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Clinical Biochem > Serum Proteins > Flashcards

Serum Proteins Flashcards

1
Q

What is the reference range for serum total protein

A

64-84 g/L

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2
Q

What is the reference range for serum albumin

A

30-45 g/L

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3
Q

What is the reference range for urine total protein

A

<0.5 g/volume

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4
Q

What is the reference range of CSF total protein

A

0.15-0.45 g/L

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5
Q

What are the indications for ordering SPE

A
  • suspected multiple myeloma or waldenstroms macrogolbulinemia
  • suspected primary amyloidosis
  • new-onset anemia associated with renal failure or insufficiency and bone pain
  • hypercalcemia
  • rouleaux formations
  • renal insufficiency with associated serum protein elevation
  • unexplained pathologic fracture or lytic lesion
  • monoclonal free light chain proteinuria
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6
Q

What is the relative % of the albumin fraction

A

53-65%

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7
Q

What is the relative % of the A1 fraction

A

2.5-5%

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8
Q

What is the relative % of the A2 fraction

A

7-13%

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9
Q

What is the relative % of the B fraction

A

8-14%

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10
Q

What is the relative % of the Y fraction

A

12-22%

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11
Q

What is albumin

A

synthesized by the liver it is a negative acute phase reactant that binds and transports many substances including acidic drugs, bilirubin and calcium as well as controling colloidal oncotic pressure

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12
Q

When is albumin decreased

A

liver disease, nephrotic syndrome and acute and chronic inflammation as well as multiple myelona

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13
Q

What are the proteins in the A1 fraction

A
  • A1 antititrypsin
  • A1 lipoproteins
  • A1 acid glycoprotein
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14
Q

What is A1 antititrypsin

A

an acute phase reactant synthesized by the liver

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15
Q

What is A1 lipoproteins

A

HDL and apoliporptein A-1, transports cholesterol and fat-soluble vitamins

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16
Q

What is A1 acid glycoprotein

A

an acute phase reactant that binds basic and lipophilic drugs, produced by the liver

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17
Q

What are the proteins in the A2 fraction

A
  • A2 macroglobulin
  • haptoglobin
  • ceruloplasmin
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18
Q

What is A2 macroglobulin

A

synthesized by the liver it is markedly increased in nephrotic syndrome and decreased in pancreatitis and prostate cancer

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19
Q

What is hapotglobin

A

an acute phase reactant that is synthesized by the liver, it binds and transports free hemoglobin. Increased in nephrotic syndrome and inflammation, decreased in intravascular hemolysis and liver disease

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20
Q

What is ceruloplasmin

A

an acute phase reactant synthesized by the liver, it binds 90% of the bodies copper. Increased in inflammation and severe infection, decreased in nephrotic syndrome, liver disease and malnutrition

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21
Q

What proteins make up the B fraction

A
  • B-lipoproteins
  • transferrin
  • B2 microglobulin
  • fibrinogen
  • C3, C4
22
Q

What are B-lipoproteins

A

synthesized in the liver, VLDL and LDL, transports cholesterol, phospholipids and hormones

23
Q

What is transferrin

A

synthesized by the liver, a negative acute phase reactant that transfers iron, increased in IDA, decreased in inflammation, liver disease, protein malnutrition and nephrotic syndrome

24
Q

What is B2 microglobulin

A

the light (B) chain of HLAs, increased in renal failure, inflammation and tumors

25
Q

What is fibrinogen

A

seen in plasma samples, synthesized by the liver it is an acute phase reactant and a coagulation protein

26
Q

What is C3, C4

A

complement factors, decreased in SLE, nephrotic syndrome, chronic renal and liver disease, increased in acute inflammation

27
Q

What proteins are in the Y fraction

A
  • immunoglobulins
  • CRP
28
Q

What are immunoglobulins

A

produced by plasma cells, involved in humoral immunity, increased in infection, autoimmune disease, myeloma, decreased in nephrotic syndrome, burns or inherited disease

29
Q

What is CRP

A

synthesized by the liver, acute phase reactant that activates the classical complement pathway

30
Q

What is a monoclonal gammopathy

A

characterized by the presence of a monoclonal peak resulting from the overproduction of a paraprotein

31
Q

What is acute inflammation

A

characterized by a decrease in albumin and increases in the fractions with positive acute phase proteins (gamma fraction may be increased if the immune system has had an opportunity to react)

32
Q

What is chronic inflammation

A

a similar pattern to acute inflammation but the changes are more pronounced

33
Q

What is liver failure

A

characterized by an increase in the gamma fraction to produce a B-Y bridge

34
Q

What is nephrotic syndrome

A

characterized by a decrease in albumin, A1 and Y fractions and increases in A2 and B fractions

35
Q

What is antibody deficiency

A

characterized by a decrease in the gamma fraction

36
Q

What is immunofixation electrophoresis

A

a sensitive method for the detection and identification of monoclonal components in the serum or urine

37
Q

How does immunofixation electrophoresis work

A

the sample is separated by agarose gel electrophoresis and different antiserums are added, the antibody-antigen complexes precipitate out and others are removed by washing the gel

38
Q

What are praproteins

A

a monoclonal immunoglobulin, polymers of immunoglobulin or light chain present in the blood or urine

39
Q

What is MGUS

A

monoclonal gammopathies of undetermined significance

40
Q

What are bence jones proteins

A

monoclonal free light chains seen in the blood and urine of patients with multiple myeloma

41
Q

What are macroglobulins

A

cause an increase in serum viscosity and seen in Waldenstroms macroglobulinemia

42
Q

What are cryoglobulins

A

proteins that precipitate at a temperature below 37C and dissolve upon warming up to body temperature

43
Q

What are cryoglobulins associated with

A

lymphoproliferative disorders, autoimmune diseases, infectious disease (hep C)

44
Q

What is the concern with cryoglobulins

A

they can falsely increase the WBC count on the coulter so a manual WBC count must be done

45
Q

What is oligoclonal banding

A

bandings that are seen in the CSF but not in the serum

46
Q

What increases serum total protein

A

dehydration, hyperlipidemia, monoclonal gammopathy, inflammatory reactions, hyperimmunoglobulinemia

46
Q

What can be used to measure albumin

A

bromocresol green and bromocresol purple

47
Q

What decreases serum total protein

A

hypogammaglobulinemia, liver disease, burns/hemorrhage, salt retention, nephrotic syndrome

48
Q

What increases CSF total protein

A

cerebral hemmorage, encephalititis, increased serum proteins, meningitis, MS

49
Q

What increases urine total protein

A

glomerulonephritis, nephrotic syndrome, pregnancy, pyelonephritis, multiple myeloma, exercise

Clinical Biochem (15 decks)

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