MDT 160 Protein slides

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MDT 160 Protein slides
2015-10-26 20:36:25
MDT 160 Protein slides

MDT 160 Protein slides
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  1. Normal SPE
  2. Albumin is?

    A) Most abundant protein in plasma
    B) approximately half of total protein
    C) Synthesized in liver
    D) all of the above
    All of the above
  3. Half life of albumin is?
    15-19 days
  4. Principle functions of albumin are?
    • Maintaining fluid balance
    • Transfer protein
  5. total extravascular albumin exceeds the total intravascular albumine by ?
  6. rare and of no clinical significance albumin disorder?
  7. Albumin disorder with:
    Increased loss (nephrotic syndrome)
    Decreased synthesis (nutritional deficit, liver failure)
  8. dimeric albumin with equal intensities?
  9. How many binding sites does Albumin has?
  10. Albumin is responsible for nearly ____% of colloid osmotic pressure
  11. Decreased concentration of serum albumin may be caused by?
    • Decrease concentration of amino acids(malnutrition, malabsorbtion)
    • Liver disease
    • Protein losing eteropathy
    • Kidney loss of albumin via urine
    • Hypotyroidism 
    • Acute disease state
  12. Increased serum albumin levels are seen?
    • dehydration
    • excessive albumin infusion
  13. Pre-albumin is so named because?
    in migrates before albumin in classic electrophoresis of serum or plasma proteins
  14. Only protein that migrates anodal to albumin is?
    pre albumin
  15. Thyroxine-binding protein
    also called transthyretin
    complexes with retinol-binding protein
    Sensitive marker of nutritional status with half life of 2 days
    all characteristics of?
    pre albumin
  16. pre albumine is decrease in?
    • hepatic damage
    • acute phase inflammatory response
    • tissue necrosis
  17. pre albumin is increased in?
    • patients receiving steroids
    • alcoholism
    • chronic renal failure.
  18. The globulin group of proteins consists of?
    • α1
    • α2
    • β
    • γ
  19. Antitrypsin
    Acid Glycoprotein ( Orosomucoid)
    are all part of what group of globulins?
    alpha 1
  20. Mutations of what gene cause α1-Alphatrypsin deficiency?
  21. protease inhibitor that binds to and inactivates trypsin
  22. -acute phase protein and is increased in acute episodes of tissue damage.
    -Deficiency leads to destruction of the alveolar walls and is associated with pulmonary deficiency ( Pulmonary Emphysema) .
    -Deficiency also seen in cirrhosis
  23. The only a screening test for α1-Antitrypsin deficiency is?
  24. What phenotype individuals most at risk for liver and lung disease from deficiency of α1-Antitrypsin?
    homozygous phenotype ZZ
  25. Principal fetal protein, used to screen for fetal abnormalities is?
    α1-Fetoprotein (AFP)
  26. what hormone is bound by AFP?
  27. Increased levels of AFP level cause?
    • spina bifida
    • neural tube defect
    • abdominal wall defect
    • anencephaly( absence of major portion of the brain)
  28. lower levels of maternal AFP indicate?
    • increased risk for Down syndrom
    • and
    • Trysomy 18
  29. AFP screening is done between?
    15-20 weeks gestational age
  30. Binding of drugs to what plasma protein has become increasingly important in regard to drug action , distribution and disposition ?
    α1-Acid glycoprotein (orosomucoid)
  31. - Acute phase protein, produced in liver, increased during inflammation.
    - inhibits cathepsin G.
    - deficiency has been associated with liver disease
    - Mutation associated with Parkinson's and chronic obstructive pulmonary disease  
    - also associated with Alzheimer disease
    alpha1 Antichromotrypsin
  32. Name α2 plasma proteins
    • α2-Macroglobuline
    • Ceruloplasmin
    • Haptoglobin
  33. -Large non-immunoglogulin in plasma
    -Synthesized in the liver
    -Increased levels in nephrosis because its large size prevents passage into the urine. Also there is an increase in synthesis.
    –It is not an acute phase protein
