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Clin Chem 2 > Protein > Flashcards

Protein Flashcards

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1
Q

collection tube for CBC / Chem

A 
• Purple top = EDTA
      - strong chelator of Ca
      - plasma
• Blue top = Citrate 
       - less potent chelator of Ca
• Green top = Heparin plasma
       -
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2
Q

3 Proteins in plasma, not serum

• significance?

A

Fibrinogen , Factor 5, Factor 8

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3
Q

2 Dz that ↑ CBC protein, w/ serum protein values normal

w/o involving lipemia /hemolysis

A

??

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4
Q

Ddx for ↑ Albumin, globulin, fibrinogen

A

Albumin

  • Relative ↑
  • glucocorticoid (possible)
  • lab interference
Globulin
- Chronic Ag stimulation 
        • Polyclonal
- Active inflamm 
        --> mild only
- Lymphoproliferative dz 
        • monoclonal
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5
Q

Ddx for ↓ Albumin, globulin, fibrinogen

A

Albumin

  • Active inflamm
  • hepatic insufficiency
  • malnutrition/malabsorption
  • Protein losing glomerulopathy
  • Exudate (sequestration)

Globulin

  • Immunodeficiency (lack of Ig)
  • ↓ hepatic fxn
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6
Q

Ddx for PanHYPERproteinemia

A

DEHYDRATION

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7
Q

Ddx for PanHYPOproteinemia

A
  • Hemodilution
  • acute blood loss
  • protein losing enteropathy
  • severe skin lesions (burns)
  • Body cavity effusions
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8
Q

Calculation/interpret Plasma Protein : Fibrinogen ratio

A 
Convert fibrinogen from mg to g 
   • (TPP - Fibrinogen) / Fibrinogen
   • >15 = normal
   •  underestimates fibrinogen 
        • hemorrhage / protein-losing dz
- ↑ TP --> overestimate fibrinogen
        • dehydration
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9
Q

5 protein fractions on Serum Protein Electrophoresis (SPE)
• Name
• Location

A

Fractions determined by finding midpoint –> 3 / 4

  1. Albumin
  2. Alpha 1
  3. Alpha 2
  4. Beta
    * ** plasma samples = fibrinogen
  5. Gamma
    * ** IgG
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10
Q

Evaluating qualitative / quantitative data of SPE tracing

A

Total protein * %fraction = Amt of fraction

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11
Q

Total protein measured by ____ in CBC

• significance?

A 
Refractometry
• Measures total solids
     - Lipid 
             • unfasted sample
     - Glucose, BUN, NaCl 
             • very high values
     - severe hemolysis
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12
Q

Total protein measured by _____ in Chem

and Albumin & globulins?

A

TP:
• Biuret colorimetric – Peptide bonds

Albumin:
• BCG dye binding method

Globulin
• Calculated !!!!

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13
Q 
Physiologic influences 
(small changes)
A 
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
  1. Gender - minimal
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14
Q

What are albumin values in young animals?

What are globulins assoc’d w/ ?

A

Albumin: 0.5 - 1 g/dL lower than adults

Globulin: Weaning & vax

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15
Q

Anabolic hormones assoc’d w/ proteins

A
  1. testosterone
  2. estrogen
  3. GH
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16
Q

Catabolic hormones assoc’ed w/ proteins

A
  1. Thyroxin
  2. Cortisol
    • w/in reference interval
    • exogenous –> upward shift in albumin
17
Q

Fibrinogen

A
  • Produced by LIVER – acute phase protein
  • ↑ inflammatory marker
  • ↓ DIC
18
Q

↑ Fibrinogen Ddx

A
  1. inflammatory

2. dehydration

19
Q

↓ Fibrinogen ddx

A
  1. DIC
  2. Hepatic failure
  3. Protein-losing dz
  4. Congenital
  5. CLOTTED blood (EDTA/citrate –> consumption)
20
Q

Most important / common cause of serum albumin < 2.0 g/dl

A
  1. Protein-losing enteropathy
  2. Protein-losing glomerulopathy
  3. hepatic insufficiency
21
Q

Serum Protein Electrophoresis

• how is it performed?

A 
• Cellulose acetate / agrose gel 
--> electrical charge 
--> protein migration based on CHARGE 
--> Bands scanned by Densitometry 
--> Electrophoretogram 
           • demonstrates relative ants of protein in each band
22
Q

Indications for SPE

A
  • Differentiate causes of hyperproteinemia
  • Characterize unexplained hypoproteinemia
  • Monitoring dz activity / progression
  • more accurate albumin
23
Q

What causes a spike or ↑ in total alpha proteins?

A
  • Active inflammation
24
Q

What proteins spike on SPE during Monoclonal gammopathy?

A

• Lymphod neoplasia
- Narrow-based spike in Beta OR Gamma region
= < albumin width

25
Q

What proteins spike on SPE during Polyclonal gammopathy?

A

• Chronic Ag stimulation
1. Broad-based spike in Beta & gamma region
= >1.5 width of albumin
2. Broad-based bridging

26
Q

List causes of monoclonal gammapathy

( Narrow based spike)

A

• Lymphoproliferative dz – multiple myeloma

27
Q

List causes of Polyclonal gammopathy

A 
Chronic antigenic stimulation 
• Broad based ↑ 
          • FIP, Ehrlichiosis, Chronic pyelonephritis
• Beta-gamma bridging
          • Hepatic insufficiency

• Assoc’d w/ hypoalbuminemia

Clin Chem 2 (6 decks)

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