Protein Analysis

Question 1

what plasma proteins are made in the liver

Answer 1

albumin
alpha globulins
beta globulins

Question 2

what is made by B-lymphocytes & plasma cells

Answer 2

gamma globulins (immunoglobulins)

Question 3

what are plasma proteins degraded by

Answer 3

macrophages and other cells

Question 4

what is the reference interval for total protein

Answer 4

5-8 g/dL

Question 5

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

Answer 5

total protein

Question 6

what makes up total protein

Answer 6

albumin
globulin

Question 7

what can be used to determine globulin amount

Answer 7

[TP] - [Alb]

Question 8

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

Answer 8

true

Question 9

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

Answer 9

fibrinogen in globulin

Question 10

which sample will traditionally have a lower total protein

Answer 10

serum

Question 11

what are the major physiologic roles of albumin

Answer 11

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

Question 12

what are the major physiological roles of plasma globulins

Answer 12

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

Question 13

what are the positive acute phase plasma globulins

Answer 13

haptoglobin
fibrinogen

Question 14

what are the negative acute phase plasma globulins

Answer 14

albumin

Question 15

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

Answer 15

positive acute phase plasma globulins

Question 16

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

Answer 16

negative acute-phase proteins

Question 17

what occurs soon after onset of inflammation

Answer 17

changes in production to acute phase inflammatory proteins

Question 18

what are the delayed-response proteins

Answer 18

immunoglobulins (gamma) produced by lymphocytes

Question 19

when are delayed-response protein prevalent

Answer 19

increased concentrations occur 1-3 weeks after onset of inflammation

Question 20

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

Answer 20

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

Question 21

what are the 2 ways to measure total protein

Answer 21

refractometry
biuret reaction

Question 22

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

Answer 22

true

Question 23

when would a biuret reaction be most appropriate

Answer 23

chemistry profile

Question 24

when would a refractometry test be the most appropriate

Answer 24

CBC for plasma total protein

Question 25

true or false: refractometry is used to indicated specific proteins

Answer 25

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

Question 26

what can be included in total solids

Answer 26

proteins glucose electrolytes

Question 27

what are some likely caused to falsely indicate increased refractometry readings

Answer 27

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

Question 28

what will not interfere or cause an increase ina refractometry result

Answer 28

bilirubin

Question 29

what is the most common total protein measurement amount for serum

Answer 29

biuret reaction (colormetric)

Question 30

what are the methods for measuring albumin

Answer 30

bromocresol green protein electrophoresis

Question 31

what is used in a bromocresol green test to identify albumin

Answer 31

BCG dye

Question 32

what are some potential interferences with a bromocresol green test

Answer 32

will bind to some globulins hemolysis

Question 33

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

Answer 33

BCG method (bromocresol green)

Question 34

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

Answer 34

albumin - most negatively charged

Question 35

what are characteristics seen due to inflammation on a SPE

Answer 35

increase alpha 2 peak wide based gamma peak

Question 36

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

Answer 36

polyclonal gammopathy (many B-lymphocyte clones)

Question 37

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

Answer 37

increase of acute phase globulins

Question 38

what is the outcome of neoplastic B-lymphocytes

Answer 38

increased production of Ig

Question 39

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

Answer 39

narrow-based region increased in the B2 / gamma globulins

Question 40

what are the main immunoglobulins affected in B-lymphocyte neoplasm

Answer 40

IgM IgA

Question 41

what is most commonly seen with monoclonal gammopathy

Answer 41

B-lymphocyte neoplasm

Question 42

what is most commonly seen with polyclonal gammopathy

Answer 42

inflammation

Question 43

what are 2 ways to analyze fibrinogen concentration in plasma

Answer 43

heat precipitant method thrombin time

Question 44

when is heat precipitant method normally used for fibrinogen

Answer 44

hyperfibriongenemia

Question 45

what are causes of hyperfibrinogenemia

Answer 45

inflammation hemoconcentration (dehydration)

