Proteins Flashcards

(52 cards)

1
Q

What is the most abundant serum protein?

A

Albumin

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2
Q

What are the manifestations of Analbuminemia?

A
  • Mild Edema

- Hyperlipidemia

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3
Q

Clinical utility of measuring Albumin? (5)

A
  • Nutritonal status
  • Hepatic synthetic function
  • Renal glomerular function
  • Negative acute phase reactant
  • Diabetic control
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4
Q

What is the T1/2 of albumin?

A

17 days

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5
Q

What is glycated albumin an indicator of?

A

short term glycemic control

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6
Q

Function of Prealbumin.

A
  • Binds thyroxine (transthyretin [TTR])

- Binds aRetinol binding protein (Vit.A complex)

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7
Q

Clinical utility of measuring Prealbumin? (3)

A
  • Nutritional status
  • Negative acute phase reactant
  • Hallmark of CSF protein electrophoresis
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8
Q

What is the major component of the alpha1 band?

A

-Alpha1-Antitrypsin (AAT)

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9
Q

Alpha1-Antitrypsin (AAT):

  • Gene
  • # of alleles
  • MC allele
  • MC genotype
A
  • SERPINA1
  • > 100 alleles (Polypmorphic)
  • PiM (MC allele)
  • PiMM (MC genotype)
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10
Q

Genotype for AAT deficiency?

A

PiZZ

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11
Q

What is the major component of increased alpha1 ban in acute inflammatory states?

A

Alpha1-Glyocoprotein

*Normally only a minor component of a1 band

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12
Q

Relative concentrations of a2-macroglobulin is elevated in what conditions?

A

-Liver and Kidney disease

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13
Q

T/F: a2-macroglobulin is lost in nephrotic syndrome.

A

False

-large size prevents loss, leading to a relative 10 fold rise in concentation

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14
Q

Ceruloplasmin is involved in what disease?

A

Wilson’s Disease

-Decreased levels

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15
Q

what is the 3rd major component of the a2 band?

A

Haptoglobin

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16
Q

What is the role of Haptoglobin?

A

Binds free Hb

-Rapidly depleted in Intravascular Hemolysis

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17
Q

What is the major Beta Globulin?

A

Transferrin

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18
Q

Function of Transferrin.

A

Transports Ferric (Fe3+)

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19
Q

Transferrin levels in IDA.

A

Markedly INcreased

*normally ~30% Saturated

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20
Q

Transferrin:

-Hallmarks of CSF electrophoresis

A
  • Asialated transferrin (so called tau protein)

- Double transferrin peak

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21
Q

What is a beta-globulin that is usually absent from serum?

22
Q

When might you see Fibrinogen on electrophoresis?

A

If specimen clots incompletely

  • May produce psuedo M spike
  • May straddle beta/gamma interface
23
Q

Where is C reactive protein (CRP) found on SPEP?

A

-gamma region

24
Q

What is a normal CRP value?

25
What is a HIGH level CRP elevation, and what may it indicate?
>10 mg/L | -Active inflammation
26
What is a LOW level CRP elevation, and what may it indicate?
3-10 mg/L - Cellular stress - Correlated with higher all cause mortality - Poor outcome following CV events
27
Normal SPEP pattern.
- Large albumin band (prealbumin invisible) - small peaked a1 band - broad a2 band - bimodal beta - broad gamma
28
Bisalbuminemai SPEP pattern.
Double albumin spike - Heterozygotes for albumin alleles - Insignificant
29
AAT deficiency pattern.
Absent A1 band | -not the most sensitive or specific assay
30
Nephrotic syndrome SPEP pattern.
Decrease of ALL bands -EXCEPT a2 band that contains a2-macroglobulin *loss of small serum proteins, particularly Albumin
31
Acute inflammation SPEP pattern.
- Decreased Albumin - Increased a1 and a2 bands - normal to increased gamma band
32
When is Beta-gamma bridging seen?
- Cirrhosis | - Increased serum IgA
33
What are additional features seen in beta-gamma bridging?
- Hypoalbuminemia | - Blunted a1 and a2 bands
34
M spike is most commonly due to what conditions? (3)
- Plasma cell neoplasm - Waldenstrom (lymphoplasmacytic lymphoma) - CLL/SLL
35
What causes a pseudo M spike? (6)
- Fibrinogen (incompletely clotted) - Hemoglobin (hemolyzed) - CRP Increase - Transferrin Increase - Abx/contrast dyes - Tumor markers
36
Where are most IgG paraproteins found in SPEP?
gamma region
37
Where are most IgM paraproteins found in SPEP?
beta-gamma interface
38
Where are most IgA paraproteins found in SPEP?
beta region
39
T/F: CSF normally contains essentially all proteins present in serum.
True; although smaller quantities
40
What are the characteristic features of CSF on PEP?
- Prominent Prealbumin band | - Double beta (transferrin) band
41
Findings of CSF electrophoresis in MS?
Oligoclonal bands | -should be Absent from serum
42
Urine Electrophoresis: | -Glomerular proteinuria
- Strong Albumin - Strong a1 - Strong Beta *Intermediate sized proteins - Albumin, AAT, transferrin
43
Urine Electrophoresis: | - Tubular proteinuria
- Weak Albumin - Strong a1 - Strong Beta
44
Urine Electrophoresis: | - Overflow proteinuria
- Monoclonal light chain (Bence Jones) | - Absent albumin, a1, a2, beta (decreased)
45
Definition of cyroglobulins.
Immunoglobulins that precipitate reversibly at low temperature.
46
Steps for detecting cyroglobulins.
- 37 till clotted - centrifuge at 37 - Serum placed at 4 for >3 days - centrifuge at 4 - precipitate is cryoglobulin - characterized by electrophoresis or immunofixation
47
What are type I cryoglobulins?
-Monoclonal Igs ass. w/ MM or Waldenstrom
48
What are type II cryoglobulins?
- Mixture of a monoclonal IgM and Polyclonal IgG | - IgM has rheumatoid factor activity (anti IgG)
49
What are type III cryoglobulins?
- Mixture of 2 polyclonal Igs (typically IgG and IgM) | - IgM has rheumatoid factor activity
50
What is the most common type of cryoglobin?
Type II
51
What is the MCC of mixed cryoglobinemia (types II and III)
HCV infection
52
what is the pH for Electrophoresis of serum? How are the bands measures?
- 8.6 | - Densitometry