PLASMA PROTEINS AND DISORDERS Flashcards
Plasma proteins are made up of different ______ of (similar or different?) chemical and physical structures
proteins
different
Plasma proteins
Synthesized and secreted into plasma from the _____,_______ ,_________________
liver, plasma cells, intestinal endothelial cells
Plasma proteins
_____ differs and so determines rate of synthesis and degradation
Half life
Functions of plasma proteins
Transport –________,______,————
Enzymes –__________
thyroxine binding globulin, sex hormone binding globulin, transferrin
Renin
Functions of plasma proteins
Protease inhibitors – _____________
Humoral immunity – _____________,
alpha1 antitrypsin
immunoglobulins
Functions of plasma proteins
Maintaining oncotic pressure –_______
Buffering –_________, haemoglobin
Albumin
All proteins
Alanine aminotransferase-
abbreviation:
Causes leading to increased levels:
ALT
liver and biliary tract disease
pancreatic disease
decompensated heart defects
abbreviation:
Causes leading to increased levels:
AST
liver diseases myocardium damage
disease of skeletal muscle and myocardium
alkaline phosphatase-
abbreviation:
Causes leading to increased levels:
ALP
liver and biliary tract disease bone diseases
Creatin kinase-
abbreviation:
Causes leading to increased levels:
CK
disease of skeletal muscle and myocardium
Lactate dehydrogenase-
abbreviation:
Causes leading to increased levels:
LD
Myocardium disease (LD1, LD2) and muscle disease hepatopathy
g-glutamy ltransferasa-
abbreviation:
Causes leading to increased levels:
GMT
liver and biliary tract disease and pancreatic disease
Causes of change in Plasma protein concentration
Increase
Decrease in _______
________ - like stasis during venipuncture
Increase _________
volume distribution
Artefactual
protein synthesis
Causes of change in Plasma protein concentration
Decrease
Decrease ________ like in ____,____,_____
Increase in _________ like ________
Increase _____ (catabolism, excretion, enteropathy)
protein synthesis ; malnutrition, malabsorption, liver disease
volume of distribution; over hydration
loss
Description of pathologic plasma protein states
Dysproteinnaemia – (normal or abnormal ?) total concentration with (normal or abnormal?) _____ as in ______/______ inflammation.
Normal
Abnormal ; ratio
acute/ chronic
Description of pathologic plasma protein states
Hyperproteinaimia – increased _____________
total plasma concentration
Description of pathologic plasma protein states
Hypoproteinaemia – Decreased _________
total plasma concetration
Description of pathologic plasma protein states
Paraproteinaemia – presence of (normal or abnormal?) and ____eased amount of particular protein(s) often (benign or malignant?) .
Abnormal
incr
malignant
Classification of plasma proteins
Based on electrophoretic pattern
From fastest to slowest
– ______
–_______
– ________
–__________
–________
–_______
Prealbumin
Albumin
Alpha 1 globulin
Alpha 2 globulins
Beta 1
Beta 2
Classification of plasma proteins
alpha 1antitrypsin
Alpha 1 globulin
Classification of plasma proteins
alpha 1 acid glycoprotein
Alpha 1 globulin
Classification of plasma proteins
transferrin
Beta 1
Classification of plasma proteins
LDL
Beta 1
Classification of plasma proteins
C3 complement
Beta 2
Classification of plasma proteins
haptoglobulin
Alpha 2 globulins
Classification of plasma proteins
alpha 2 macroglobulin
Alpha 2 globulins
Classification of plasma proteins
ceruloplasmin
alpha 2 globulins
Prealbumin ( ________ )
A transport protein for:
_____ hormones
_______ (_____)
Transthyretin
Thyroid
Retinol (vitamin A)
Prealbumin (Transthyretin)
Lower levels found in:
_____ disease, nephrotic syndrome, __________ response, malnutrition
liver
acute phase inflammatory
Prealbumin (Transthyretin)
(Short or Long?) half-life (__ days)
Short
2 days
Albumin
About ___-___ g/L in normal adult
Synthesized in the ____ as ______ and secreted as _____
36 - 55
liver
preproalbumin; albumin
Albumin
Half-life in plasma: ____ days
____eases rapidly in injury, infection and surgery
20
Decr
Most abundant plasma protein is ???
Albumin
Albumin Functions
Maintains __________ pressure
oncotic
_____% of plasma oncotic pressure is maintained by albumin
80
Albumin: Functions
A (specific or non-specific?) carrier of hormones, calcium, free fatty acids, drugs, etc.
