w plasma & ECF

- transport water insoluble analytes

Question 2

oncotic pressure vs hydrostatic pressure

Answer 2

• Oncotic: aka colloid osmotic pressure- pulls water in BV bc of albumin
• Hydrostatic: pull water out

Question 3

Name the carrier of:

(a) Iron (b) Heme (c) T3 & T4 (d) cortisol (e) copper

Answer 3

a. Fe = transferrin
b. heme = haptoglobin
c. thyroid = thyroxine binding globulin (TBG)
d. cortisol = cortisol binding globulin (CBG)
e. Cu = ceruloplasmin

Question 4

significance of inc. total protein, inc. alb. & inc. globulin

Answer 4

dehydration (hypovolemia)

Question 5

significance of inc. total protein, normal alb. & inc. globulin

Answer 5

multiple myeloma

Question 6

significance of dec. total protein, dec. alb. & normal globulin

Answer 6

nephrotic syndrome, malabsortion

Question 7

Compare between monoclonal myeloma and multiple myeloma in terms of immunoglobulins

Answer 7

Multiple myeloma: Ig LOW bc suppress Ig

Monoclonal myeloma: Ig HI

Question 8

Bence Jones protein (BJP) is a _ or _ found in the _. And detection of it may suggest _ _ or _ _

Answer 8

a. monoclonal globulin protein
b. Ig light chain
c. urine
d. multiple myeloma or Waldenström’s macroglobulinemia

Question 9

_ _ is present in more than 2/3 of multiple myeloma cases.

Answer 9

Waldenström’s macroglobulinemia

Question 10

what happens in blood in cryoglobulinaemia

Answer 10

• protein in blood precipitate when below 37ºC (body temp)

Question 11

What will happen to bones in case of malignancy due to multiple myeloma?

Answer 11

cytokine is released => activates osteoclast to resorb bone => hypercalcemia = lytic bone lesions detectable under x-ray

Question 12

features in Waldenström’s macroglobulinemia that differentiate from multiple myeloma

Answer 12

• *no bone lesions
• Hyperviscocity is more prevalent
• large molecular weight of IgM
• Less malignant than myeloma

Question 13

a) acute phase proteins that inc. due to inflammatory response & function each
b) name a protein that decreases

Answer 13

a) - C-reactive protein: inflammatory activator
- Alpha antitrypsin: inflammatory inhibitor > inhibit proteases
- Haptoglobin: mops up Hb from local haemolysis
b) dec. albumin

Question 14

What is transferrin? significance if inc. & dec. of plasma transferrin

Answer 14

a) protein that carries 2 iron transporting protein
b) Inc transferrin = iron deficiency anaemia
dec. = iron overload diseases & protein malnutrition

Question 15

in protein electrophoresis what proteins are found on the gamma region (near the anode)?

Answer 15

• CRP
• Ig
• Fibrinogen

Question 16

in protein electrophoresis what proteins are found on the beta region?

Answer 16

• transferrin

- LDL

Question 17

in protein electrophoresis what proteins are found on the alpha-2 region?

Answer 17

• Haptoglobulin

- HDL

Question 18

Describe the order of zones in protein electrophoresis from cathode to anode (Neg to Pos ABG)

Answer 18

(neg charge) Albumin - alpha1 - alpha2 - beta - gamma (pos charge)

Question 19

cause of hypoalbuminemia

Answer 19

• inc. renal sceretion
• dec. intestinal absorption
• dec. synthesis in liver

Question 20

Alpha1 antitrypsin deficiency is due to

Answer 20

heriditary problem

Question 21

Name the condition if you see dec. albumin & fused beta-gamma globulin

Answer 21

cirrhosis

Question 22

difference b/w sensitivity & specificity & equ. of each

Answer 22

• specificity: without disease = TNeg / all cases{TN+FP}

- sensitivity: with disease = TPos / all cases{TP+FN}

Question 23

characteristics of choosing a biomarker for diagnostics

Answer 23

• cost
• release kinetics
• relative tiss. [ ]
• Sensitivity & specificity

Question 24

Where can you find ALT, AST, ALP & GGT

Answer 24

• ALT: hepatocyte
• AST: hepatocyte, RBC, skeletal muscles
• ALP: bone, hepatic, placenta
• GGT: liver

Question 25

@ the beginning of AMI, _ is released, following _, which is measured. But in a pregnant woman _ is measured bc _

Answer 25

a) Troponin I
b) troponin T (Tn T) is measured
c) Troponin I is measured bc Tn T expressed in skeletal muscles of utero

Question 26

Release kinetics of CK-MB vs cTroponin (cTn)

Answer 26

@ beginning of infarction,

• CK-MB: small baseline easy detect rise; doesn’t last long
• cTn: high baseline = hard to detect; last for long = hard to tell reinfarcture

Question 27

early (1-4hrs) & late marker (6hrs) for AMI

& perfect marker & cheap assays

Answer 27

Early: myoglobin
Late: LD1
Perfect: cTnI & cTnT
Cheap: CKMB & LD1

Question 28

_ isoenzyme is sensitive as a late marker for AMI, specific and last for long periods.

Answer 28

LD1

Question 29

2 Drawbacks for using CK-MB as a marker for diagnosing AMI

Answer 29

1. CK-MB won’t rise till 4-8hrs after chest pain begins

2. rise in CK-MB may be masked by a rise in CK-MM => %CK activity < 5% = F.neg. result

Question 30

GIlbert’s syndrome causes _ due to reduced activity of _

Answer 30

a) hyperbilirubinameia

b) glucurunosyl-transferase