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CPR 2 > Serum Proteins And Associated Disp4ders > Flashcards

Serum Proteins And Associated Disp4ders Flashcards

1
Q

What is the blood plasma?

A

The non-cellular liquid layer of the blood obtained by sedimentation and Centrifugation

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2
Q

What is blood serum?

A

Prepared in laboratory

In the laboratory whole blood is allowed to coagulate before Centrifugation. The resulting fluid is blood serum.
(Blood serum is blood plasma without blood coagulating factors)

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3
Q

What is the function of serum protein electrophoresis(SPEP)?

A

Separates serum proteins regarding their overall charge

This method is often combined with densitometry

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4
Q

What are the main serum proteins?

A

Albumin

a and B globulins

y-globulins

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5
Q

What is the function of albumin?

A

Maintenance of oncotic pressure

Transport: calcium ions, free fatty acids, bilirubin, hormones and drugs

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6
Q

What are the functions of a and B globulins?

A

Enzymes

Transport

Inhibitor proteins

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7
Q

What are the functions of y-globulins?

A

Immune response

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8
Q

Where is albumin synth3sized?

A

Albumin is extremely synthesized in the liver (14 g/day) and is released into the blood

Albumin is small and the most abundant serum protein

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9
Q

What is the range of serum albumin?

A

3.5-5 g/dL

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10
Q

Explain the main functions of albumin

A
  1. Maintenance of the osmotic pressure in the blood and prevention of edema
  2. Transport of some lipids like free fatty acids, bilirubin, steroid hormones and drugs
  3. Binding and transport of ca”chum ions in the blood

Note: Individual”s with congenital analbunemia appear normal and do not show edema. Other serum pr9teins regulate the osmotic pressure early 9n.

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11
Q

What are the causes of hypoalbumpnemia?

A
  • Decreased synthesis of albumin

- Increased loss of albumin

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12
Q

What are the effects of decreased synthesis of albumin?

A

Kwashiorkor-dietary deficiency of proteins and often infections

Liver cirrhosis -severe liver damage impairs synthesis of serum proteins

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13
Q

What are the effects of increased loss of albumin?

A

Kidney disease-loss of urine due to damage of glomerulus basement membrane

Severe burns-damage of blood vessels leads t9 huge loss 9f serum

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14
Q

What can be used to ind8cate a1 globulin fraction?

A
  1. a1 Antitrypsin (>90%)
  2. a Fetotrypsin
  3. Transcortin
  4. Retinol binding protein
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15
Q

What is the clinical significance of a1 antotrypsin (a1-AT)?

A
  1. a1-Antitrypsin is a serum protein released by the liver and inhibits neutrophil e”dataset in lung alveoli
  2. A reduced amount of a1-AT in the blood can lead to excessive degradation of elastin in the lung and to emphysema
  3. Hereditary deficiency of a1-AT results from a defective hepatic N-glycosylation and reduced release into the blood. This can lead to pulmonary and liver disease
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16
Q

How can smoking lead to emohysema?

A

Smoking activates neutrophils which release neutrophil elastase and at the same time ROS modify the structure of a1-AT and reduce the binding to neutrophil elastase

Elevated neutrophil elastase destroys elastin in the alveoli

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17
Q

What 8s the clinical significance of AFP?

A

AFP is an a1 globulin that is abundant in fetal plasma which has very low levels of albumin. It may have function similar to albumin in fetal life

AFP level is low in healthy adults but it increases in cancer and is used as a serum marker for liver cancer

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18
Q

What is the use of maternal AFP?

A

Maternal serum AFP is used as a marker for possible fetal abnormalities

AFP is mostly found in the amniotic fluid. A small amount of amniotic fluid can cross the placenta and AFP can be measured in maternal serum

High maternal serum AFP level can be an indicator of neural tube defects

Low maternal serum AFP level can be an indicator of Down syndrome

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19
Q

What are transcortin and retinol binding protein?

A

These are a1 globulins that transport specific lipids

Transcortin transports 75% of cortisol in blood

Retinol-binding protein transports retinol in blood from the liver to the peripheral tissues

20
Q

What can be used to indicate a2 globulin fraction?

A
  1. A2 macroglobulin
  2. Ceruloplasmin
  3. Hepatoglobin
21
Q

What is the significance a2 Macroglobulin?

A

One of the largest serum proteins

A2M is the major component of the a2 globulin fraction. It has many different functions and inhibits an enormous variety of serum proteases like plasmin (fibrinolysis) and thrombin (coagulation)

A greater than 10 fold increase (abnormal) in blood is often found in patients with Nephrotuc syndrome due to damage of the basement membrane of the glomerulus

The synthesis of a2 macroglobulin is increased and it’s loss into urine is prevented by its large size whereas albumin is very small and lost into urine in nephrotic syndrome

22
Q

What color is ceruloplasmin?

A

A blue a2 globulin

23
Q

What are the functions if ceruloplasmin?

A
  1. Copper transport in blood

2. Ferroxidase activity

24
Q

Where is ceruloplasmin formed?

