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Clinical Pathology > Protein Analysis > Flashcards

Protein Analysis Flashcards

1
Q

what plasma proteins are made in the liver

A

albumin
alpha globulins
beta globulins

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2
Q

what is made by B-lymphocytes & plasma cells

A

gamma globulins (immunoglobulins)

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3
Q

what are plasma proteins degraded by

A

macrophages and other cells

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4
Q

what is the reference interval for total protein

A

5-8 g/dL

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5
Q

what is the main / overall category to look for overall protein

A

total protein

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6
Q

what makes up total protein

A

albumin
globulin

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7
Q

what can be used to determine globulin amount

A

[TP] - [Alb]

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8
Q

true or false:
changes in [TP] are usually due to changes in albumin & one or more of the globulin concentrations

A

true

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9
Q

in a plasma sample, what can cause an increase in total protein

A

fibrinogen in globulin

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10
Q

which sample will traditionally have a lower total protein

A

serum

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11
Q

what are the major physiologic roles of albumin

A

binding proteins
major contributor to oncotic pressure (helps hold water in plasma)

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12
Q

what are the major physiological roles of plasma globulins

A

transport lipids
inactivate inflammatory proteases
binds hemoglobin dimers in plasma
transports iron
converts to fibrin for hemostasis
binds antigens

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13
Q

what are the positive acute phase plasma globulins

A

haptoglobin
fibrinogen

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14
Q

what are the negative acute phase plasma globulins

A

albumin

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15
Q

which type/phase of plasma globulin has an increased production within hours of the onset of inflammation

A

positive acute phase plasma globulins

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16
Q

what type/phase of plasma proteins has decreased production within hours to weeks of the onset of inflammation

A

negative acute-phase proteins

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17
Q

what occurs soon after onset of inflammation

A

changes in production to acute phase inflammatory proteins

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18
Q

what are the delayed-response proteins

A

immunoglobulins (gamma) produced by lymphocytes

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19
Q

when are delayed-response protein prevalent

A

increased concentrations occur 1-3 weeks after onset of inflammation

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20
Q

true or false:
delayed - response proteins will not affect total protein

A

false
delayed-time proteins may cause an increase in total protein if there is a big enough quantity

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21
Q

what are the 2 ways to measure total protein

A

refractometry
biuret reaction

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22
Q

true or false:
refractometry total protein should be within 0.3 g/d: of biuret total protein

A

true

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23
Q

when would a biuret reaction be most appropriate

A

chemistry profile

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24
Q

when would a refractometry test be the most appropriate

A

CBC for plasma total protein

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25
Q

true or false:
refractometry is used to indicated specific proteins

A

false
light will bend due to the presence of solids of anything

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26
Q

what can be included in total solids

A

proteins
glucose
electrolytes

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27
Q

what are some likely caused to falsely indicate increased refractometry readings

A

increased…
glucose
urea
sodium/ chloride
lipemia
excess EDTA in blood

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28
Q

what will not interfere or cause an increase ina refractometry result

A

bilirubin

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29
Q

what is the most common total protein measurement amount for serum

A

biuret reaction (colormetric)

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30
Q

what are the methods for measuring albumin

A

bromocresol green
protein electrophoresis

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31
Q

what is used in a bromocresol green test to identify albumin

A

BCG dye

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32
Q

what are some potential interferences with a bromocresol green test

A

will bind to some globulins
hemolysis

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33
Q

what is the most common method for identifying albumin levels in a clinic

A

BCG method (bromocresol green)

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34
Q

which protein part can be seen on the far left of a SPE

A

albumin - most negatively charged

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35
Q

what are characteristics seen due to inflammation on a SPE

A

increase alpha 2 peak
wide based gamma peak

36
Q

what is causing the wide base gamma peak increase in a case of inflammation

A

polyclonal gammopathy (many B-lymphocyte clones)

37
Q

what is causing the increased peak at alpha 2 on a SPE test for inflammation

A

increase of acute phase globulins

38
Q

what is the outcome of neoplastic B-lymphocytes

A

increased production of Ig

39
Q

what is seen on a SPE due to B-lymphocyte neoplasm

A

narrow-based region increased in the B2 / gamma globulins

40
Q

what are the main immunoglobulins affected in B-lymphocyte neoplasm

A

IgM
IgA

41
Q

what is most commonly seen with monoclonal gammopathy

A

B-lymphocyte neoplasm

42
Q

what is most commonly seen with polyclonal gammopathy

A

inflammation

43
Q

what are 2 ways to analyze fibrinogen concentration in plasma

A

heat precipitant method
thrombin time

44
Q

when is heat precipitant method normally used for fibrinogen

A

hyperfibriongenemia

45
Q

what are causes of hyperfibrinogenemia

A

inflammation
hemoconcentration (dehydration)

