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Boards.CP.Chemistry > Proteins > Flashcards

Proteins Flashcards

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1
Q

What is the most abundant serum protein?

A

Albumin

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2
Q

What are the manifestations of Analbuminemia?

A
  • Mild Edema

- Hyperlipidemia

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3
Q

Clinical utility of measuring Albumin? (5)

A
  • Nutritonal status
  • Hepatic synthetic function
  • Renal glomerular function
  • Negative acute phase reactant
  • Diabetic control
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4
Q

What is the T1/2 of albumin?

A

17 days

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5
Q

What is glycated albumin an indicator of?

A

short term glycemic control

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6
Q

Function of Prealbumin.

A
  • Binds thyroxine (transthyretin [TTR])

- Binds aRetinol binding protein (Vit.A complex)

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7
Q

Clinical utility of measuring Prealbumin? (3)

A
  • Nutritional status
  • Negative acute phase reactant
  • Hallmark of CSF protein electrophoresis
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8
Q

What is the major component of the alpha1 band?

A

-Alpha1-Antitrypsin (AAT)

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9
Q

Alpha1-Antitrypsin (AAT):

  • Gene
  • # of alleles
  • MC allele
  • MC genotype
A
  • SERPINA1
  • > 100 alleles (Polypmorphic)
  • PiM (MC allele)
  • PiMM (MC genotype)
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10
Q

Genotype for AAT deficiency?

A

PiZZ

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11
Q

What is the major component of increased alpha1 ban in acute inflammatory states?

A

Alpha1-Glyocoprotein

*Normally only a minor component of a1 band

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12
Q

Relative concentrations of a2-macroglobulin is elevated in what conditions?

A

-Liver and Kidney disease

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13
Q

T/F: a2-macroglobulin is lost in nephrotic syndrome.

A

False

-large size prevents loss, leading to a relative 10 fold rise in concentation

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14
Q

Ceruloplasmin is involved in what disease?

A

Wilson’s Disease

-Decreased levels

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15
Q

what is the 3rd major component of the a2 band?

A

Haptoglobin

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16
Q

What is the role of Haptoglobin?

A

Binds free Hb

-Rapidly depleted in Intravascular Hemolysis

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17
Q

What is the major Beta Globulin?

A

Transferrin

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18
Q

Function of Transferrin.

A

Transports Ferric (Fe3+)

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19
Q

Transferrin levels in IDA.

A

Markedly INcreased

*normally ~30% Saturated

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20
Q

Transferrin:

-Hallmarks of CSF electrophoresis

A
  • Asialated transferrin (so called tau protein)

- Double transferrin peak

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21
Q

What is a beta-globulin that is usually absent from serum?

A

Fibrinogen

22
Q

When might you see Fibrinogen on electrophoresis?

A

If specimen clots incompletely

  • May produce psuedo M spike
  • May straddle beta/gamma interface
23
Q

Where is C reactive protein (CRP) found on SPEP?

A

-gamma region

24
Q

What is a normal CRP value?

A

<3 mg/L

25
Q

What is a HIGH level CRP elevation, and what may it indicate?

A

> 10 mg/L

-Active inflammation

26
Q

What is a LOW level CRP elevation, and what may it indicate?

A

3-10 mg/L

  • Cellular stress
  • Correlated with higher all cause mortality
  • Poor outcome following CV events
27
Q

Normal SPEP pattern.

A
  • Large albumin band (prealbumin invisible)
  • small peaked a1 band
  • broad a2 band
  • bimodal beta
  • broad gamma
28
Q

Bisalbuminemai SPEP pattern.

A

Double albumin spike

  • Heterozygotes for albumin alleles
  • Insignificant
29
Q

AAT deficiency pattern.

A

Absent A1 band

-not the most sensitive or specific assay

30
Q

Nephrotic syndrome SPEP pattern.

A

Decrease of ALL bands
-EXCEPT a2 band that contains a2-macroglobulin

*loss of small serum proteins, particularly Albumin

31
Q

Acute inflammation SPEP pattern.

A
  • Decreased Albumin
  • Increased a1 and a2 bands
  • normal to increased gamma band
32
Q

When is Beta-gamma bridging seen?

A
  • Cirrhosis

- Increased serum IgA

33
Q

What are additional features seen in beta-gamma bridging?

A
  • Hypoalbuminemia

- Blunted a1 and a2 bands

34
Q

M spike is most commonly due to what conditions? (3)

A
  • Plasma cell neoplasm
  • Waldenstrom (lymphoplasmacytic lymphoma)
  • CLL/SLL
35
Q

What causes a pseudo M spike? (6)

A
  • Fibrinogen (incompletely clotted)
  • Hemoglobin (hemolyzed)
  • CRP Increase
  • Transferrin Increase
  • Abx/contrast dyes
  • Tumor markers
36
Q

Where are most IgG paraproteins found in SPEP?

A

gamma region

37
Q

Where are most IgM paraproteins found in SPEP?

A

beta-gamma interface

38
Q

Where are most IgA paraproteins found in SPEP?

A

beta region

39
Q

T/F: CSF normally contains essentially all proteins present in serum.

A

True; although smaller quantities

40
Q

What are the characteristic features of CSF on PEP?

A
  • Prominent Prealbumin band

- Double beta (transferrin) band

41
Q

Findings of CSF electrophoresis in MS?

A

Oligoclonal bands

-should be Absent from serum

42
Q

Urine Electrophoresis:

-Glomerular proteinuria

A
  • Strong Albumin
  • Strong a1
  • Strong Beta

*Intermediate sized proteins - Albumin, AAT, transferrin

43
Q

Urine Electrophoresis:

- Tubular proteinuria

A
  • Weak Albumin
  • Strong a1
  • Strong Beta
44
Q

Urine Electrophoresis:

- Overflow proteinuria

A
  • Monoclonal light chain (Bence Jones)

- Absent albumin, a1, a2, beta (decreased)

45
Q

Definition of cyroglobulins.

A

Immunoglobulins that precipitate reversibly at low temperature.

46
Q

Steps for detecting cyroglobulins.

A
  • 37 till clotted
  • centrifuge at 37
  • Serum placed at 4 for >3 days
  • centrifuge at 4
  • precipitate is cryoglobulin
  • characterized by electrophoresis or immunofixation
47
Q

What are type I cryoglobulins?

A

-Monoclonal Igs ass. w/ MM or Waldenstrom

48
Q

What are type II cryoglobulins?

A
  • Mixture of a monoclonal IgM and Polyclonal IgG

- IgM has rheumatoid factor activity (anti IgG)

49
Q

What are type III cryoglobulins?

A
  • Mixture of 2 polyclonal Igs (typically IgG and IgM)

- IgM has rheumatoid factor activity

50
Q

What is the most common type of cryoglobin?

A

Type II

51
Q

What is the MCC of mixed cryoglobinemia (types II and III)

A

HCV infection

52
Q

what is the pH for Electrophoresis of serum? How are the bands measures?

A
  • 8.6

- Densitometry

Boards.CP.Chemistry (17 decks)

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