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MLS 421 Clinical Chemistry II > Serum Proteins and Methods > Flashcards

Serum Proteins and Methods Flashcards

1
Q

Where are most plasma proteins synthesized?

A

Liver hepatocyte.

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2
Q

Where are immunoglobulins synthesized?

A

Plasma Cells.

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3
Q

Where is hemoglobin synthesized?

A

Nucleated RBC’s.

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4
Q

Where is Von Willebrand’s Factor synthesized?

A

Epithelial and megakaryocytes.

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5
Q

What is the mathematical equation to determine total protein?

A

Total protein = Albumin + Globulins

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6
Q

What is the A/G Ratio?

A

The ratio between albumin and globulin.

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7
Q

How would you go about calculating the A/G Ratio?

A

Total Protein - Albumin = Calculated Globulin Level

Albumin/Globulin = A/G Ratio

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8
Q

What is the reference interval for total protein?

A

6.5 - 8.3 g/dL

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9
Q

What is the reference interval for transthyretin (prealbumin)?

A

0.1 - 0.4 g/dL

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10
Q

What is the reference interval for albumin?

A

3.5 - 5.0 g/dL

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11
Q

What is the reference interval for alpha-1-globulins?

A

0.1 - 04 g/dL

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12
Q

What is the reference interval for alpha-2-globulins?

A

0.3 - 0.8 g/dL

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13
Q

What is the reference interval for beta-globulins?

A

0.6 - 1.1 g/dL

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14
Q

What is the reference interval for gamma-globulins?

A

0.5 - 1.7 g/dL

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15
Q

Define hyperproteinemia.

A

Increased serum proteins levels.

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16
Q

What are some causes of hyperproteinemia?

A

Hemoconcentration and increased abnormal protein.

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17
Q

What are some causes of hypoproteinemia?

A

A decrease serum proteins level; excessive loss due to salt retention syndrome and decreased synthesis.

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18
Q

Define acute phase reactants.

A

Individual fractions of total protein that are involved in the inflammatory process.

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19
Q

Reference interval for transthyretin (prealbumin).

A

0.1 - 0.4 g/dL

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20
Q

What is the clinical significance of transthyretin (prealbumin)?

A

Transport ~10% of T3 and T4 proteins; Retinol Binding Protein (circulates 1:1).

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21
Q

When would transthyretin (prealbumin) be increased?

A

In Hodgkin’s and renal disease.

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22
Q

When would transthyretin (prealbumin) be decreased?

A

In malnutrition, liver disease, activation of acute phase reactants, and tissue necrosis.

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23
Q

What method(s) are used to measure transthyretin?

A

Electrophoresis: high resolution, migrates ahead of albumin.
Quantitative test: nephelometry

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24
Q

Reference interval of albumin.

A

3.5 - 5.5 g/dL

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25
Q

What is the clinical significance of albumin?

A

2/3 of all serum proteins, it maintains oncotic pressure, acts as a protein transporter, and a source of amino acids.

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26
Q

When would you see an increase in albumin?

A

Dehydration.

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27
Q

When would you see a decrease in albumin?

A

Common in many illnesses, including chronic liver disease.

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28
Q

Define bisalbuminemia.

A

Presence of two albumin bands instead of the single band usually seen in electrophoresis. .

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29
Q

What methods are used to test for albumin?

A

Dye methods, immunochemical, and/or nephelometry.

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30
Q

Reference interval of alpha1-antitrypsin.

A

0.2 - 0.4 g/dL

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31
Q

What is the clinical significance of alpha1-antitrypsin?

A

Acute phase reactant with antiprotease activity. Without it, elastase from PMNs attack tissue.

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32
Q

When would you find an increase in alpha1-antitrypsin?

A

Inflammation or malignancy.

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33
Q

When would you find a decrease in alpha1-antitrypsin?

A

Inherited disorders which leads to lung or liver diseases.

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34
Q

What methods are used to test for alpha1-antitrypsin?

A

Electrophoresis: makes up 90% of the alpha-1 band.
Quantitative: nephelometry.

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35
Q

Reference interval for alpha-1-acid glycoprotein.

A

0.05 - 0.14 g/dL

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36
Q

What is the clinical significance of alpha-1-acid glycoprotein?

A

Formation of certain membranes and fibers, associated with collagen. Inactivates basic, lipophilic hormones such as progesterone and drugs.

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37
Q

When would you see an increase in alpha-1-acid glycoprotein?

A

Inflammation, pregnancy, CA, RA, pneumonia, stress.

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38
Q

When would you see a decrease in alpha-1-acid glycoprotein?

A

Not listed.

39
Q

What method is used to test for alpha-1-acid glycoprotein?

A

Nephelometry.

40
Q

Reference range for alpha1-fetoprotein.

A

<6 ng/mL in nonpregnant patients.

41
Q

What is the clinical significance of alpha1-fetoprotein?

A

Synthesized in fetal liver, also in some tumors.

42
Q

When would you see an increase in alpha1-fetoprotein?

A

Maternal serum in spina bifida and neural tube defects; hepatocellular Ca and and gonadal tumors.

43
Q

When would you see a decrease in alpha1-fetoprotein?

A

Maternal serum in down syndrome.

44
Q

What method is used to test for alpha1-fetoprotein?

A

Immunoassay: EIA.

45
Q

Reference interval for haptoglobin.

A

~0.4 - 0.6 g/dL

46
Q

What is the clinical significance of haptoglobin?

A

Irreversible binding of free oxyhemoglobin in plasma: Hgb-Hp complex; acute phase reactant.

