protein electrophoretogram

Question 1

Fraction: Pre-albumin

Answer 1

prealbumin

Question 2

Function: pre-albumin

Answer 2

• Transport protein for thyroid hormones (transthyretin)

Question 3

Pos or neg APR: Pre-Albumin

Answer 3

Neg (decreases during inflammation)

Question 4

Condition(s) in which it ↓: Pre-Albumin

Answer 4

Malnutrition (sensitive marker of protein nutritional status)

Question 5

Fraction: Albumin

Answer 5

Albumin

Question 6

Function: Albumin

Answer 6

1. Maintains fluid balance between blood and interstitial fluid by contributing 80% of colloidal osmotic (oncotic) pressure of intravascular fluid
2. Transports insoluble substances in blood

Question 7

Pos or Neg APR: Albumin

Answer 7

neg (decreases in inflammation)

Question 8

Condition(s) in which it ↓: Albumin

Answer 8

• Decreased synthesis (malnutrition, liver failure, acute inflammation or infection (Neg APR))
• Increased loss (nephrotic syndrome)
• Causes edema when serum Alb is < 2.5 g/dL Edema: excessive accumulation of interstitial fluid

Question 9

Conditions in which it ↑ if applicable: Albumin

Answer 9

dehydration

Question 10

Fraction: alpha-1-antitrypsin

Answer 10

alpha 1

Question 11

Function: alpha-1-antitrypsin

Answer 11

• major protein of ⍺1 fraction
• A trypsin inhibitor that prevents over-catabolism of structural protein in the lung

Question 12

Pos or neg APR: alpha-1-antitrypsin

Answer 12

Pos (increases during inflammation)

Question 13

Condition(s) in which it ↓ if applicable: alpha-1-antitrypsin

Answer 13

• in congenital alpha-1-antitrypsin deficiency
• Causes pulmonary emphysema

Question 14

Fraction: alpha-1-fetoprotein

Answer 14

alpha 1

Question 15

Function: alpha-1-fetoprotein

Answer 15

• principal fetal protein
• synthesized by developing embryo & fetal liver

Question 16

Condition(s) in which it ↓ if applicable: alpha-1-fetoprotein

Answer 16

• Decrease in maternal blood: Down Syndrome

Question 17

Conditions in which it ↑: alpha-1-fetoprotein

Answer 17

• Increased in maternal blood: spinal bifida, or open neural tube defect
• If present in adult serum: hepatocellular carcinoma, germ cell tumors (ie. testicular cancer)

Question 18

Fraction: Haptoprotein

Answer 18

alpha 2

Question 19

Function: Haptoglobin

Answer 19

• A glycoprotein and a major component of ⍺2 fraction
• Binds free Hgb (but not Mgb) during intravascular hemolysis
• HAP-Hgb complex cleared by reticulo-endothelial cells (prevents renal loss of Hgb)

Question 20

Pos or Neg APR: Haptoglobin

Answer 20

Pos (increased during inflammation, infection, or malignancy)

Question 21

Condition(s) in which it ↓: Haptoglobin

Answer 21

Decreased in intravascular hemolysis → sensitive indicator of intravascular hemolysis

Question 22

Fraction: alpha-2-macroglobulin

Answer 22

alpha 2

Question 23

Function: alpha-2-macroglobulin

Answer 23

• A major component of ⍺2 fraction
• The largest non-immunoglobulin protein in plasma
• Is a protease inhibitor, inhibits variety of proteinases (trypsin, thrombin, kallikrein & plasmin)

Question 24

Conditions in which it ↑: alpha-2-macroglobulin

Answer 24

– Increased: in nephrotic syndrome, Increased synthesis to maintain oncotic pressure due to loss in albumin

Question 25

Fraction: ceruloplasmin

Answer 25

alpha 2

Question 26

Function: Ceruloplasmin

Answer 26

- Is a Cu transport protein, binds 90% of body copper (Cu), prevents its deposition in organs - Also a Cu-containing oxidase enzyme Regulates Fe absorption, transport & utilization by oxidizing Fe2+ to Fe3+ (only Fe3+ can bind to transferrin & be stored in ferritin)