Question 46

what are causes of hypofibrinogenemia

Answer 46

increased fibrinogen consumption decreased synthesis of fibrinogen

Question 47

what causes increased fibrinogen consumption

Answer 47

intravascular coagulation

Question 48

what causes dissemination intravascular coagulation

Answer 48

increased consumption and increased fibrinogenolysis

Question 49

what can be a cause of decreased synthesis of fibrinogen

Answer 49

hepatic insufficiency

Question 50

what are causes of hyperproteinemia

Answer 50

dehydration inflammation B-cell neoplasia

Question 51

what is the cause of hypoproteinemia

Answer 51

protein loss

Question 52

what are signs of hyperproteinemia due to dehydration

Answer 52

total protein increase albumin increase globulin increase

Question 53

what are signs of hyperproteinemia due to inflammation

Answer 53

total protein increase albumin decrease globulin increase

Question 54

what are signs of hyperproteinemia due to B-cell neoplasia

Answer 54

total protein increase albumin decrease globulin increase

Question 55

what is the cause of increased everything in dehydration

Answer 55

decreased plasma water

Question 56

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

Answer 56

cytokines

Question 57

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

Answer 57

B-cell clones produced antibodies

Question 58

what is the most common hyperproteinemia

Answer 58

dehydration (nonselective dysproteinemia)

Question 59

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

Answer 59

true the patient could have been hypoproteinemic before dehydration

Question 60

what are causes of hyperalbuminema

Answer 60

dehydration increase albumin synthesis by glucocorticoids

Question 61

what is used to differentiate between inflammatory and neoplastic hyperglobulinemia

Answer 61

SPE

Question 62

what are the 2 basic mechanisms of hypoproteinemia

Answer 62

increased protein loss from vessels decreased protein production by liver

Question 63

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

Answer 63

PLN (kidney)

Question 64

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

Answer 64

failure of passive transfer or lymphoid hypoplasia

Question 65

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

Answer 65

hepatic insufficiency

Question 66

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

Answer 66

H2O shifts -- hemodilution hypoproteinemia and anemia

Question 67

what causes the hemodilution in hypoproteinemia due to blood loss

Answer 67

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

Question 68

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

Answer 68

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

Question 69

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

Answer 69

protein-losing enteropathy

Question 70

what causes protein-losing enteropathy

Answer 70

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

Question 71

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

Answer 71

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

Question 72

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

Answer 72

protein-losing dermatopathy

Question 73

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

Answer 73

hypoproteinemia hypoalbuminemia decreased globulins

Question 74

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

Answer 74

increased globulins inflammatory dysproteinemia

Question 75

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

Answer 75

extravasation of plasma proteins

Question 76

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

Answer 76

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

Question 77

what are ways hypoproteinemia can occur due to decreased protein production

Answer 77

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

Question 78

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

Answer 78

> 80% loss of functional mass

Question 79

what is most commonly seen with hepatic insufficiency

Answer 79

decreased production of albumin and (mostly) globulins

Question 80

why does malabsorption / maldigestion create decreased protein production

Answer 80

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

Question 81

how does the decreased protein production occur in cachectic states

Answer 81

decreased intake of nutrients = increase protein degradation

Question 82

what are the main 2 ways hypoalbuminemia occurs

Answer 82

decreased albumin production by liver increased albumin loss from vessels

Question 83

what are conditions that cause hypoalbuminemia because of decreased albumin synthesis

Answer 83

inflammation hepatic insufficiency malabsorption or maldigestion cachectic states

Question 84

what are conditions that cause hypoalbuminemia because of increased albumin loss

Answer 84

blood loss protein-losing nephropathy protein-losing enteropathy

Question 85

what is the albumin half life in most mammals

Answer 85

1 week to 10 days

Question 86

what is the albumin half life in a horse

Answer 86

3 weeks