46
Q

what are causes of hypofibrinogenemia

A

increased fibrinogen consumption
decreased synthesis of fibrinogen

47
Q

what causes increased fibrinogen consumption

A

intravascular coagulation

48
Q

what causes dissemination intravascular coagulation

A

increased consumption and increased fibrinogenolysis

49
Q

what can be a cause of decreased synthesis of fibrinogen

A

hepatic insufficiency

50
Q

what are causes of hyperproteinemia

A

dehydration
inflammation
B-cell neoplasia

51
Q

what is the cause of hypoproteinemia

A

protein loss

52
Q

what are signs of hyperproteinemia due to dehydration

A

total protein increase
albumin increase
globulin increase

53
Q

what are signs of hyperproteinemia due to inflammation

A

total protein increase
albumin decrease
globulin increase

54
Q

what are signs of hyperproteinemia due to B-cell neoplasia

A

total protein increase
albumin decrease
globulin increase

55
Q

what is the cause of increased everything in dehydration

A

decreased plasma water

56
Q

what is the main source of increased total protein and globulins in inflammation

A

cytokines

57
Q

what is the main source of increased total protein and globulins in B-cell neoplasia

A

B-cell clones produced antibodies

58
Q

what is the most common hyperproteinemia

A

dehydration (nonselective dysproteinemia)

59
Q

true or false:
protein concentrations may still be WRI during dehydration

A

true
the patient could have been hypoproteinemic before dehydration

60
Q

what are causes of hyperalbuminema

A

dehydration
increase albumin synthesis by glucocorticoids

61
Q

what is used to differentiate between inflammatory and neoplastic hyperglobulinemia

A

SPE

62
Q

what are the 2 basic mechanisms of hypoproteinemia

A

increased protein loss from vessels
decreased protein production by liver

63
Q

what cause of hypoproteinemia will you see a globulin level within WRI

A

PLN (kidney)

64
Q

in what case of hypoproteinemia would you expect to see a WRI of total protein and albumin

A

failure of passive transfer or lymphoid hypoplasia

65
Q

which case of hypoproteinemia is due to decreased production due to decreased liver function

A

hepatic insufficiency

66
Q

what would you expect to see in a case of hypoproteinemia with hemorrhage or blood loss

A

H2O shifts – hemodilution
hypoproteinemia and anemia

67
Q

what causes the hemodilution in hypoproteinemia due to blood loss

A

feeling thirsty because of dehydration –> putting more water into the system causing rehydration but also diluting the system

68
Q

what would you expect to see in a case of hypoproteinemia with protein-losing nephropathy

A

alpha-2 macroglobulin remain in plasma = proteinuria
hypoalbuminemia (selective!!!)

69
Q

in what condition would you expect to see hypoproteinemia, hypoalbuminemia and decreased globulins

A

protein-losing enteropathy

70
Q

what causes protein-losing enteropathy

A

increased rate of proteins entering intestine without being resorbed (usually albumin and mostly globulins)

71
Q

what are some clinical cases in which you would expect to see protein-losing enteropathy

A

small intestinal mucosal disease
intestinal blood loss due to parasitism
inflammatory exudation

72
Q

what would you expect to see in a burn patient when it comes to increased protein loss from plasma

A

protein-losing dermatopathy

73
Q

what are some signs of protein-losing dermatopathy in a burn patient

A

hypoproteinemia
hypoalbuminemia
decreased globulins

74
Q

due to the nature of burns healing, what could be misleading to treating protein-losing dermatopathy in a burn patient in the later stages

A

increased globulins
inflammatory dysproteinemia

75
Q

what type of protein loss would cause hypoproteinemia, hypoalbuminemia & decreased globulins because of plasma oozing out of vessels

A

extravasation of plasma proteins

76
Q

with a chronic case of extravasation of plasma proteins, what would you expect to see

A

concurrent inflammatory response would alter proteins such as globulins will increase over time

77
Q

what are ways hypoproteinemia can occur due to decreased protein production

A

hepatic insufficiency
malabsorption in the intestines or maldigestion
cachectic stats (malignancies, chronic diseases)

78
Q

what percent of the liver needs to be damaged in order to start seeing decreased protein production

A

> 80% loss of functional mass

79
Q

what is most commonly seen with hepatic insufficiency

A

decreased production of albumin and (mostly) globulins

80
Q

why does malabsorption / maldigestion create decreased protein production

A

decreased intake of nutrient = too few amino acids for protein production

81
Q

how does the decreased protein production occur in cachectic states

A

decreased intake of nutrients = increase protein degradation

82
Q

what are the main 2 ways hypoalbuminemia occurs

A

decreased albumin production by liver
increased albumin loss from vessels

83
Q

what are conditions that cause hypoalbuminemia because of decreased albumin synthesis

A

inflammation
hepatic insufficiency
malabsorption or maldigestion
cachectic states

84
Q

what are conditions that cause hypoalbuminemia because of increased albumin loss

A

blood loss
protein-losing nephropathy
protein-losing enteropathy

85
Q

what is the albumin half life in most mammals

A

1 week to 10 days

86
Q

what is the albumin half life in a horse

A

3 weeks

Clinical Pathology (16 decks)

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