Protein Flashcards
collection tube for CBC / Chem
• Purple top = EDTA
- strong chelator of Ca
- plasma
• Blue top = Citrate
- less potent chelator of Ca
• Green top = Heparin plasma
-3 Proteins in plasma, not serum
• significance?
Fibrinogen , Factor 5, Factor 8
2 Dz that ↑ CBC protein, w/ serum protein values normal
w/o involving lipemia /hemolysis
??
Ddx for ↑ Albumin, globulin, fibrinogen
Albumin
- Relative ↑
- glucocorticoid (possible)
- lab interference
Globulin
- Chronic Ag stimulation
• Polyclonal
- Active inflamm
--> mild only
- Lymphoproliferative dz
• monoclonal
Ddx for ↓ Albumin, globulin, fibrinogen
Albumin
- Active inflamm
- hepatic insufficiency
- malnutrition/malabsorption
- Protein losing glomerulopathy
- Exudate (sequestration)
Globulin
- Immunodeficiency (lack of Ig)
- ↓ hepatic fxn
Ddx for PanHYPERproteinemia
DEHYDRATION
Ddx for PanHYPOproteinemia
- Hemodilution
- acute blood loss
- protein losing enteropathy
- severe skin lesions (burns)
- Body cavity effusions
Calculation/interpret Plasma Protein : Fibrinogen ratio
Convert fibrinogen from mg to g
• (TPP - Fibrinogen) / Fibrinogen
• >15 = normal
• underestimates fibrinogen
• hemorrhage / protein-losing dz
- ↑ TP --> overestimate fibrinogen
• dehydration5 protein fractions on Serum Protein Electrophoresis (SPE)
• Name
• Location
Fractions determined by finding midpoint –> 3 / 4
- Albumin
- Alpha 1
- Alpha 2
- Beta
* ** plasma samples = fibrinogen - Gamma
* ** IgG
Evaluating qualitative / quantitative data of SPE tracing
Total protein * %fraction = Amt of fraction
Total protein measured by ____ in CBC
• significance?
Refractometry
• Measures total solids
- Lipid
• unfasted sample
- Glucose, BUN, NaCl
• very high values
- severe hemolysisTotal protein measured by _____ in Chem
and Albumin & globulins?
TP:
• Biuret colorimetric – Peptide bonds
Albumin:
• BCG dye binding method
Globulin
• Calculated !!!!
Physiologic influences (small changes)
1. Age
• Young: TP low until 6month
• Geriatrics: TP higher (↓ Albumin/ ↑ Globulin)
2. Nutritional status
• severe starvation (↓ Albumin)
3. Pregnancy --> lactation
• mild ↓ albumin
4. Hormonal
- Gender - minimal
What are albumin values in young animals?
What are globulins assoc’d w/ ?
Albumin: 0.5 - 1 g/dL lower than adults
Globulin: Weaning & vax
Anabolic hormones assoc’d w/ proteins
- testosterone
- estrogen
- GH
Catabolic hormones assoc’ed w/ proteins
- Thyroxin
- Cortisol
- w/in reference interval
- exogenous –> upward shift in albumin
Fibrinogen
- Produced by LIVER – acute phase protein
- ↑ inflammatory marker
- ↓ DIC
↑ Fibrinogen Ddx
- inflammatory
2. dehydration
↓ Fibrinogen ddx
- DIC
- Hepatic failure
- Protein-losing dz
- Congenital
- CLOTTED blood (EDTA/citrate –> consumption)
Most important / common cause of serum albumin < 2.0 g/dl
- Protein-losing enteropathy
- Protein-losing glomerulopathy
- hepatic insufficiency
Serum Protein Electrophoresis
• how is it performed?
• Cellulose acetate / agrose gel
--> electrical charge
--> protein migration based on CHARGE
--> Bands scanned by Densitometry
--> Electrophoretogram
• demonstrates relative ants of protein in each bandIndications for SPE
- Differentiate causes of hyperproteinemia
- Characterize unexplained hypoproteinemia
- Monitoring dz activity / progression
- more accurate albumin
What causes a spike or ↑ in total alpha proteins?
- Active inflammation
What proteins spike on SPE during Monoclonal gammopathy?
• Lymphod neoplasia
- Narrow-based spike in Beta OR Gamma region
= < albumin width
What proteins spike on SPE during Polyclonal gammopathy?
• Chronic Ag stimulation
1. Broad-based spike in Beta & gamma region
= >1.5 width of albumin
2. Broad-based bridging
List causes of monoclonal gammapathy
( Narrow based spike)
• Lymphoproliferative dz – multiple myeloma
List causes of Polyclonal gammopathy
Chronic antigenic stimulation
• Broad based ↑
• FIP, Ehrlichiosis, Chronic pyelonephritis
• Beta-gamma bridging
• Hepatic insufficiency
• Assoc’d w/ hypoalbuminemia
