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Clinical Pathology > Plasma Proteins & Dysproteinemia (3) > Flashcards

Plasma Proteins & Dysproteinemia (3) Flashcards

Dr. Harvey

1
Q

What are plasma proteins? Where are they made?

A

comprised of hundreds of proteins

liver: most
lymphoid organs

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2
Q

Describe the differences of a neonate vs adult plasma concentration

A

neonate: less, ~4-6 g/dL
adult: more 6-8 g/dL

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3
Q

How do you measure plasma protein?

A

physical - refractometric
biochemical- spectrophotometric
fractionation - electrophoresis

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4
Q

What is in the buffy coat?

A

leukocytes
platelets

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5
Q

In a microhematocrit tube, what can the plasma appearance be?

A

icterus index (yellow color)
lipemia (chylomicrons/VLDL)
hemolysis (free hemoglobin)

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6
Q

What do biochemical measurements regarding serum proteins measure?

A

total protein and albumin concentrations in serum are measured separately using 2 different spectrophotometric assays

DO NOT measure total globulins

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7
Q

What can lead to erroneously increased plasma protein concentration?

A

hemolysis in the sample (hemoglobin is not plasma protein)

lipemia - interferes with light transmission

marked increase in nonprotein solids

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8
Q

How do you fractionate serum/plasma proteins?

A

separation by protein electrophoresis

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9
Q

Why do you perform serum protein electrophoresis?

A

unexplained hyperglobulinemia present

immunoglobulin deficiency suspected

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10
Q

What is the importance of albumin?

A

small but plays a huge role in osmotic pressure

negative acute-phase protein

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11
Q

What does hypoalbuminemia result in?

A

edema

low total calcium in blood

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12
Q

What are acute-phase proteins?

A

defined as proteins with more than 25% change in serum concentrations in response to inflammatory cytokines

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13
Q

What are the types of acute-phase proteins and their definitions?

A

positive: increasing serum concentration - inflammation

negative: decreasing serum concentration

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14
Q

What are the positive acute phase proteins for all species?

A

serum amyloid A (SAA)

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15
Q

What are the positive acute phase proteins specific to dogs?

A

c-reactive protein

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16
Q

What are the positive acute phase proteins specific to ruminants?

A

haptoglobin

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17
Q

What is serum amyloid A associated with?

A

HDLs

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18
Q

What are functions of haptoglobin?

A
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19
Q

What is fibrinogen?

A

classified as coagulation factor I

scaffolding for inflammatory cells, fibroblasts, and endothelial cells when deposited in tissues

precursor to fibrin in coagulation

heat-labile - measure difference after heating

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20
Q

When is fibrinogen increased?

A

dehydration (all plasma proteins)

active inflammation - cattle & goats, horses

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21
Q

What is ceruloplasmin?

A

copper transport

ferroxidase activity facilitates iron mobilization from tissue stores

plasma antioxidant

a-2 protein

22
Q

What is transferrin?

A

iron-binding metalloprotein

correlates with total iron binding capacity (TIBC)

iron transport throughout body

negative acute-phase protein

23
Q

What is ferritin?

A

iron-containing protein, primarily found inside cells

low concentrations in plasma - it is stored

plasma ferritin correlates with total body iron STORES

acute-phase, high? reflect inflammation

24
Q

What is antithrombin?

A

a protease inhibitor

inhibits thrombin and certain other coagulation factors

requires GAGs like heparin for optimal activity

25
Q

What are the negative acute-phase proteins thus discussed?

A

albumin
transferrin

26
Q

Where are immunoglobulins on the serum protein electrophoresis?

A

gamma wave

27
Q

What can cause hyperproteinemia? (high plasma protein concentration)

A

dehydration
hyperglobulinemia (greater serum proteins other than albumin)

28
Q

What can cause hypoproteinemia? (low plasma protein concentration)

A

dilution - overhydration
decreased production
increased loss
sequestration in body cavities (fluid accumulation)

29
Q

What is a result of inflammation?

A

increased loss of some proteins (especially albumin)

increased synthesis of some proteins due to altered cytokines

decreased synthesis of other proteins due to altered cytokines

30
Q

What comprises hypoproteinemia?

A

hypoalbumemia
hypoglobulinemia

31
Q

When ______ and ______ are decreased, it is called panhypoproteinemia

A

hypoalbuminemia
hypoglobulinemia

32
Q

What is expected to remain the same regarding panhypoproteinemia? Why?

A

albumin to globulin ratio

because both decrease or both increase

hypoalbuminemia + hypoglobulinemia = panhypoproteinemia

33
Q

What happens to the fluid balance in dehydration? What part is lost? What is the result?

A

only the fluid component of blood is lost - proteins and erythrocytes are not lost

causes a relative hyperproteinemia and erythrocytosis (high)

34
Q

What happens to the fluid balance in external hemorrhage? What part is lost? What is the result?

A

all components of blood are lost equally

fluid replaced more rapidly than protein & cells

causes hypoproteinemia & anemia

35
Q

What are indicators of hypoalbuminemia?

A

excessive fluid therapy - globulins should be decreased

decreased synthesis - liver failure, inflammation, marked hyperglobulinemia

protein losing glomerulopathy

36
Q

Hyperalbuminemia causes ____

A

dehydration - globulins should also be increased

or artifact

37
Q

What are results from hypoglobulinemia?

A

increased loss - hemorrhage loss - albumin also low
—> hemorrhage
—> protein-losing enteropathy

failure of passive transfer of immunoglobulins via colostrium

overhydration

decreased production of Igs - humoral immunodeficiency

38
Q

What results in hyperglobulinemia?

A

hemoconcentration - dehydration

increased immunoglobulins - immune-mediated response, neoplastic lymphoid cells

increase acute-phase protein concentrations may contribute when inflammation is present - haptoglobin, fibrinogen

39
Q

Differentiate hyperglobulinemia on serum protein electrophoresis - polyclonal vs monoclonal

A

polyclonal

monoclonal

40
Q

What is a bench jones protein?

A

light chain of Ig, seen in monoclonal

41
Q

What are lipoproteins?

A
42
Q

What are chylomicrons? How are they formed and when are they utilized?

A

formed in the mucosal cells of the duodenum and jejunum following digestion of fa tin the diet

43
Q

The core triglycerides of chylomicrons are rapidly hydrolyzed by ______

A

the action of lipoprotein lipase in capillary beds

44
Q

What do hematocrit tubes look like with a problem regarding lipoproteins?

A

white cloudy plasma - postprandial lipemia

chylomicrons forms a cream layer in plasma samples

45
Q

What are VLDLs?

A

transport the bulk of endogenous triglycerides**

plasma remains cloudy/milky after standing overnight

cream layer NOT present

46
Q

What are LDLs?

A

metabolic products of VLDLs

major mechanism by which cholesterol is transported to peripheral tissues

47
Q

What are HDLs

A

densest lipoproteins

formed in the liver and complete molecules are formed in the plasma by addition of remnants from other lipoproteins

transport cholesterol from tissues BACK to the liver - reverse cholesterol transport

48
Q

Differentiate function of LDLs vs HDL

A

LDL: to peripheral tissue
HDL: back to liver

49
Q
A
50
Q
A

Clinical Pathology (28 decks)

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