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Clinical Pathology > Lecture 13: Proteins > Flashcards

Lecture 13: Proteins Flashcards

1
Q

What are some functions of proteins

A
  1. Colloid oncotic pressure
  2. Nutritive
  3. Coagulation
  4. Immune response
  5. Carrier proteins
  6. Maintain acid base balance
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2
Q

what is the major site of plasma protein synthesis- albumin, globulins, fibrinogen and clotting factors

A

liver

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3
Q

what is the second major source of plasma proteins- immunoglobulins

A

Immune system

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4
Q

define dysproteinemia

A

abnormal concentration of normal proteins or presence of abnormal proteins in blood

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5
Q

__is a common cause of dysproteinemia

A

inflammation

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6
Q

__acute phase proteins increase with inflammation

A

positive acute phase proteins

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7
Q

what are some positive acute phase proteins

A
  1. Fibrinogen
  2. SAA
  3. C-reactive protein
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8
Q

__ acute phase proteins decrease with inflammation

A

negative acute phase proteins

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9
Q

what is the major negative acute phase protein

A

albumin

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10
Q

what is an example of delayed response proteins

A

immunoglobulins

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11
Q

plasma total protein is liquid/non-cellular portion of __blood

A

anti coagulated

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12
Q

serum total protein- liquid/non-cellular portion of __blood

A

coagulated blood

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13
Q

__total protein contains fibrinogen and clotting factors, whereas __total protein does not contain fibrinogen and clotting factors

A

plasma, serum

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14
Q

refractometry to measure TP is affected by non-protein substances such as __

A

urea, glucose, Na, Cl

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15
Q

what 3 things can interfere with reading refractometer to measure TP

A
  1. Lipemia- blur the line
  2. Hemolysis- increase protein
  3. Icterus
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16
Q

what is analytic principle of refractometry

A

refractive index are proportional to the protein concentration

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17
Q

what is analytic principle of biuret method to measure TP

A

copper based chemical reaction causing color change and detected by spectrophotometry

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18
Q

the biuret method to measure TP is inaccurate when protein is <__

A

1gl/dL

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19
Q

t or f: biuret method is effective in measure protein in CSF and urine

A

false- normal specimens should have very low protein

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20
Q

albumin is produced by __

A

hepatocytes

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21
Q

albumin is major contributor to __

A

vascular oncotic pressure

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22
Q

how Can you measure albumin

A

bromcresol green dye binds albumin

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23
Q

Measuring albumin via bromcresol green dye can cause falsely high values in __, and falsely low values in __

