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Medical Biochemistry > protein electrophoretogram > Flashcards

protein electrophoretogram Flashcards

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USMLE® Step 1 flashcards
1
Q

Fraction: Pre-albumin

A

prealbumin

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2
Q

Function: pre-albumin

A
  • Transport protein for thyroid hormones (transthyretin)
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3
Q

Pos or neg APR: Pre-Albumin

A

Neg (decreases during inflammation)

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4
Q

Condition(s) in which it ↓: Pre-Albumin

A

Malnutrition (sensitive marker of protein nutritional status)

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5
Q

Fraction: Albumin

A

Albumin

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6
Q

Function: Albumin

A
  1. Maintains fluid balance between blood and interstitial fluid by contributing 80% of colloidal osmotic (oncotic) pressure of intravascular fluid
  2. Transports insoluble substances in blood
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7
Q

Pos or Neg APR: Albumin

A

neg (decreases in inflammation)

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8
Q

Condition(s) in which it ↓: Albumin

A
  • Decreased synthesis (malnutrition, liver failure, acute inflammation or infection (Neg APR))
  • Increased loss (nephrotic syndrome)
  • Causes edema when serum Alb is < 2.5 g/dL Edema: excessive accumulation of interstitial fluid
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9
Q

Conditions in which it ↑ if applicable: Albumin

A

dehydration

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10
Q

Fraction: alpha-1-antitrypsin

A

alpha 1

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11
Q

Function: alpha-1-antitrypsin

A
  • major protein of ⍺1 fraction
  • A trypsin inhibitor that prevents over-catabolism of structural protein in the lung
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12
Q

Pos or neg APR: alpha-1-antitrypsin

A

Pos (increases during inflammation)

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13
Q

Condition(s) in which it ↓ if applicable: alpha-1-antitrypsin

A
  • in congenital alpha-1-antitrypsin deficiency
  • Causes pulmonary emphysema
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14
Q

Fraction: alpha-1-fetoprotein

A

alpha 1

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15
Q

Function: alpha-1-fetoprotein

A
  • principal fetal protein
  • synthesized by developing embryo & fetal liver
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16
Q

Condition(s) in which it ↓ if applicable: alpha-1-fetoprotein

A
  • Decrease in maternal blood: Down Syndrome
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17
Q

Conditions in which it ↑: alpha-1-fetoprotein

A
  • Increased in maternal blood: spinal bifida, or open neural tube defect
  • If present in adult serum: hepatocellular carcinoma, germ cell tumors (ie. testicular cancer)
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18
Q

Fraction: Haptoprotein

A

alpha 2

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19
Q

Function: Haptoglobin

A
  • A glycoprotein and a major component of ⍺2 fraction
  • Binds free Hgb (but not Mgb) during intravascular hemolysis
  • HAP-Hgb complex cleared by reticulo-endothelial cells (prevents renal loss of Hgb)
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20
Q

Pos or Neg APR: Haptoglobin

A

Pos (increased during inflammation, infection, or malignancy)

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21
Q

Condition(s) in which it ↓: Haptoglobin

A

Decreased in intravascular hemolysis → sensitive indicator of intravascular hemolysis

22
Q

Fraction: alpha-2-macroglobulin

A

alpha 2

23
Q

Function: alpha-2-macroglobulin

A
  • A major component of ⍺2 fraction
  • The largest non-immunoglobulin protein in plasma
  • Is a protease inhibitor, inhibits variety of proteinases (trypsin, thrombin, kallikrein & plasmin)
24
Q

Conditions in which it ↑: alpha-2-macroglobulin

A

– Increased: in nephrotic syndrome, Increased synthesis to maintain oncotic pressure due to loss in albumin

25
Q

Fraction: ceruloplasmin

A

alpha 2

26
Q

Function: Ceruloplasmin

A
  • Is a Cu transport protein, binds 90% of body copper (Cu), prevents its deposition in organs
  • Also a Cu-containing oxidase enzyme
    Regulates Fe absorption, transport & utilization by oxidizing Fe2+ to Fe3+ (only Fe3+ can bind to transferrin & be stored in ferritin)
27
Q

