Proteins

Question 1

Reference intervals

Answer 1

Clinical Laboratory Standatds Institute recommends to
collect samples from minimum 120 individuals to determine
reference intervals by nonparametric means.

Question 2

Sensitivity:

Answer 2

capacity of the test to identify all individuals

with disease – probability of a positive test among patients with disease

Question 3

Specificity

Answer 3

indicates the effectiveness of a test to correctly

identify those without disease; probability of a negative test among patients without disease

Question 4

Newborns (variables that affect

laboratory test results)

Answer 4

High: Bilirubin, alkaline phosphatase
Low: glucose
Creatinine increases from infancy to puberty

Question 5

Old people variable test results

Answer 5

High: Urea, cholesterol
Low: PTH and estrogen

Question 6

Male higher than female

Answer 6

ALT,AST, CK

Albumin, calcium, magnesium

Question 7

Female

Answer 7

Higher: gamma globulin, reticulocyte count
Lower: iron, ferettin

Question 8

Circadian variation

Answer 8

Fasting glucose in higher in the morning than evening
o Insulin: basal level higher in the morning than
later in the day, and its response to glucose is also
greater in the morning
o Iron: Morning levels are higher than afternoon or
evening levels
o Cortisol: peak in the morning

Question 9

Low protein diet:

Answer 9

retinol binding protein,

prealbumin decreased

Question 10

Sodium range

Answer 10

135-145 mmol/L

Question 11

Potassium range

Answer 11

3.5-5.5 mmol/L

Question 12

Calcium range

Answer 12

2.1-2.6 mmol/L

Question 13

HCO3 range

Answer 13

22-30 mmol/L

Question 14

Total protein

Answer 14

6-8 g/dL

Question 15

Alpha feto protein

Answer 15

Glycoprotein, major fetal serum protein
 Marker of hepatocellular carcinoma and nonseminomatous germ cell tumors
 Elevated during pregnancy, in cirrhosis, hepatitis

Question 16

CEA

Answer 16

Glycoprotein belonging to the immunoglobulin superfamily involved in cell adhesion
 Slightly increased: smokers, after alcohol consumption, pregnant women, patients with diabetes, hepatitis, pancreatitis, colitis
 Increased in: colorectal, liver, lung, pancreatic cancer  Used to monitor treatment and determine recurrence

Question 17

Agammaglobulinemia

Answer 17

Bruton’s disease = X-linked agammaglobulinemia
Typically:
Low levels of IgG (<0,015 g/l), undetectable levels of the other immunoglobulins

Question 18

Monoclonal gammopathy:

Answer 18

Multiple myeloma (IgG, IgA, IgM, IgE, IgD)
Waldenstrom’s macroglobulinemia (IgM)
Lymphomas
MGUS–monoclonalgammopathyof undetermined significance

Question 19

Positive APP:

Answer 19

CRP, serum amyloid A, procalcitonine, α1 acid glycoprotein, α1 antitrypsin,
α1 antichymotrypsin,
α2 macroglobulin, haptoglobin, ceruloplasmin, complement proteins, hemopexin, fibrinogen, lactoferrin

Question 20

Negative APP (decreased in response to infla )

Answer 20

Albumin, transferrin, pre albumin

Question 21

Acute inflammation

Answer 21

alpha 1, alpha 2 elevated

Question 22

Chronic inflammation

Answer 22

gamma-globulins elevated

Polyclonal gammopathy – similar pattern can be observed in autoimmune diseases

Question 23

Bisalbuminemia: double band in electrophoresis;

Answer 23

hereditary (electrophoreticallydistinctformsoralbumindimers)or acquired (may be associated with hiperamylasemia, penicillin theraphy, diabetes or the nephrotic syndrome)

Question 24

Analbuminemia

Answer 24

rare autosomal recessive disorder, mild clinical signs and biochemical abnormalities: fatigue, low blood pressure, edema, increased concentration of other plasma proteins „compensates” the lack of albumin.