A

rabbits, birds

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24
Q

how do you calculate globulin from chem panel

A

globulin= TP- albumin

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25
how do you measure and categorize globulins
protein electrophoresis
26
what is analytic principle of serum electrophoresis
proteins separate in a gel based on ability to migrate through gel exposed to electrical field. Migrate based on size and charge
27
what protein migrates the most vs least on serum electrophoresis
Most: albumin Least: IgG
28
what positive acute phase proteins are in alpha region on SPE
macroglobulin, haptoglobin, SAA
29
what positive acute phase protein is in gamma region on SPE
CRP
30
what immuglobulins are present in beta and gamma regions
beta: IgA, IgM Gamma: IgG
31
How would polyclonal SPE appear And what does that indicate
multiple wide based peaks Indicates: inflammation
32
how would monoclonal SPE appear and what does that indicate
Singular tall sharp peak Indicates: cancer
33
what are 2 major causes of increase globulins
inflammation Cancer
34
Identify the following SPE as normal, polyclonal and monoclonal
Left: normal Middle: polyclonal Right: monoclonal
35
what is normal albumin: globulin ratio
1:1
36
significant increase or decrease in A/G ratio suggest __
selective dysproteinemia
37
increase AG ratio can be due to __, __ or __
increased albumin, decreased globulin or both
38
decrease AG ratio can be due to __, __ or __
increased globulin, decreased albumin or both
39
define panhyperproteinemia
increase in both albumin and globulins
40
what are the ddx for hyperproteinemia
1. Hemoconcentration-dehydration 2. Increased protein synthesis: inflammatory diseases- infectious, non-infectious, neoplasia
41
what is only ddx for hyperalbuinemia
hemoconcentration/ dehydration
42
how does inflammation cause hyperproteinemia
cytokine affect hepatocytes and lymphocytes to increase protein production
43
what are the expected dysproteinemia patterns with hyperproteinemia caused by inflammation: within few days and delayed response
within few days: increase + acute phase protein and decrease - acute phase protein (albumin) Delayed: increase + acute phase protein and Ig’s
44
what are the expected SPE patterns with hyperproteinemia caused by inflammation
1. Polyclonal gammopathy: broad based increase in gamma proteins 2. Increases in alpha or beta region
45
characterize the abnormalities seen here and likely cause
1. TP increased 2. Decreased albumin 3. Increase globulins 4. AG ratio 1:5 SPE: polyclonal gammopathy Cause: inflammation
46
Cat with bacterial pneumonia: characterize the abnormalities and likely cause
1. TP WNL 2. Borderline decrease albumin 3. Borderline increase globulins 4. AG ratio 1:2 5. SPE: increase a2 globulins, wide base increase y globulins- polyclonal Inflammation
47
Describe the pathogenesis of how infection leads to increase alpha globulins and decrease albumin
1. Infection 2. Cytokines from macrophages and lymphocytes released 3. Increase + acute phase proteins- globulins 4. Decrease - acute phase proteins- albumin 5. Increase alpha globulins, decrease albumin
48
how does infection cause increase in gamma globulins
1. Infection 2. Cytokines from macrophages and lymphocytes 3. Plasma cells release AB’s/Igs 4. Increase gamma globulins
49
What produces fibrinogen
hepatocytes
50
what is most common way to measure fibrinogen
heat-precipitation method
51
fibrinogen can be increased by ___ or __
dehydration or inflammation
52
how do you determine if fibrinogen is increased by dehydration or inflammation
plasma protein: fibrinogen ratio
53
what PP:F in cattle indicates dehydration and inflammation
PP:F >15 indicate dehydration PP:F <10 indicate inflammation
54
what PP:F in horses indicates dehydration and inflammation
PP:F >20 indicates dehydration PP:F <15 indicates inflammation
55
what produces SAA
hepatocytes
56
where does SAA migrate to on SPE
alpha-region
57
what is the major acute phase protein in most domestic species except pigs
SAA
58
Measuring SAA for inflammation is more commonly used in __
large animals
59
what is CRP produced by
hepatocytes
60
where does CRP migrate to on SPE
gamma region
61
what is the major acute phase protein in dogs
CRP
62
what acute phase protein is helpful in monitoring inflammatory diseases in dogd
CRP
63
what types of neoplasia can cause hyperproteinemia
B lymphocyte neoplasia- lymphoma/ leukemia or PCT
64
what are expected SPE patterns for neoplasia causing hyperproteinemia
monoclonal gammopathy
65
what are the 4 criteria to dx multiple myeloma
1. Monoclonal gammopathy 2. Bence-Jones proteinuria 3. Greater than 20% plasma cells in bone marrow 4. Lytic bone lesions
66
what are the ddx for hypoproteinemia
1. Increase protein loss from vascular space (blood loss, PLE, PLN, PLD, peritonitis, pleuritis, vasculitis) 2. Decrease protein synthesis and/or increase protein catabolism (hepatic insufficiency, malabsorption/digestion) 3. FPT 4. Hemodulution
67
what are ddx for hypoalbuminemia
1. Decreased albumin synthesis (inflammation, hepatic insufficiency, malabsorption) 2. Increased albumin loss (blood loss, PLE, PLN, PLD) 3. Hemodilution
68
inflammation __hepatic albumin synthesis
decrease
69
what are the causes of hypoalbuminemia due to decreased production
1. Inflammation- decrease hepatic albumin synthesis 2. Hepatic insufficiency- liver failure, PSS 3. Starvation/cachexia/ malabsorption/digestion
70
what are the causes of hypoalbunemia from loss of albumin
1. Non-selective loss- blood loss, PLE, exudative skin disease (burns) 2. Selective loss- PLN
71
why check the urine if there is hypoalbuminemia
1. If no proteinuria then look at causes for low albumin- likely inflammation 2. If proteinuria rule out ddx for increase albumin loss and hemodilution
72
a dog is severely dehydrated and has hypoalbuminemia. What would happen when you rehydrate this patient: A. Albumin decrease B. Albumin increase C. Albumin would not change
A. Albumin decrease- hemodilution (albumin increases with dehydration)
73
what are some causes of selective hypoglobulinemia
1. FPT 2. SCID- lack functional B or T cells 3. Selective Ig deficiency
74
interpret And cause
1. TP increase 2. Albumin: increase 3. Globulin normal Ddx: dehydration- increase albumin
75
Interpret abnormalities and likely cause
1. TP: decrease 2. Albumin: decrease 3. Globulin decrease Selective hypoproteinemia and hypoglobulinemia Ddx: FPT
76
Case ex: Classify anemia, cause of anemia, classify leukon, describe protein abnormalities, cause of protein changes, what happens to protein levels upon rehydration
1. Anemia: normocytic, normochromic non-regenerative 2. Cause of anemia: chronic inflammation 3. Leukon: inflammation and stress 4. Protein abnormalities: low TP, low albumin, normal globulins 5. Cause of protein changes: inflammation, negative acute phase protein 6. Rehydration- protein levels drop
77
case: classify anemia, cause of anemia, classify leukon, describe protein abnormalities, cause or protein changes
1. Anemia- normocytic, normochromic non-regenerative 2. Cause of anemia: blood loss 3. Leukon: stress and inflamamtion 4. Protein abnormalities: panhypoproteinemia 5. Cause: blood loss

Clinical Pathology (15 decks)

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