non-specific
albumin : Functions
Tissue cells can take up albumin by ______ where it is hydrolyzed to _______
pinocytosis
amino acids
Albumin is Useful in treatment of liver diseases, hemorrhage, shock and burns
T/F
T
Hypoalbuminemia
Causes
– Decreased _______
– Increased _________
albumin synthesis
losses of albumin
Hypoalbuminemia
Causes: Increased losses of albumin
-Increased ______ in infections
-Excessive ______ by the kidneys ( ________ )
-Excessive loss in _______
-Severe _____ (plasma loss in the absence of _________)
catabolism
excretion
nephrotic syndrome
bowel
burns; skin barrier
Hypoalbuminemia
Effects
______ due to low oncotic pressure
Reduced ______ of drugs and other substances in plasma
Reduced protein-bound _____
Edema
transport
calcium
Hypoalbuminemia
Effects: Reduced protein-bound calcium
Total plasma calcium level ______
Ionized calcium level _________
drops
may remain normal
Hyperalbuminemia
Cause:
_________
Albumin _______
_______ like stasis during _______
dehydration
infusion
Artifactual; venipuncture
Alpha 1-Antitrypsin
Synthesized by the ______ and ______
An _______ protein that inhibits ______
liver and macrophages
acute-phase
proteases
Proteases are produced ____genously and from ______ and _____
endo
leukocytes and bacteria
Infection leads to protease release from bacteria and from leukocytes
T/F
T
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
defective alpha 1-Antitrypsin
liver; cannot secrete the protein
accumulation; hepatocytes
Clinical Consequences of Alpha 1-Antitrypsin Deficiency
_______ with evidence of ________
Childhood __________
______________ in young adults
Neonatal jaundice; cholestasis
liver cirrhosis
Pulmonary emphysema
Alpha Fetoprotein (AFP)
Synthesized in the ———- and ________ by the parenchymal cells of the _____
developing embryo and fetus
liver
AFP levels _____ease gradually during intra- uterine life and reach adult levels at birth
decr
Function of AFP is _____ but it may _______ from ___________
unknown
protect fetus
immunologic attack by the mother
Function of AFP in adults?
No known physiological function in adults
Alpha- Fetoprotein (AFP)
Elevated maternal AFP levels are associated with:
________,_______
Neural tube defect, anencephaly
Alpha - Fetoprotein (AFP)
Decreased maternal AFP levels are associated with:
– Increased risk of _________
Down’s syndrome
AFP is a tumor marker for: ________ and ______
Hepatoma and testicular cancer
Ceruloplasmin
Synthesized by the ______
Contains >____% of serum _____
liver
90
copper
Ceruloplasmin is not Important for iron absorption from the intestine
T/F
F
It is
Wilson’s disease:
– Due to low plasma levels of ________
– ____ is accumulated in the ______ and _____
ceruloplasmin
Copper
liver and brain
Haptoglobin
Synthesized by the ____
Binds to _______ to form complexes that are metabolized in the ______
liver
free hemoglobin
RES
Haptoglobin
Limits _____ losses by preventing ____ loss from kidneys
iron
Hb
Plasma level of Haptoglobin decreases during _________ hemolysis
intravascular
Transferrin
A major ____-transport protein in plasma
___% saturated with ___
iron
30; iron
Plasma level of Transferrin rises in Malnutrition, liver disease, inflammation, malignancy
T/F
F
It drops
Transferrin
Iron deficiency results in decreased hepatic synthesis
T/F
F
Increased
Transferrin
is A ____tive acute phase protein
nega
Beta 2–Microglobulin
A component of ________________
human leukocyte antigen (HLA)
Beta 2–Microglobulin
Present on the surface of _____ and most nucleated cells
lymphocytes
Beta 2–Microglobulin
Filtered by the renal glomeruli due to its small size but most (>99%) is reabsorbed
T/F
T
Beta 2–Microglobulin
Elevated serum levels are found in
Impaired ____ function
Overproduction in ______
kidney
disease
Beta 2–Microglobulin
May be a tumor marker for:
———-,———-,———-
Leukemia, lymphomas, multiple myeloma
C-Reactive Protein (CRP)
A marker for _______________ disease
ischemic heart
C-Reactive Protein (CRP)
An acute-phase protein synthesized by the ______
Is Important for _______
liver
phagocytosis
C-Reactive Protein (CRP)
High plasma levels are found in many ________ conditions such as rheumatoid arthritis
inflammatory
Gammaglobulins
Elevated levels
May result from stimulation of
___ cells (______________)
________ proliferation (_________)
B; Polyclonal hypergamma globulinemia
Monoclonal; Paraproteinemia
Gammaglobulins
Polyclonal hypergammaglobulinemia:
Stimulation of ______________ produce a wide range of antibodies
many clones of B cells
Gamma-globulin band appears (small or large?) in electrophoresis
Large
Monoclonal Hypergammaglobulinemia
Proliferation of a __________ produces a __________ Ig
single B-cell clone
single type of
Monoclonal Hypergammaglobulinemia
Appears as a __________ band (paraprotein or M band) in electrophoresis
separate dense
Monoclonal Hypergammaglobulinemia
Paraproteins are characteristic of ________________ proliferation
Clinical condition: _______
malignant B-cell
multiple myeloma
Negative Acute Phase Proteins
These proteins ____ease in inflammation – _________,______,_______
decr
Albumin, prealbumin, transferrin
Negative Acute Phase Proteins
Mediated by inflammatory response via cytokines and hormones
Synthesis of these proteins decrease to __________ for _________
save amino acids for positive acute phase proteins
Transudates and Exudates
A value of ____ or ___ g/L is often taken as the dividing line between the two types of fluid.
25 or 30
Measurement of ____________ can also be done to differentiate the fluids( transudate and exudate)
lactate dehydrogenase
_________ and _______ is quite useful in deciding cause of fluid accumulating in dead spaces
Microbiological tests and cytology