47
Q

When would you see an increased in haptoglobin?

A

Response to inflammation or malignancy.

48
Q

When would you see a decrease in haptoglobin?

A

Intravascular hemolytic anemia.

49
Q

What method is used to test for haptoglobin?

A

Electrophoresis: alpha-2 region.
Quantitative: nephelometry, SDS PAGE

50
Q

Reference interval for alpha2-macroglobulin.

A

0.15 - 0.42 g/dL

51
Q

What is the clinical significance of alpha2-macroglobulin?

A

Major protease inhibitor, along with alpha1-antitrypsin.

52
Q

When would you see an increase in alpha2-macroglobulin?

A

Nephrotic syndrome.

53
Q

When would you see a decrease in alpha2-macroglobulin?

A

Severe acute pancreatitis; before treatment for cancer of the prostate.

54
Q

What methods are used to test for alpha2-macroglobulin?

A

Electrophoresis: alpha-2 region.
Quantitative: nephelometry.

55
Q

Reference range for ceruloplasmin.

A

0.015 - 0.060 g/dL

56
Q

What is the clinical significance of ceruloplasmin?

A

Contains copper (1+ or 2+ oxidation state), antioxidant, late acute phase reactant.

57
Q

When would you see an increase in ceruloplasmin?

A

Weak acute phase reactant, late reaction.

58
Q

When would you see an decrease in ceruloplasmin?

A

Wilson’s disease, a disorder of copper metabolism, malnutrition, and liver disease.

59
Q

What methods are used to test for ceruloplasmin?

A

Electrophoresis: alpha-2 region.
Quantitative: nephelometry, turbidimetry

60
Q

Reference range for transferrin.

A

0.2 - 0.36 g/dL

61
Q

What is the clinical significance of transferrin?

A

Iron transport; acute phase reactant.

62
Q

When would you see a increase in transferrin?

A

Iron deficiency.

63
Q

When would you see a decrease in transferrin?

A

Chronic diseases.

64
Q

What method is used to test for transferrin?

A

Electrophoresis: beta-globulin fraction.
Quantitative: immunonephelometry.

65
Q

Reference range for hemopexin.

A

0.05 - 0.10 g/dL

66
Q

What is the clinical significance of hemopexin?

A

Removes circulating heme when haptoglobin is used up.

67
Q

When would you see a increase in hemopexin?

A

Diabetes mellitus, MD, melanoma.

68
Q

When would you see a decrease in hemopexin?

A

HA, phenytonin (diphenylhydantoin).

69
Q

What methods are used to test for hemopexin?

A

Electrophoresis: beta-globulin fraction.
Quantitative: radioimmunodiffusion.

70
Q

Reference range for microglobulin.

A

0.0001 - 0.0002 g/dL.

71
Q

What is the clinical significance of microglobulin?

A

Component of human leukocyte antigen (HLA) molecule class I; on the cell surface of all nucleated cells.

72
Q

When would you see an increase in microglobulin?

A

Renal failure, inflammation, lymphocytosis, lymphocyte breakdown.

73
Q

When would you see a decrease in microglobulin?

A

Not listed.

74
Q

What methods are used to test for microglobulin?

A

Nephelometry.

75
Q

Reference range for fibrinogen.

A

0.2 - 0.45 g/dL

76
Q

What is the clinical significance of fibrinogen?

A

Fibrinogen is an acute phase reactant found only in plasma. Its function is to form a fibrin clot when activated by thrombin.

77
Q

When would you see an increase in fibrinogen?

A

Acute phase reactant reactions, e.g. inflammatory condition.

78
Q

When would you see a decrease in fibrinogen?

A

Extensive coagulation, when fibrin is being used up.

79
Q

What method is used to test for fibrinogen?

A

Immunoassays, nephelometry, beta-region in electrophoresis.

80
Q

Reference range for complement.

A

~0.08 - 0.24 g/dL

81
Q

What is the clinical significance of complement?

A

Immune defense mechanism: cell lysis, killing bacteria, opsonization, chemotaxis, and B-cell activation.

82
Q

When would you see an increase in complement?

A

Inflammation.

83
Q

When would you see a decrease in complement?

A

Malnutrition, lupus, DIC.

84
Q

What method is used to test for complement?

A

Beta-2 region of electrophoresis; nephelometry.

85
Q

Reference range for immunoglobulins.

A

~0.5 - 1.7 g/dL

86
Q

What is the clinical significance of immunoglobulins?

A

Antibodies in immune system.

87
Q

When would you see an increase in immunoglobulins?

A

Polyclonal gammopathy, monoclonal diseases.

88
Q

When would you see a decrease in immunoglobulins?

A

Hypogammaglobulinemia.

89
Q

What method is used to measure immunoglobulins?

A

Gamma-region in electrophoresis; immunofixation, nephelometry or turbidimetry, immunosubtraction electrophoresis.

90
Q

Reference range for C-Reactive Protein.

A

0.001 g/dL

91
Q

What is the clinical significance of C-Reactive Protein?

A

Highly sensitive acute phase reactant.

92
Q

When would you see an increase in C-Reactive Protein?

A

Levels rise whenever there is tissue necrosis such as MI, trauma, infection, surgery, or neoplastic proliferation. Levels rise in 24-48 hours.

93
Q

When would you see a decrease in C-Reactive Protein?

A

Not listed.

94
Q

What methods are used to test for C-Reactive Protein?

A

Electrophoresis: migrates in the beta to gamma regions; nephelometry or immunoassay.

MLS 421 Clinical Chemistry II (20 decks)

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