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House Clinical Pathology > PLASMA PROTEINS AND DISORDERS > Flashcards

PLASMA PROTEINS AND DISORDERS Flashcards

1
Q

Plasma proteins are made up of different ______ of (similar or different?) chemical and physical structures

A

proteins

different

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2
Q

Plasma proteins

Synthesized and secreted into plasma from the _____,_______ ,_________________

A

liver, plasma cells, intestinal endothelial cells

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3
Q

Plasma proteins

_____ differs and so determines rate of synthesis and degradation

A

Half life

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4
Q

Functions of plasma proteins

Transport –________,______,————

Enzymes –__________

A

thyroxine binding globulin, sex hormone binding globulin, transferrin

Renin

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5
Q

Functions of plasma proteins

Protease inhibitors – _____________

Humoral immunity – _____________,

A

alpha1 antitrypsin

immunoglobulins

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6
Q

Functions of plasma proteins

Maintaining oncotic pressure –_______

Buffering –_________, haemoglobin

A

Albumin

All proteins

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7
Q

Alanine aminotransferase-

abbreviation:

Causes leading to increased levels:

A

ALT

liver and biliary tract disease
pancreatic disease
decompensated heart defects

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8
Q

abbreviation:

Causes leading to increased levels:

A

AST

liver diseases myocardium damage

disease of skeletal muscle and myocardium

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9
Q

alkaline phosphatase-

abbreviation:

Causes leading to increased levels:

A

ALP

liver and biliary tract disease bone diseases

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10
Q

Creatin kinase-

abbreviation:

Causes leading to increased levels:

A

CK

disease of skeletal muscle and myocardium

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11
Q

Lactate dehydrogenase-

abbreviation:

Causes leading to increased levels:

A

LD

Myocardium disease (LD1, LD2) and muscle disease hepatopathy

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12
Q

g-glutamy ltransferasa-

abbreviation:

Causes leading to increased levels:

A

GMT

liver and biliary tract disease and pancreatic disease

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13
Q

Causes of change in Plasma protein concentration

Increase
Decrease in _______

________ - like stasis during venipuncture

Increase _________

A

volume distribution

Artefactual

protein synthesis

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14
Q

Causes of change in Plasma protein concentration

Decrease

Decrease ________ like in ____,____,_____

Increase in _________ like ________

Increase _____ (catabolism, excretion, enteropathy)

A

protein synthesis ; malnutrition, malabsorption, liver disease

volume of distribution; over hydration

loss

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15
Q

Description of pathologic plasma protein states

Dysproteinnaemia – (normal or abnormal ?) total concentration with (normal or abnormal?) _____ as in ______/______ inflammation.

A

Normal

Abnormal ; ratio

acute/ chronic

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16
Q

Description of pathologic plasma protein states

Hyperproteinaimia – increased _____________

A

total plasma concentration

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17
Q

Description of pathologic plasma protein states

Hypoproteinaemia – Decreased _________

A

total plasma concetration

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18
Q

Description of pathologic plasma protein states

Paraproteinaemia – presence of (normal or abnormal?) and ____eased amount of particular protein(s) often (benign or malignant?) .

A

Abnormal

incr

malignant

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19
Q

Classification of plasma proteins
Based on electrophoretic pattern
From fastest to slowest
– ______
–_______
– ________
–__________
–________
–_______

A

Prealbumin

Albumin

Alpha 1 globulin
Alpha 2 globulins
Beta 1

Beta 2

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20
Q

Classification of plasma proteins
alpha 1antitrypsin

A

Alpha 1 globulin

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21
Q

Classification of plasma proteins

alpha 1 acid glycoprotein

A

Alpha 1 globulin

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22
Q

Classification of plasma proteins

transferrin

A

Beta 1

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23
Q

Classification of plasma proteins

LDL

A

Beta 1

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24
Q

Classification of plasma proteins

C3 complement

A

Beta 2

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25
Q

Classification of plasma proteins

haptoglobulin

A

Alpha 2 globulins

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26
Q

Classification of plasma proteins

alpha 2 macroglobulin

A

Alpha 2 globulins

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27
Q

Classification of plasma proteins

ceruloplasmin

A

alpha 2 globulins

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28
Q

Prealbumin ( ________ )
— A transport protein for: —

_____ hormones
—
_______ (_____)
—

A

Transthyretin

Thyroid

Retinol (vitamin A)

