Protein Analysis Flashcards
what plasma proteins are made in the liver
albumin
alpha globulins
beta globulins
what is made by B-lymphocytes & plasma cells
gamma globulins (immunoglobulins)
what are plasma proteins degraded by
macrophages and other cells
what is the reference interval for total protein
5-8 g/dL
what is the main / overall category to look for overall protein
total protein
what makes up total protein
albumin
globulin
what can be used to determine globulin amount
[TP] - [Alb]
true or false:
changes in [TP] are usually due to changes in albumin & one or more of the globulin concentrations
true
in a plasma sample, what can cause an increase in total protein
fibrinogen in globulin
which sample will traditionally have a lower total protein
serum
what are the major physiologic roles of albumin
binding proteins
major contributor to oncotic pressure (helps hold water in plasma)
what are the major physiological roles of plasma globulins
transport lipids
inactivate inflammatory proteases
binds hemoglobin dimers in plasma
transports iron
converts to fibrin for hemostasis
binds antigens
what are the positive acute phase plasma globulins
haptoglobin
fibrinogen
what are the negative acute phase plasma globulins
albumin
which type/phase of plasma globulin has an increased production within hours of the onset of inflammation
positive acute phase plasma globulins
what type/phase of plasma proteins has decreased production within hours to weeks of the onset of inflammation
negative acute-phase proteins
what occurs soon after onset of inflammation
changes in production to acute phase inflammatory proteins
what are the delayed-response proteins
immunoglobulins (gamma) produced by lymphocytes
when are delayed-response protein prevalent
increased concentrations occur 1-3 weeks after onset of inflammation
true or false:
delayed - response proteins will not affect total protein
false
delayed-time proteins may cause an increase in total protein if there is a big enough quantity
what are the 2 ways to measure total protein
refractometry
biuret reaction
true or false:
refractometry total protein should be within 0.3 g/d: of biuret total protein
true
when would a biuret reaction be most appropriate
chemistry profile
when would a refractometry test be the most appropriate
CBC for plasma total protein
true or false:
refractometry is used to indicated specific proteins
false
light will bend due to the presence of solids of anything
what can be included in total solids
proteins
glucose
electrolytes
what are some likely caused to falsely indicate increased refractometry readings
increased…
glucose
urea
sodium/ chloride
lipemia
excess EDTA in blood
what will not interfere or cause an increase ina refractometry result
bilirubin
what is the most common total protein measurement amount for serum
biuret reaction (colormetric)
what are the methods for measuring albumin
bromocresol green
protein electrophoresis
what is used in a bromocresol green test to identify albumin
BCG dye
what are some potential interferences with a bromocresol green test
will bind to some globulins
hemolysis
what is the most common method for identifying albumin levels in a clinic
BCG method (bromocresol green)
which protein part can be seen on the far left of a SPE
albumin - most negatively charged
what are characteristics seen due to inflammation on a SPE
increase alpha 2 peak
wide based gamma peak
what is causing the wide base gamma peak increase in a case of inflammation
polyclonal gammopathy (many B-lymphocyte clones)
what is causing the increased peak at alpha 2 on a SPE test for inflammation
increase of acute phase globulins
what is the outcome of neoplastic B-lymphocytes
increased production of Ig
what is seen on a SPE due to B-lymphocyte neoplasm
narrow-based region increased in the B2 / gamma globulins
what are the main immunoglobulins affected in B-lymphocyte neoplasm
IgM
IgA
what is most commonly seen with monoclonal gammopathy
B-lymphocyte neoplasm
what is most commonly seen with polyclonal gammopathy
inflammation
what are 2 ways to analyze fibrinogen concentration in plasma
heat precipitant method
thrombin time
when is heat precipitant method normally used for fibrinogen
hyperfibriongenemia
what are causes of hyperfibrinogenemia
inflammation
hemoconcentration (dehydration)
what are causes of hypofibrinogenemia
increased fibrinogen consumption
decreased synthesis of fibrinogen
what causes increased fibrinogen consumption
intravascular coagulation
what causes dissemination intravascular coagulation
increased consumption and increased fibrinogenolysis
what can be a cause of decreased synthesis of fibrinogen