Pos or neg APR: ceruloplasmin

A

Pos (increases during inflammation)

28
Q

Condition(s) in which it ↓: ceruloplasmin

A
  • Menkes syndrome (congenital, kinky hair Dz)
    Impaired intestinal absorption of Cu2+, Serum Cu2+ ↓
  • Wilson’s Dz (congenital, Kayser-Fleischer rings)
    Cu2+ cannot be incorporated into Cp → toxic deposits of Cu2+ in tissues → damage, esp liver & brain
    Serum Cu2+ ↓, urine Cu2+ ↑ & biopsy liver Cu2+ positive
29
Q

Fraction: transferrin

A

beta

30
Q

Function: transferrin

A

The major component of the β fraction

Transports Fe3+ to bone marrow, liver, & RE cells for storage by ferritin

31
Q

Pos or neg APR: transferrin

A

Neg (decreases in inflammation)

32
Q

Conditions in which it ↑: transferrin

A

Iron deficiency anemia (compensatory mechanism to enhance Fe absorption)

33
Q

Fraction: beta-2-microglobulin

A

beta

34
Q

Function: beta-2-microglobulin

A
  • A light chain of the MHC (major histocompatibilit y complex) found on the surface of most nucleated cells; esp. high on lymphocytes
  • Functions to present Ags to cytotoxic T lymphocytes
35
Q

Condition(s) in which it ↓: Beta-2-microglobulin

A
  • increased cellular destruction (leukemia, MM, or renal transplant rejection) → urine levels also increase
  • Renal failure (↓ GFR) → urine levels ↓
36
Q

Conditions in which it ↑: Beta-2-microglobulin

A

Decrease (often normal) in blood but increased in urine

Suggests renal tubular Dz (↓ reabsorbed & catabolized by RTE)

37
Q

Fraction: Complement proteins, C3 & C4

A

beta

38
Q

Function: Complement proteins, C3 & C4

A

identify, destroy and remove foreign pathogens and damaged ‘self’ materials

39
Q

Pos or Neg APR: Complement Proteins, C3 & C4

A

Pos (increase during inflammation + certain types of cancer)

40
Q

Condition(s) in which it ↓: Complement proteins, C3 & C4

A
  • Autoimmune disease (lupus, rheumatologic)
  • Recurrent infection (usually bacterial)
  • Others: immune complex-induced renal Dzs
41
Q

Fraction: fibrinogen

A

beta-gamma interzone

42
Q

Function: fibrinogen

A

Functions in thrombosis

43
Q

Pos or Neg APR: fibrinogen

A

Pos (increases during inflammation)

44
Q

Condition(s) in which it ↓: fibrinogen

A

Disseminated intravascular coagulation (DIC)

45
Q

Fraction: C-reactive protein

A
  • Involved in innate immunity by activating complement → enhances phagocytosis of bacteria & fungi
  • is the most sensitive APR, compared to other APRs (HAP & C3,C4), it rises the fastest & highest
46
Q

Pos or Neg APR: C-reactive protein

A

Pos (increased during inflammation)

47
Q

Conditions in which it ↑: C-Reactive Protein

A 
Infection or inflammation (a key inflammatory marker)- CRP test
Cardiovascular Dz (a marker for cardiovascular Dz risk)- hs-CRP (high sensitive)
48
Q

Fraction: Immunoglobulins

A

gamma

49
Q

Function: immunoglobulins

A

Produced by plasma cells in blood & lymph in response to infection

50
Q

Pos or Neg APR: Immunoglobulins

A

Pos

51
Q

Condition(s) in which it ↓: Immunoglobulins

A

immunodeficiency: congenital or acquired (HIV)

52
Q

Conditions in which it ↑: Immunoglobulins

A
  • Polyclonal gammopathy → broad peak

o Infection or chronic inflammatory conditions

  • Monoclonal gammopathy → single sharp peak

o Multiple Myeloma: IgG, IgA, IgM rare

o Waldenstrom’s macroglobuline mia: IgM

Medical Biochemistry (2 decks)

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