Proteins and enzymes in blood

Question 1

Most of plasma protein

Answer 1

Albumin
40 g/L
Oncotic pressure, binds things (bili), buffer, aa source.
Reduced in disease: less production, permeable capillaries, more renal and GI loss.

Question 2

CRP

Answer 2

Acute phase protein:
6-8 hours after tissue damage.
Should be

Question 3

Alpha-1-globulin

Answer 3

= alpha-1-antitrypsin
Antagonist to serine proteases.
Positive acute phase protein.

Question 4

Alpha-2-globulins

Answer 4

1. Haptoglobulins

2. Caeruloplasmin - holds copper

Question 5

Beta-globulins

Answer 5

1. Transferrin - transports iron in plasma. Negative acute phase protein.
2. LDL
3. Complements.

Question 6

Gamma-globulins (with concentrations)

Answer 6

IgG   14 g/L 
IgA    2.5
IgM    1.5
IgD    0.03 
IgE     Trace

Question 7

Tumour markers

Answer 7

PSA 
AFP - Liver 
Ca19-9 - Pancreas 
Ca125 - Ovarian 
CEA - colorectal

Question 8

Amylase

Answer 8

High in acute pancreatitis

Question 9

Creatinine kinase

Answer 9

Muscle damage 
Can be physiologically high in Afrocabs 
Pathological: 
 - Duchenne Muscular Dystrophy 
 - MI 
 - Statin myopathy 
 - Rhabdomyolysis

Question 10

Alkaline Phosphatase

Answer 10

Lots in liver, bone, intestine and placenta.
Physiological rise in pregnancy and childhood.
Pathological rise is bone or liver:
- >5x ULN: Paget’s, osteomalacia, cholestasis, cirrhosis
- less: tumours, fractures, osteomyelitis, infiltrated liver, hepatitis.

Question 11

Troponin

Answer 11

Myocardial injury
Measure at 6hr and 12hrs post onset of chest pain.
Stays elevated for a week.

Question 12

Markers of liver cell damage

Answer 12

ALT, 
AST, 
Alk phos, 
gamma GT, 
Bilirubin.

Question 13

Aminotransferases (ALT and AST)

Answer 13

1 = viral.

Question 14

Alkaline phosphatase

Answer 14

30-150 iu/L

Raised in cholestasis, bone disease and pregnancy.

Question 15

Gamma GT

Answer 15

30-150iu/L (also)

Raised in chronic alcohol use, bile duct disease and metastases. Also shows that high ALP is hepatic.