Protein

Question 1

Proteins differ from carbs and lipids how? (3)

Answer 1

• Contain nitrogen
• Must be continually synthesized (most synthesized in liver, also in plasma cells/bone marrow)
• Not stored for emergency use

Question 2

What 4 hormones control protein SYNTHESIS?

Answer 2

1. Growth Hormone 2. Insulin 3. Testosterone 4. Thyroxine

Question 3

What 2 hormones control protein CATABOLISM?

Answer 3

1. Cortisol 2. Glucagon

Question 4

Nitrogen Balance. Negative and Positive causes:

Answer 4

Neg: excessive tissue destruction (burns), wasting disease, continual high fever, starvation.
Pos: periods of growth, pregnancy, repair processes

Question 5

Total Serum Protein: TSP

Answer 5

albumin and globulin

Globulins = a-1-globulin, a-2-globulin, B-globulin, and y-globulin proteins

Question 6

How do yo separate proteins?

Answer 6

Electrophroresis: technique separates proteins based on charge.

Question 7

Clinical Application of Electrophoresis. What samples will you use this for?

Answer 7

serum, urine, CSF

Question 8

Total Serum Protein (TSP) Function

Answer 8

Transport small molecules, receptors, catalyze biochemical rxns, structural, nutritional source, oncotic pressure, defense against foreign antigen, hormones, aids in maintenance of homeostasis, maintenance of acid-base balance

Question 9

Total Serum Protein (TSP) Factors that affect it

Answer 9

malnutrition, hepatic function with dec. syntesis, renal functinon w/ inc. urinary loss, metabolic disorders and enzyme defects, GI function with dec. absorption or inc. loss, disease causing cellular proliferation, inc. synthesis, dehydration

Question 10

Lab Measurement TSP specimens

Answer 10

Fasting serum: specimen of choice
Total urine protein, CSF protein, Body fluid protein.
Recommended to take concurrent samples for comparison.

Question 11

Math equation to calculate globulins

Answer 11

TSP - albumin = globulins

Question 12

Screening for Disorders, you can use 2 tests

Answer 12

TSP and albumin are a componenet of routine screening pannels (chem profile, metabolic, hepatic function, renal function)
Protein Electrophoresis (abnormal result warrants further follow up)

Question 13

Acute Phase Reactants: Which are Positive (+APR) and Negative (-APR)?

Answer 13

Pos: Alpha-1antitrypsin (AAT), Hepatoglobin (HPT), Ceruloplasmin (CER), Fibrinogen (FBG), *C-reactive protein (CRP)
Neg: *Albumin (ALB), Pre-albumin (PALB), Transferrin (TRF)

Question 14

Pre-albumin (PALB)

Answer 14

• Sensitive marker of nutritional status
• Transports thyroid hormone and retinol
• Routine clinical methods are not sensitive to visualize on SPE (Serum protein electrophoresis)

Question 15

Decreased PALB (Prealbumin)

Answer 15

1. Liver disease (dec synthesis)
2. Malnutrition, anorexia, malabsorption
   (-APR) Acute phase reactants

Question 16

Albumin (ALB)

Answer 16

• Most predominant protein of TSP
• Functions to maintain oncotic pressure of plasma
• Predominant protein lost in renal disease
• Transports less soluble compounds
• Synthesized in liver

Question 17

Decreased ALB (Albumin)

Answer 17

Liver disease, renal disease (NS), GI loss, (-APR)

Question 18

Increased ALB (Albumin)

Answer 18

Dehydration

Question 19

Alpha-1-antitrypsin (AAT)

Answer 19

Majority of alpha-1-globulins
Neutralizes trypsin-like enzymes
Phenotype MM

Question 20

Decreased AAT (Alpha-1-antitrypsin)

Answer 20

Severe pulmonary disease, liver disease, juvenile hepatic cirrhosis

Question 21

Increased AAT (Alpha-1-antitrypsin)

Answer 21

(+APR)

Question 22

Aplha-2-macroglobulin (AMG)

Answer 22

HUGE protein: unable to pass glomerulus

Inhibits protease, inhibits thrombin

Question 23

Increased AMG (Alpha-2-macroglobulin)

Answer 23

Nephrotic Syndrome (Up to 10x, maintains oncotic pressure in absence of albumin)

Question 24

Haptoglobin (HPT)

Answer 24

-Binds free hemoglobin

Question 25

Decreased Haptoglobin (HPT)

Answer 25

Hemolytic anemia

Question 26

Increased Haptoglobin (HPT)

Answer 26

(+APR)

Question 27

Ceruloplasmin (CER)

Answer 27

Contains >90% copper

Question 28

Decreased Ceruloplasmin (CER)

Answer 28

Associated w/ Wilson's disease (dec serum copper, inc urine copper) Liver Disease

Question 29

Increased Ceruloplasmin (CER)

Answer 29

(+APR)

Question 30

Transferrin (TRF)

Answer 30

Major component of beta-globulins | Transports iron in plasma

Question 31

Decreased Transferrin (TRF)

Answer 31

Liver disease, renal disease, (-APR)

Question 32

Increased Transferrin (TRF)

Answer 32

Iron Deficiency Anemia (IDA)

Question 33

Beta-lipoprotein (LDL)

Answer 33

``` "Bad cholesterol" Transports lipids (esp. cholesterol) through plasma ```

Question 34

Increased Beta-lipoprotein (LDL)

Answer 34

Nephrotic syndrome, Increased risk of CHD

Question 35

Complement C3 Component

Answer 35

- Components of beta globulins | - Participates in immune response contributing to cell lysis

Question 36

Decreased Complement C3 Component

Answer 36

Recurrent infections

Question 37

C-Reactive Protein (CRP)

Answer 37

Most sensitive of the APRs: levels rise within 24-48 hrs. | Serial measurements helpful

Question 38

Increased C-Reactive Protein (CRP)

Answer 38

Inflammatory response | Cardiac risk assessment (need 'high sensitivity' method)

Question 39

Imunoglobulins (Ig)

Answer 39

- Gamma globulins - Antibodies: heavy chain, light chain - Produced by plasma cells (B-cells) in bone marrow

Question 40

Decreased Immunoglobulins (Ig)

Answer 40

"hypogammaglobulinemia": Congenital, genetic (Selective IgA, Bruton's) Acquired (NS, AIDS)

Question 41

Increased Immunoglobulins (Ig)

Answer 41

"hypergammaglobulinemia": - Polyclonal increase: response to infecion - Monoclonal increase: unrestrained proliferation (multiple myeloma, waldenstrom's macroglobulinemia)

Question 42

Increased Urine Protein

Answer 42

- Increased glomerular permeability (NS, renal disease) - Multiple Myeloma (paraprotein) - Intravascular hemolysis (hemoglobin) - Tubular failure (drugs, toxins)

Question 43

CSF Protein

Answer 43

Proteins in CSF from plasma, Normal pattern similar to SPE but in lower conc., Concurrent serum

Question 44

CSF Protein Clinically measured why?

Answer 44

Assess integrity of blood brain barrier | Aid in diagnosis of disease

Question 45

Increased CSF Protein

Answer 45

Meningitis, Multiple Sclerosis