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Clinical Chemistry Spring 2023 > Protein Part 2 > Flashcards

Protein Part 2 Flashcards

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1
Q

What is the functional unit of the liver?

A

Lobule

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2
Q

What protein plays a role in metabolism of drugs and other xenobiotics?

A

Heme-cytochrome P450

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3
Q

What happens to excess amino acids in the body?

A

They get degraded in the liver and stored as fat. They can be turned into energy too by getting converted to material for the TCA cycle.

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4
Q

What is the amino acid range in blood?

A

35 - 65 mg/dL

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5
Q

What is the protein turnover rate in the human body?

A

125 - 220 g/ day

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6
Q

Can albumin store amino acids?

A

Yes

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7
Q

What is HIF, hypoxia inducible factor (intracellular protein)

A

A transcription factor that plays an essential role in the cellular response to low oxygen, or orchestrating a metabolic switch that allows cells to survive in this environment.

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8
Q

What is the formula to find globulin?

A

Total protein - albumin = globulin

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9
Q

What is the normal range A/G ratio?

A

1:1 - 2.5:1

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10
Q

What is the normal range of total protein in serum?

A

Approx. 6.5 - 8.3 g/dL

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11
Q

What is the total albumin normal range in serum?

A

3.5 - 5.5 g/dL

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12
Q

Would albumin level change at early stage of liver disease?

A

They do not change during early stage of liver disease

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13
Q

Would albumin levels change in late stage liver disease?

A

Yes, it would be extremely low because the liver cannot produce anymore albumin. If it gets low enough the body will release immunoglobulins in the body to maintain Oncotic pressure.

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14
Q

What two proteins decrease during acute phase reaction?

A

Albumin and transferrin

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15
Q

List positive acute phase reactant

A

Mannose binding protein
Haptoglobulin
CRP
Ceruloplasmin
Complements
Alpha 1 Anti-trypsin
Ferritin
Fibrinogen
Amyloid

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16
Q

List Negative Acute Phase Reactant

A

Transthyretin
Transferrin
Transportin
Antithrombin
Retinol Binding Protein
Albumin

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17
Q

What are the reasons for hypoproteinemia?

A
  1. Excretion in urine in renal disease
  2. Leakage into the GI tract
  3. Loss of blood
  4. Decreased intake
  5. Decreased synthesis
  6. Increased protein catabolism
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18
Q

What are reasons for hyperproteinemia?

A

Dehydration (most common)
Increased Gamma-globulin
Myeloma
Waldenstrom’s macroglobuliemia
Chronic infection

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19
Q

The a1 hump of serum protein electrophoresis contains…

A

A1-antitrypsin and A1-acid glycoprotein

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20
Q

The A2 hump of serum protein electrophoresis contains…

A

Alpha 2-macrogloulin and haptoglobin

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21
Q

The beta band of the serum protein electrophoresis contains…

A

Hemopexin, transferrin, b-lipoprotein, C3

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22
Q

The gamma band of the serum protein electrophoresis contains…

A

Immunoglobulin

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23
Q

What are other names for pre-albumin?

A

Transthyretin (TTR) or Thyroxine-binding prealbumin (TBPA)

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24
Q

What is the role of transthyretin (TTR)/Thyroxine-binding prealbumin (TBPA)

A

Serves as a transport protein for a small fraction of thyroid hormones, esp. thyroxine. It binds with retinol-binding protein to transport retinol.

