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Clinical Chemistry Spring 2023 > Protein Part 2 > Flashcards

Protein Part 2 Flashcards

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
Q

True or false, Prealbumin fractions are typically seen on SPE.

A

False they are not per notes

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26
Q

What is the clinical significance of pre-albumin fraction?

A
  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
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27
Q

What is the half life of prealbumin?

A

2 days or shorter b/c it can go through the glomerulus

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28
Q

What is the half life of albumin?

A

20 days

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29
Q

What is Oncotic pressure?

A

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.

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30
Q

What is the function of albumin fraction?

A
  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
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31
Q

Hypoalbuminemia production decreases when?

A

Malnutrition & liver disease

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32
Q

Hypoalbuminemia increases loss / use after synthesis when…

A

GI tract via intestinal leakage
Loss in renal disease
Burns
Acites (liver cirrhosis)
Inflammation / neoplasm
Pregnancy (used by baby)

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33
Q

What happens to Oncotic pressure in edema?

A

It decreases leading to water leakage into tissue

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34
Q

Reasons for hyperalbuminemia?

A

Usually due to dehydration or a relative decrease

35
Q

What is bisalbuminemia?

A

Non-harmful to the individual (so far) and is an unusual molecular characteristic.

36
Q

What is albuminemia?

A

Extremely low or absent albumin

37
Q

Function of A1-antitrypsin (APR)

A

Neutralizes trypsin and trypsin like enzymes. Examples are protease inhibitor and neutrophil elastase.

38
Q

A1-antitrypsin levels can increase during…?

A

Acute phase reaction, pregnancy, and oral contraceptive use

39
Q

A1-antitrypsin deficiencies occur in

A

Emphysematous pulmonary disease
and juvenile hepatic cirrhosis and chronic liver disease

40
Q

What are other names for alpha-1 acid glycoprotein?

A

Orosomucoid or AAG

41
Q

What is the function of alpha-1 acid glycoprotein?

A
  1. Maintain cell membrane formation and fibers associated with collagen.
  2. Maintain mucus membrane integrity.
42
Q

AAG cannot stain well in SPE because of high carb content, what would you use to quantify it?

A

Immunonephelomerty, immuno fixation, and immunoassay

43
Q

What are conditions when alpha-1 acid glycoprotein increases?

A

Any conditions relating to cell proliferation. Examples are acute phase reaction, pneumonia, RA, pregnancy, cancer

44
Q

What are conditions that would lead to a decrease in alpha-1 acid glycoprotein?

A

Inborn errors of metabolism

45
Q

Alpha-1 Fetoprotein is made by what and where?

A

Synthesized by fetal yolk sac and parenchyma cells of the fetal liver. It gradually decreases after birth.

46
Q

What is the clinical significance of A1-fetoprotein (AFP)?

A

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
Q

A1-fetoprotein can be detected in maternal blood up to…?

A

7-8 months

48
Q

A1-Fetoprotein can be used for what other purpose besides cancer detection?

A

Used as a screening test for several fetal conditions between 12 & 20 weeks gestational age.

49
Q

Elevated A1-fetoproteins in a pregnant woman can mean…?

A

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
Q

Low levels of AFP in pregnant women may suggest…?

A

3-4X increased risk for Down Syndrome

51
Q

Alph2 macroglobulin functions are…?

A
  1. Neutralize enzymes
  2. Carrier for zinc
  3. Role in the innate or nonspecific immune response
52
Q

What are two methods to measure alpha2 macroglobulin?

A

Nephelometry and immunoassay

53
Q

Alpha 2 macroglobulin increases are observed in what condition?

54
Q

Prothrombin’s function is?

A

Convert thrombin in process of coagulation

55
Q

What is a method to measure prothrombin?

A

Prothrombin time

56
Q

Decreases in prothrombin are observed in what conditions?

A
  1. Liver disease
  2. Vitamin K deficiency
57
Q

What is the function of thyroid binding globulin?

A

Transport protein for T3 and T4

58
Q

What are methods to measure T3 and T4?

A

Immunoassay
Indirect by T3 uptake TBG binding capacity

59
Q

Thyroid binding globulin decrease is observed when?

A

When the body has high demands for it.

60
Q

Haptoglobulin purpose is?

A

Binds free hemoglobin to prevent loss of hemoglobin via urine, and to transport it to the liver for recycling.

61
Q

What are methods to measure haptoglobin?

A

Immuno Nephelometry
haptoglobin electrophoresis
Immunoassay

62
Q

Haptoglobin increases when a patient experiences…?

A
  1. Burns
  2. Nephrotic syndrome
  3. Rheumatic disease
  4. Stress
  5. Infection
  6. Acute infection
  7. Tissue necrosis
63
Q

Haptoglobin decreases when?

A

In vitro hemolysis

64
Q

Ceruloplasmin function is to…?

A
  1. Transport protein for copper
  2. Enzymatic activities: Cu oxidase, histamines, ferroxidase
65
Q

Ceruloplasmin is measures using…

A

Immunonephelometry
Immunoassay

66
Q

Ceruloplasmin increases when…?

A
  1. Inflammation
  2. Pregnancy
  3. Malignancies
  4. Oral estrogen therapy
67
Q

Ceruloplasmin decreases when a patient…

A

Has Wilson’s disease, Menke’s Kinky hair syndrome

68
Q

Erythropoietin function is…?

A

Protein hormone produced in the kidney that stimulates erythropoiesis, releases young RBCs, and reduces maturation time for RBCs.

69
Q

Decreases in erythropoietin is observed in patients with…?

A

Stage 3 renal disease

70
Q

Fibrinogen does what?

A

It’s coagulation factor 1. It is converted to fibrin by thrombin.

71
Q

Fibrinogen increases when?

A

During inflammation, pregnancy, and oral contraceptives

72
Q

Fibrinogen is measured how?

A

By coagulation

73
Q

Describe fibrinogen in an electrophoresis?

A

Forms a distinct band between beta and gamma areas when plasma is electrophoresised

74
Q

Plasminogen….

A

Lysis fibrin clots

75
Q

Complements purpose. Is…

A

Enhancing nonspecific cellular immune response such as phagocytosis, anaphylaxis, and lysis

76
Q

Complement levels decrease in what conditions…?

A

Malnutrition
DIC
SLE
RA
Recurrent infection

77
Q

How is complement measured?

A
  1. Immunonephelometry
  2. Immunoassay
  3. CH50 (SHEEP RBC + AB)
  4. Total hemolytic complement
78
Q

C-1 esterase inhibitors inhibit…?

A

C1 esterase. (Activated C-1)

79
Q

Deficiency C-1 esterase inhibitor is seen in what condition?

A

Deficiency results in angioneurotic edema

80
Q

Hemopexin function is

A

Binds free heme

81
Q

Elevated Hemopexin levels are seen in

A

Acute phase reaction (inflammation?)

82
Q

Decreases in Hemopexin are seen in…?

A

IV hemolysis and hemolytic anemia

83
Q

What are two methods to measure Hemopexin?

A

Nephelometry and immunoassay

Clinical Chemistry Spring 2023 (6 decks)

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