A

Formed in the liver by binding of copper to Apo ceruloplasmin. The released ceruloplasmin transports 95% of copper in blood

25
Q

What is Wilson disease?

A

Patients with Wilson disease have a very low blood levels of ceruloplasmin as hepatic copper binding is deficient. Apo ceruloplasmin (without copper ) is released into the blood where it is degraded

26
Q

What causes Wilson disease?

A

Patients have a deficiency of a copper-transporting ATPase (ATPase7-B) which 8s needed to form ceruloplasmin and is also needed for release 9f copper into bile

Damage due to copper accumulation in the liver, leakage into the blood and deposits in brain, eyes, kidney and skin.

Hepatic dysfunction, neurologically and psychiatric symptoms

27
Q

How does ceruloplasmin impact ferroxidase?

A

Ceruloplasmin acting as an enzyme needs copper for its ferroxidase activity

Ferroxidase forms ferric ion

Macrophages degrade heme and release ferrous ion which could lead to radical formation (Fenton reaction)

This is prevented by ceruloplasmin which forms ferric ion that can be bound to transferrin and transported in blood

28
Q

What is Haptoglobin?

A

An a2 globulin that binds to free hemoglobin dimers in the blood and prevents loss of Hb in urine

29
Q

What is the functioning 9f haptoglobin?

A

Haptoglobulin-hemoglobin complex is taken up by macrophages. This explains why acute hemolysis l3ads to a low serum level 9f free haptoglobin

Serum protein electrophoresis is used to monitor the progress in patients with hemolytic anemia

30
Q

What is transferrin?

A

Transferrin 8s a B-globulin which transports ferric ion in blood between: intestine, liver, bone marrow and spleen

Transferrin can bind two Fe3+ atoms for transport (Normally the transferrin binding sites are not all filled with iron)

31
Q

What are the clinical evaluations of transferrin?

A

Low transferrin saturation is found in patients with iron deficiency as fewer sites of transferrin are filled

High transferrin saturation is found in patients with iron overload (High serum iron leads to increased binding)

32
Q

What is hemopoxin?

A

Is a B-globulin that binds to free heme in the blood and prevents the loss of heme iron

33
Q

What happens heme-hemopoxin?

A

Taken up into heoat9cytesvand the iron is bound to the storage protein ferritin

Hemopoxin prevents:
A. Heme-induced damage of plasma membranes (heme insertion and ROS)
B. Heme usage by microbes: heme is an important source of iron for pathogenic m8croorgabisms

34
Q

How do LDL separate in SPEP?

A

They separate with B-globulins

LDLs have only apo-B100 which has an overall positive charge

LDL are also named B-lipoproteins

35
Q

What are y-globulin synthesized by?

A

Plasma cells/activated B cells

36
Q

What’s the origin of IgM?

A

Is found in blood and lymph and it 8s first antibody to be produced in response to an antigen (infection)

37
Q

What are the origins of IgG?

A

Smallest and most common- found in all body fluids. It is produced By repeated exposure to the same antigen. IgG can cross the placenta giving passive immunity to the fetus and new born

38
Q

What are the origins of IgE?

A

Is found in the lung, skin, mucous membranes and secreted in allergic reactions

39
Q

Where is IgA found?

A

Found in body secretions and protects body surfaces. It is the main antibody found in human milk

40
Q

What is the role of IgD?

A

Uncertain

41
Q

What is the impact of serum protein electrophoresis in multiple myeloma?

A

Multiple myeloma is a tumor of the plasma cells and is an example of monoclonal gammopathyb

It is characterized by the presence 9f high amounts 9f a single type of immunoglobin produced by a malignant clone of the cell

Serum protein electrophoresis is an important tool that helps in diagnosis and monitoring patientswith multiple myeloma

42
Q

What is an acute phase reaction of the liver?

A

Leases to changes in the synthesis 9f serum proteins

The hepatic acute phase reaction is an overall positive response to prevent damage following an injury such as in:
Infections
Extreme stress
Burns 
Major crush injury
Allergy or other
43
Q

How can acute phase reactants be subdivided?

A

Into positive and negative reactants depending on the amounts synthesized

44
Q

What are the positive reactants of acute phase ?

A

Serum proteins that are synthesized in larger amount as they reduce inflammation and deprive microbes of iron.

Examples:
a1-antitrypsin 
Ceruloplasmin 
Haptoglobin 
Hemopoxin
45
Q

What are the negative acute phase reactants?

A

Serum proteins that are synthesized in smaller amount in order to preserve amino acids for the increased synthesis of positive acute phase reactants

Examples:
Albumin
Transcortin
Retinol-binding protein
Transferrin
46
Q

What is special about C-reactive protein?

A

It is an acute phase reactant that does not lead to a peak in SPEP

47
Q

Where is C-reactive protein (CRP)?

A

Is synthesized and released during inflammation and was first found in blood of patients with acute inflammation. CRP was named after the fact that it reacted with the C-polypeptide of pneumococcus

CRP can increase to 30,000 times of its normal level

There is a specific test for CRP and it is used to monitor the proces of inflammation, trauma and infection

CPR 2 (32 decks)

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