Proteins

Question 1

When would you see a raised IgM

Answer 1

PBC

Question 2

When would you see a raised IgG?

Answer 2

Chronic infection and some AI diseases

Question 3

When would you see a raised IgA?

Answer 3

Micronodular cirrhosis

Question 4

When is alpha fetoprotein raised?

Answer 4

Primary Hepatoma (tumour marker)

Question 5

When is total protein increased?

Answer 5

Dehydration (haemoconcentration)

Hypergammaglobulinemia (increased synthesis)- e.g. in chronic infection (polyclonal) or myeloma (monoclonal).

Question 6

When is total protein reduced?

Answer 6

Haemodilution
Hypoalbuminaemia: protein loss through gut or kidney, malnutrition.
Hypogammaglobuminaemia

Question 7

What are the functions of albumin in the blood?

Answer 7

Transport (e.g. drugs, Ca, Mg, FFAs, hormones (T3 and T4)
Haemodynamics
Nutrition

Question 8

Which proteins are increased in the acute phase response?

Answer 8

Fibrinogen
Haptoglobin
CRP
alpha1 and alpha2 globulins (e.g. alpha-1-antitrypsin, caeruloplasmin, alpha 2-macroglobulin, haptaglobin)

Question 9

Which proteins are decreased in the acute phase response?

Answer 9

Albumin

Transferrin

Question 10

What are the causes of proteinuria?

Answer 10

Benign: orthostatic, exercise, fever
Overload: BJP
Glomerular: Glomerulonephritis, SLE
Tubular: Fanconi's syndrome, heavy metals
Urinary tract: infection