Question 27

Pos or neg APR: ceruloplasmin

Answer 27

Pos (increases during inflammation)

Question 28

Condition(s) in which it ↓: ceruloplasmin

Answer 28

- Menkes syndrome (congenital, kinky hair Dz) Impaired intestinal absorption of Cu2+, Serum Cu2+ ↓ - Wilson’s Dz (congenital, Kayser-Fleischer rings) Cu2+ cannot be incorporated into Cp → toxic deposits of Cu2+ in tissues → damage, esp liver & brain Serum Cu2+ ↓, urine Cu2+ ↑ & biopsy liver Cu2+ positive

Question 29

Fraction: transferrin

Answer 29

beta

Question 30

Function: transferrin

Answer 30

The major component of the β fraction Transports Fe3+ to bone marrow, liver, & RE cells for storage by ferritin

Question 31

Pos or neg APR: transferrin

Answer 31

Neg (decreases in inflammation)

Question 32

Conditions in which it ↑: transferrin

Answer 32

Iron deficiency anemia (compensatory mechanism to enhance Fe absorption)

Question 33

Fraction: beta-2-microglobulin

Answer 33

beta

Question 34

Function: beta-2-microglobulin

Answer 34

- A light chain of the MHC (major histocompatibilit y complex) found on the surface of most nucleated cells; esp. high on lymphocytes - Functions to present Ags to cytotoxic T lymphocytes

Question 35

Condition(s) in which it ↓: Beta-2-microglobulin

Answer 35

* increased cellular destruction (leukemia, MM, or renal transplant rejection) → urine levels also increase * Renal failure (↓ GFR) → urine levels ↓

Question 36

Conditions in which it ↑: Beta-2-microglobulin

Answer 36

Decrease (often normal) in blood but increased in urine Suggests renal tubular Dz (↓ reabsorbed & catabolized by RTE)

Question 37

Fraction: Complement proteins, C3 & C4

Answer 37

beta

Question 38

Function: Complement proteins, C3 & C4

Answer 38

identify, destroy and remove foreign pathogens and damaged ‘self’ materials

Question 39

Pos or Neg APR: Complement Proteins, C3 & C4

Answer 39

Pos (increase during inflammation + certain types of cancer)

Question 40

Condition(s) in which it ↓: Complement proteins, C3 & C4

Answer 40

- Autoimmune disease (lupus, rheumatologic) - Recurrent infection (usually bacterial) - Others: immune complex-induced renal Dzs

Question 41

Fraction: fibrinogen

Answer 41

beta-gamma interzone

Question 42

Function: fibrinogen

Answer 42

Functions in thrombosis

Question 43

Pos or Neg APR: fibrinogen

Answer 43

Pos (increases during inflammation)

Question 44

Condition(s) in which it ↓: fibrinogen

Answer 44

Disseminated intravascular coagulation (DIC)

Question 45

Fraction: C-reactive protein

Answer 45

- Involved in innate immunity by activating complement → enhances phagocytosis of bacteria & fungi - is the most sensitive APR, compared to other APRs (HAP & C3,C4), it rises the fastest & highest

Question 46

Pos or Neg APR: C-reactive protein

Answer 46

Pos (increased during inflammation)

Question 47

Conditions in which it ↑: C-Reactive Protein

Answer 47

``` Infection or inflammation (a key inflammatory marker)- CRP test Cardiovascular Dz (a marker for cardiovascular Dz risk)- hs-CRP (high sensitive) ```

Question 48

Fraction: Immunoglobulins

Answer 48

gamma

Question 49

Function: immunoglobulins

Answer 49

Produced by plasma cells in blood & lymph in response to infection

Question 50

Pos or Neg APR: Immunoglobulins

Answer 50

Pos

Question 51

Condition(s) in which it ↓: Immunoglobulins

Answer 51

immunodeficiency: congenital or acquired (HIV)

Question 52

Conditions in which it ↑: Immunoglobulins

Answer 52

- Polyclonal gammopathy → broad peak o Infection or chronic inflammatory conditions - Monoclonal gammopathy → single sharp peak o Multiple Myeloma: IgG, IgA, IgM rare o Waldenstrom’s macroglobuline mia: IgM