Unit 4 - Protein Diseases Flashcards by Melanie Laird

Which major serum protein is immediately anodal and fast?

Albumin

How well did you know this?

Not at all

Perfectly

Which analyte helps you orient your SPE and why?

Albumin
Fastest, most abundant, to positive/anodal side

How well did you know this?

Not at all

Perfectly

Which are the slowest migrators?

Gamma

How well did you know this?

Not at all

Perfectly

Which have the lowest net negative charge?

Gamma

How well did you know this?

Not at all

Perfectly

Endosmosis

Gamma globulins weakly negative, so strong cations push them back

How well did you know this?

Not at all

Perfectly

What causes increased total protein levels

Hemoconcentration
Overproduction
Retention

How well did you know this?

Not at all

Perfectly

What causes low levels of protein

Hemodilution
Underproduction
Excessive loss

How well did you know this?

Not at all

Perfectly

Edema signifies ___ levels of protein

Edema, because albumin redistributed into the tissues causing water retention

How well did you know this?

Not at all

Perfectly

How does albumin function as a protein reserve?

Source of amino acids by degradation by the liver

How well did you know this?

Not at all

Perfectly

Total protein measured range

6-8 g/dL

How well did you know this?

Not at all

Perfectly

Albumin measured range

3.5-5 g/dL

How well did you know this?

Not at all

Perfectly

Globulin measured calculated

2.5-3.0 g/dL

How well did you know this?

Not at all

Perfectly

Osmotic pressure

Entire number of dissolved particles in a solution

How well did you know this?

Not at all

Perfectly

Oncotic pressure

Subset of osmotic pressure caused by suspended colloidal molecules like proteins

How well did you know this?

Not at all

Perfectly

Liver disease albumin levels

Decreased synthesis

How well did you know this?

Not at all

Perfectly

What would hereditary analbuminemia do to serum protein levels?

Low/No albumin
All other globulins increased for compensation

How well did you know this?

Not at all

Perfectly

Hemodilution

Estrogens/pregnancy
CHF
Blood collected above an IV line

How well did you know this?

Not at all

Perfectly

What causes high albumin levels

Dehydration
Tourniquet

How well did you know this?

Not at all

Perfectly

Disorder of overproduction of gamma globulins

MM
Chronic liver disease (hepatitis)
Infection

How well did you know this?

Not at all

Perfectly

Wear and Tear proteins in urine

Tamm Horsfall

How well did you know this?

Not at all

Perfectly

Is protein normal in urine?

Not unless its Tamm Horsfall protein

How well did you know this?

Not at all

Perfectly

Is albumin estimation reliable using densitometry?

How well did you know this?

Not at all

Perfectly

Which band is normally the smallest?

Alpha-1

How well did you know this?

Not at all

Perfectly

Alpha-1 Globulins

Anti-Trypsin
Glycoprotein (doesn’t stain well)
Lipoprotein
Fetoprotein

How well did you know this?

Not at all

Perfectly

What does anti-trypsin do and where is it found

Alpha-1 Controls proteolytic enzymes after inflammation Effective against leukocyte elastase

Which form of cholesterol is in Alpha-1?

HDL Good Cholesterol

What are the globulins in Alpha-2

Haptoglobin Macroglobulin Lipoprotein VLDL Ceruloplasmin

What does haptoglobin do

Binds free hgb to prevent loss

After a hemolytic event, what happens to haptoglobin?

Decreases

What does ceruloplasmin do

Bind Copper

What color is ceruloplasmin

Green, elevated in pregnancy

What are the globs in Beta

Transferrin Hemopexin Lipoprotein (LDL) C3

What does transferrin do

Transport iron

What happens to transferrin levels in iron deficiency anemia

Increases

What does hemopexin do

Binds heme to recycle it and prevent tissue damage from excess heme

What happens to hemopexin levels in hemolytic anemias

Decrease

Order of Ig in gamma region

IgA IgM IgG

Where is CRP

Gamma region

What are SPEP primarily used for?

Identifying monoclonal gammopathies

What causes bisalbuminemia

Genetics or drugs

Acute phase reaction levels

--> Low alb Inc Alpha-1 --> Inc Alpha-2 Decreased transferrin

Nephrotic Syndrome levels

PROFOUNDLY low albumin PROFOUNDLY high alpha-2

What causes nephrotic syndrome

Kidney disease with large amounts of protein in the urine

If you see a spike where CRP should be, how do you report it?

Consistent with monoclonal band/spike

Polyclonal Hypergammaglobulinemia levels

All antibodies high Low albumin High alpha-2

Polyclonal hypergammaglobulinemia is also associated with

Chronic inflammation

Severe hepatic disease

Polyclonal gammopathy Low alb low alpha 1 low alpha 2 low beta

Hypogammaglobulinemia

Can be congenital or aquired

Where is alpha-1 antitrypsin produced

Liver

If antitrypsin can't be secreted, what can happen?

It builds up in the liver and liver damage ensues

Antitrypsin disease affects what organ?

Lungs

Antitrypsin gentoypes

Normal - MM Carrier - MZ Homozygote - ZZ

Beta-gamma bridge

Liver disease

Most common monoclonal disorder

Multiple myeloma

Least common monoclonal disorder

B cell overproduction

Multiple Myeloma acronym

CRAB Calcium inc Renal dysfunction Anemia Bone lesions

MM causes an overproduction of

Antibodies and/or light chains

What causes the renal dysfunction of MM?

Excess light chains that deposit in the kidneys and cause damage

What is a poor prognostic sign for MM?

Free light chains in the serum and urine Increased beta microglobulin Decreased albumin

Immunosubtraction

Add antibody to the therapeutic monoclonal and repeat electrophoresis

What if the spike doesn't move with immunosubtraction?

The spike eisnt caused by the monoclonal antibody therapy

What if the spike moves with immunosubtraction

The spike was caused by the therapy and you can see what was under the spike

What is the downfall of SPE with very high monoclonal antibodies?

Prozone/postzone can cause it to be falsely negative

When is CSF positive for oligoclonal bands?

only when serum is negative for oligobands