hepatic insufficiency
what are causes of hyperproteinemia
dehydration
inflammation
B-cell neoplasia
what is the cause of hypoproteinemia
protein loss
what are signs of hyperproteinemia due to dehydration
total protein increase
albumin increase
globulin increase
what are signs of hyperproteinemia due to inflammation
total protein increase
albumin decrease
globulin increase
what are signs of hyperproteinemia due to B-cell neoplasia
total protein increase
albumin decrease
globulin increase
what is the cause of increased everything in dehydration
decreased plasma water
what is the main source of increased total protein and globulins in inflammation
cytokines
what is the main source of increased total protein and globulins in B-cell neoplasia
B-cell clones produced antibodies
what is the most common hyperproteinemia
dehydration (nonselective dysproteinemia)
true or false:
protein concentrations may still be WRI during dehydration
true
the patient could have been hypoproteinemic before dehydration
what are causes of hyperalbuminema
dehydration
increase albumin synthesis by glucocorticoids
what is used to differentiate between inflammatory and neoplastic hyperglobulinemia
SPE
what are the 2 basic mechanisms of hypoproteinemia
increased protein loss from vessels
decreased protein production by liver
what cause of hypoproteinemia will you see a globulin level within WRI
PLN (kidney)
in what case of hypoproteinemia would you expect to see a WRI of total protein and albumin
failure of passive transfer or lymphoid hypoplasia
which case of hypoproteinemia is due to decreased production due to decreased liver function
hepatic insufficiency
what would you expect to see in a case of hypoproteinemia with hemorrhage or blood loss
H2O shifts – hemodilution
hypoproteinemia and anemia
what causes the hemodilution in hypoproteinemia due to blood loss
feeling thirsty because of dehydration –> putting more water into the system causing rehydration but also diluting the system
what would you expect to see in a case of hypoproteinemia with protein-losing nephropathy
alpha-2 macroglobulin remain in plasma = proteinuria
hypoalbuminemia (selective!!!)
in what condition would you expect to see hypoproteinemia, hypoalbuminemia and decreased globulins
protein-losing enteropathy
what causes protein-losing enteropathy
increased rate of proteins entering intestine without being resorbed (usually albumin and mostly globulins)
what are some clinical cases in which you would expect to see protein-losing enteropathy
small intestinal mucosal disease
intestinal blood loss due to parasitism
inflammatory exudation
what would you expect to see in a burn patient when it comes to increased protein loss from plasma
protein-losing dermatopathy
what are some signs of protein-losing dermatopathy in a burn patient
hypoproteinemia
hypoalbuminemia
decreased globulins
due to the nature of burns healing, what could be misleading to treating protein-losing dermatopathy in a burn patient in the later stages
increased globulins
inflammatory dysproteinemia
what type of protein loss would cause hypoproteinemia, hypoalbuminemia & decreased globulins because of plasma oozing out of vessels
extravasation of plasma proteins
with a chronic case of extravasation of plasma proteins, what would you expect to see
concurrent inflammatory response would alter proteins such as globulins will increase over time
what are ways hypoproteinemia can occur due to decreased protein production
hepatic insufficiency
malabsorption in the intestines or maldigestion
cachectic stats (malignancies, chronic diseases)
what percent of the liver needs to be damaged in order to start seeing decreased protein production
> 80% loss of functional mass
what is most commonly seen with hepatic insufficiency
decreased production of albumin and (mostly) globulins
why does malabsorption / maldigestion create decreased protein production
decreased intake of nutrient = too few amino acids for protein production
how does the decreased protein production occur in cachectic states
decreased intake of nutrients = increase protein degradation
what are the main 2 ways hypoalbuminemia occurs
decreased albumin production by liver
increased albumin loss from vessels
what are conditions that cause hypoalbuminemia because of decreased albumin synthesis
inflammation
hepatic insufficiency
malabsorption or maldigestion
cachectic states
what are conditions that cause hypoalbuminemia because of increased albumin loss
blood loss
protein-losing nephropathy
protein-losing enteropathy
what is the albumin half life in most mammals
1 week to 10 days
what is the albumin half life in a horse
3 weeks