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29
Q

Prealbumin (Transthyretin)
—
Lower levels found in:
—
—_____ disease, nephrotic syndrome, __________ response, malnutrition —

A

liver

acute phase inflammatory

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30
Q

Prealbumin (Transthyretin)
—

(Short or Long?) half-life (__ days)

A

Short

2 days

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31
Q

Albumin

About ___-___ g/L in normal adult
—
Synthesized in the ____ as ______ and secreted as _____

A

36 - 55

liver

preproalbumin; albumin

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32
Q

Albumin

— Half-life in plasma: ____ days
—
____eases rapidly in injury, infection and surgery

A

20

Decr

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33
Q

Most abundant plasma protein is ???

A

Albumin

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34
Q

Albumin Functions

Maintains __________ pressure

A

oncotic

35
Q

_____% of plasma oncotic pressure is maintained by albumin

A

80

36
Q

Albumin: Functions

A (specific or non-specific?) carrier of hormones, calcium, free fatty acids, drugs, etc.

A

non-specific

37
Q

albumin : Functions

Tissue cells can take up albumin by ______ where it is hydrolyzed to _______

A

pinocytosis

amino acids

38
Q

Albumin is Useful in treatment of liver diseases, hemorrhage, shock and burns

T/F

A

T

39
Q

Hypoalbuminemia
Causes

– Decreased _______
– Increased _________

A

albumin synthesis

losses of albumin

40
Q

Hypoalbuminemia

Causes: Increased losses of albumin

-Increased ______ in infections

-Excessive ______ by the kidneys ( ________ )

-Excessive loss in _______

-Severe _____ (plasma loss in the absence of _________)

A

catabolism

excretion

nephrotic syndrome

bowel

burns; skin barrier

41
Q

Hypoalbuminemia
Effects

______ due to low oncotic pressure

Reduced ______ of drugs and other substances in plasma

Reduced protein-bound _____

A

Edema

transport

calcium

42
Q

Hypoalbuminemia
Effects: Reduced protein-bound calcium

Total plasma calcium level ______

Ionized calcium level _________

A

drops

may remain normal

43
Q

Hyperalbuminemia
Cause:

_________
Albumin _______
_______ like stasis during _______

A

dehydration

infusion

Artifactual; venipuncture

44
Q

Alpha 1-Antitrypsin
—

Synthesized by the ______ and ______
—
An _______ protein that inhibits ______
—

A

liver and macrophages

acute-phase

proteases

45
Q

— Proteases are produced ____genously and from ______ and _____
—

A

endo

leukocytes and bacteria

46
Q

— Infection leads to protease release from bacteria and from leukocytes

T/F

A

T

47
Q

Genetic deficiency of Alpha 1-Antitrypsin

This is when Synthesis of the __________ occurs in the ____ but it _______, leading to _______ in _____ and is deficient in plasma

A

defective alpha 1-Antitrypsin

liver; cannot secrete the protein

accumulation; hepatocytes

48
Q

Clinical Consequences of Alpha 1-Antitrypsin Deficiency

_______ with evidence of ________

Childhood __________

______________ in young adults

A

Neonatal jaundice; cholestasis

liver cirrhosis

Pulmonary emphysema

49
Q

Alpha Fetoprotein (AFP)
Synthesized in the ———- and ________ by the parenchymal cells of the _____

A

developing embryo and fetus

liver

50
Q

AFP levels _____ease gradually during intra- uterine life and reach adult levels at birth

A

decr

51
Q

Function of AFP is _____ but it may _______ from ___________

A

unknown

protect fetus

immunologic attack by the mother

52
Q

Function of AFP in adults?