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25
True or false, Prealbumin fractions are typically seen on SPE.
False they are not per notes
26
What is the clinical significance of pre-albumin fraction?
1. Very sensitive marker of poor protein nutritional status 2. Increased in patients on steroids, or have chronic renal failure. 3. Decreased in elastic damage, acute phase inflammatory response, and tissue necrosis
27
What is the half life of prealbumin?
2 days or shorter b/c it can go through the glomerulus
28
What is the half life of albumin?
20 days
29
What is Oncotic pressure?
An effect that protein pulls water into compartment, as the force of osmosis tries to equalize the amount of water in blood and in the interstitial fluid. The pulling power is called Oncotic pressure.
30
What is the function of albumin fraction?
1. Maintain Oncotic pressure 2. Maintenance of colloid osmotic pressure of intravascular fluid 3. Binding of various substances in blood (Negativity) 4. Serves as a nutritional source of amino acids when necessary 5. Buffering capacity - maintaining acid-base balance
31
Hypoalbuminemia production decreases when?
Malnutrition & liver disease
32
Hypoalbuminemia increases loss / use after synthesis when…
GI tract via intestinal leakage Loss in renal disease Burns Acites (liver cirrhosis) Inflammation / neoplasm Pregnancy (used by baby)
33
What happens to Oncotic pressure in edema?
It decreases leading to water leakage into tissue
34
Reasons for hyperalbuminemia?
Usually due to dehydration or a relative decrease
35
What is bisalbuminemia?
Non-harmful to the individual (so far) and is an unusual molecular characteristic.
36
What is albuminemia?
Extremely low or absent albumin
37
Function of A1-antitrypsin (APR)
Neutralizes trypsin and trypsin like enzymes. Examples are protease inhibitor and neutrophil elastase.
38
A1-antitrypsin levels can increase during…?
Acute phase reaction, pregnancy, and oral contraceptive use
39
A1-antitrypsin deficiencies occur in
Emphysematous pulmonary disease and juvenile hepatic cirrhosis and chronic liver disease
40
What are other names for alpha-1 acid glycoprotein?
Orosomucoid or AAG
41
What is the function of alpha-1 acid glycoprotein?
1. Maintain cell membrane formation and fibers associated with collagen. 2. Maintain mucus membrane integrity.
42
AAG cannot stain well in SPE because of high carb content, what would you use to quantify it?
Immunonephelomerty, immuno fixation, and immunoassay
43
What are conditions when alpha-1 acid glycoprotein increases?
Any conditions relating to cell proliferation. Examples are acute phase reaction, pneumonia, RA, pregnancy, cancer
44
What are conditions that would lead to a decrease in alpha-1 acid glycoprotein?
Inborn errors of metabolism
45
Alpha-1 Fetoprotein is made by what and where?
Synthesized by fetal yolk sac and parenchyma cells of the fetal liver. It gradually decreases after birth.
46
What is the clinical significance of A1-fetoprotein (AFP)?
The elevation of A1-fetoprotein is indicative of liver hepatocellular carcinoma or gonad tumor. In other words it is a marker of cancer in an adult.
47
A1-fetoprotein can be detected in maternal blood up to…?
7-8 months
48
A1-Fetoprotein can be used for what other purpose besides cancer detection?
Used as a screening test for several fetal conditions between 12 & 20 weeks gestational age.
49
Elevated A1-fetoproteins in a pregnant woman can mean…?
TWINS! Bad news Anencephaly, spina bifida (neural tube defects) spine not closed, atresia (ear opening is closed), fetal distress ataxia-telangiectasia (Louis-Barr Syndrome), and hemolytic anemia
50
Low levels of AFP in pregnant women may suggest…?
3-4X increased risk for Down Syndrome
51
Alph2 macroglobulin functions are…?
1. Neutralize enzymes 2. Carrier for zinc 3. Role in the innate or nonspecific immune response
52
What are two methods to measure alpha2 macroglobulin?
Nephelometry and immunoassay
53
Alpha 2 macroglobulin increases are observed in what condition?
Nephrotic
54
Prothrombin’s function is?
Convert thrombin in process of coagulation
55
What is a method to measure prothrombin?
Prothrombin time
56
Decreases in prothrombin are observed in what conditions?
1. Liver disease 2. Vitamin K deficiency
57
What is the function of thyroid binding globulin?
Transport protein for T3 and T4
58
What are methods to measure T3 and T4?
Immunoassay Indirect by T3 uptake TBG binding capacity
59
Thyroid binding globulin decrease is observed when?
When the body has high demands for it.
60
Haptoglobulin purpose is?
Binds free hemoglobin to prevent loss of hemoglobin via urine, and to transport it to the liver for recycling.
61
What are methods to measure haptoglobin?
Immuno Nephelometry haptoglobin electrophoresis Immunoassay
62
Haptoglobin increases when a patient experiences…?
1. Burns 2. Nephrotic syndrome 3. Rheumatic disease 4. Stress 5. Infection 6. Acute infection 7. Tissue necrosis
63
Haptoglobin decreases when?
In vitro hemolysis
64
Ceruloplasmin function is to…?
1. Transport protein for copper 2. Enzymatic activities: Cu oxidase, histamines, ferroxidase
65
Ceruloplasmin is measures using…
Immunonephelometry Immunoassay
66
Ceruloplasmin increases when…?
1. Inflammation 2. Pregnancy 3. Malignancies 4. Oral estrogen therapy
67
Ceruloplasmin decreases when a patient…
Has Wilson’s disease, Menke’s Kinky hair syndrome
68
Erythropoietin function is…?
Protein hormone produced in the kidney that stimulates erythropoiesis, releases young RBCs, and reduces maturation time for RBCs.
69
Decreases in erythropoietin is observed in patients with…?
Stage 3 renal disease
70
Fibrinogen does what?
It’s coagulation factor 1. It is converted to fibrin by thrombin.
71
Fibrinogen increases when?
During inflammation, pregnancy, and oral contraceptives
72
Fibrinogen is measured how?
By coagulation
73
Describe fibrinogen in an electrophoresis?
Forms a distinct band between beta and gamma areas when plasma is electrophoresised
74
Plasminogen….
Lysis fibrin clots
75
Complements purpose. Is…
Enhancing nonspecific cellular immune response such as phagocytosis, anaphylaxis, and lysis
76
Complement levels decrease in what conditions…?
Malnutrition DIC SLE RA Recurrent infection
77
How is complement measured?
1. Immunonephelometry 2. Immunoassay 3. CH50 (SHEEP RBC + AB) 4. Total hemolytic complement
78
C-1 esterase inhibitors inhibit…?
C1 esterase. (Activated C-1)
79
Deficiency C-1 esterase inhibitor is seen in what condition?
Deficiency results in angioneurotic edema
80
Hemopexin function is
Binds free heme
81
Elevated Hemopexin levels are seen in
Acute phase reaction (inflammation?)
82
Decreases in Hemopexin are seen in…?
IV hemolysis and hemolytic anemia
83
What are two methods to measure Hemopexin?
Nephelometry and immunoassay

Clinical Chemistry Spring 2023 (6 decks)

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