A

No known physiological function in adults

53
Q

Alpha- Fetoprotein (AFP)

Elevated maternal AFP levels are associated with:

________,_______

A

Neural tube defect, anencephaly

54
Q

Alpha - Fetoprotein (AFP)

Decreased maternal AFP levels are associated with:
– Increased risk of _________

A

Down’s syndrome

55
Q

AFP is a tumor marker for: ________ and ______

A

Hepatoma and testicular cancer

56
Q

Ceruloplasmin

Synthesized by the ______

Contains >____% of serum _____

A

liver

90

copper

57
Q

Ceruloplasmin is not Important for iron absorption from the intestine

T/F

A

F

It is

58
Q

Wilson’s disease:

– Due to low plasma levels of ________

– ____ is accumulated in the ______ and _____

A

ceruloplasmin

Copper

liver and brain

59
Q

Haptoglobin

Synthesized by the ____
—
Binds to _______ to form complexes that are metabolized in the ______
—

A

liver

free hemoglobin

RES

60
Q

Haptoglobin

— Limits _____ losses by preventing ____ loss from kidneys
—

A

iron

Hb

61
Q

— Plasma level of Haptoglobin decreases during _________ hemolysis

A

intravascular

62
Q

Transferrin
—
A major ____-transport protein in plasma —

___% saturated with ___
—

A

iron

30; iron

63
Q

—
— Plasma level of Transferrin rises in Malnutrition, liver disease, inflammation, malignancy

T/F
—

A

F

It drops

64
Q

Transferrin
—
— Iron deficiency results in decreased hepatic synthesis

T/F

A

F

Increased

65
Q

Transferrin
—
— is A ____tive acute phase protein

A

nega

66
Q

Beta 2–Microglobulin
A component of ________________

—

A

human leukocyte antigen (HLA)

67
Q

Beta 2–Microglobulin

— Present on the surface of _____ and most nucleated cells
—

A

lymphocytes

68
Q

Beta 2–Microglobulin

— Filtered by the renal glomeruli due to its small size but most (>99%) is reabsorbed

T/F

A

T

69
Q

Beta 2–Microglobulin

Elevated serum levels are found in —

Impaired ____ function
— Overproduction in ______
—

A

kidney

disease

70
Q

Beta 2–Microglobulin

— May be a tumor marker for:
—

———-,———-,———-

A

Leukemia, lymphomas, multiple myeloma

71
Q

C-Reactive Protein (CRP)

A marker for _______________ disease

A

ischemic heart

72
Q

C-Reactive Protein (CRP)
An acute-phase protein synthesized by the ______

Is Important for _______

A

liver

phagocytosis

73
Q

C-Reactive Protein (CRP)

High plasma levels are found in many ________ conditions such as rheumatoid arthritis

A

inflammatory

74
Q

Gammaglobulins
Elevated levels
May result from stimulation of

___ cells (______________)

________ proliferation (_________)

A

B; Polyclonal hypergamma globulinemia

Monoclonal; Paraproteinemia

75
Q

Gammaglobulins

Polyclonal hypergammaglobulinemia:

Stimulation of ______________ produce a wide range of antibodies

A

many clones of B cells

76
Q

Gamma-globulin band appears (small or large?) in electrophoresis

A

Large

77
Q

Monoclonal Hypergammaglobulinemia
—

Proliferation of a __________ produces a __________ Ig
—

A

single B-cell clone

single type of

78
Q

Monoclonal Hypergammaglobulinemia
—
— Appears as a __________ band (paraprotein or M band) in electrophoresis
—

A

separate dense

79
Q

Monoclonal Hypergammaglobulinemia
—
— Paraproteins are characteristic of ________________ proliferation

— Clinical condition: _______

A

malignant B-cell

multiple myeloma

80
Q

Negative Acute Phase Proteins

These proteins ____ease in inflammation – _________,______,_______

A

decr

Albumin, prealbumin, transferrin

81
Q

Negative Acute Phase Proteins

Mediated by inflammatory response via cytokines and hormones

Synthesis of these proteins decrease to __________ for _________

A

save amino acids for positive acute phase proteins

82
Q

Transudates and Exudates

A value of ____ or ___ g/L is often taken as the dividing line between the two types of fluid.

A

25 or 30

83
Q

Measurement of ____________ can also be done to differentiate the fluids( transudate and exudate)

A

lactate dehydrogenase

84
Q

_________ and _______ is quite useful in deciding cause of fluid accumulating in dead spaces

A

Microbiological tests and cytology

House Clinical Pathology (45 decks)

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