  34. - Copper transport protein
    - Participates in plasma redox reactions
    - levels fluctuate with a variety of physiological states, but measurement is usually to screen for Wilson’s disease
    - plasma levels decrease usually due to inhibition of synthesis
  35. Synthesized in the liver (hepatocytes)
    Binds to, and preserves, hemoglobin
    Low levels in intravascular hemolysis
    Increased levels because it is an acute phase
    tetramer ( 2 alpha and 2 beta chains)
  36. how many molecules of ferric iron can be bound to one molecule of transferrin?
  37. Negative acute phase protein
    transports and prevents the lass of iron through kidney, also binds copper
    Increased in: iron deficiency anemia ( abnormal high), pregnancy and estrogen therapy.
    Decreased in acute inflammation due to decrease synthesis by the liver
  38. which disorder is inherited as an autosomal recessive trait due to mutation of both Transferrin genes, with a resulting absence of Transferrin.
    Can be effectively treated with plasma infusion of Transferrin
  39. Immunoglobulin that migrates in the gamma and beta regions and is increased in infections, autoimmune and liver disease ?
  40. the ratio of κ and λ chains is?
  41. mechanism that changes an antibody from one class to another is  know as?
    isotype switching
  42. what region of the antibody changes during class switching?
    constant region of the heavy chain.
  43. most abundant antibody found in plasma and lymph.
    act on bacteria, fungi, viruses by opsonization or agglutination
    activate complement, neutralize toxins
    increased in liver disease, parasitic disease, rheumatic diseases
    decrease in acquired immunodificiency, hereditary deficiency,
  44. migrates in the alpha-2, beta and gamma regions.
    found in secritions: mucus, tears, saliva, gastrointestinal and respiratory mucus.
    has two Isotypes
    could be classified as secretory or serum
  45. migrates in the gamma region
    appears first in response to antigenic stimulation
    Pentamer, neutrally accruing
    Increased: toxoplasmosis, primary biliar cirrhosis, cytomegalovirus
  46. the most sensitive indicator of an acute phase reaction (inflammation, trauma, infection)
    C-reactive protein ( CRP)
  47. γ Region includes immunoglobulins such as?
    IgG, IgA, IgM, IgD and IgE
  48. Single sharp peak at γ Region indicates a _______ and associated with __________
    • paraprotein
    • monoclonal gammopathy
  49. A small band at γ Region is indicative of?
  50. normal SPE
  51. Immediate response pattern:
    Decrease in albumin 
    Increase in APR haptoglobin
  52. Nephrotic Syndrome:
    Decreased albumin
    Increased α2-macroglobulin
    Decreased gamma globulins
  53. Hepatic cirrhosis: 
    Decreased albumin (synthesis)
    Increased gamma globulins (polyclonal gammopathy)
  54. Monoclonal gammopathy:
    Albumin decreased
    Sharp peak in gamma region
  55. Serum VS Plasma
    • Total Protein levels in plasma are higher than in serum
    • Fibrinogen is present in plasma but not in serum
    • SPEP will show a “monoclonal” band in the gamma region that is due to fibrinogen
  56. Kjeldahl’s method (reference)
    Direct photometry
    Folin-Ciocalteu (Lowery) method
    Dye-binding methods (Amido black; Coomassie Brilliant Blue; Silver)
    Precipitation with sulfosalicylic acid or trichloracetic acid (TCA)
    Biuret method
    analytical methods for measuring total proteins
  57. total protein levels less than reference interval, occurs in any condition where a negative nitrogen balance exists?
  58. an increase in total plasma proteins, is not an acute state, but is the result of the underlying cause, dehydration, excessive production of the γ- globulins.
  59. the specimen most often used to determine the total protein is?
  60. total protein, ↑
    albumin ↑
    globulin ↑
  61. total protein ↓
    albumine ↓
    globulin ↓
    salt retention syndrome
  62. total protein ↑
    albumin : normal
    globulin ↑
    • multiple myeloma
    • monoclonal and polyclonal gammopathies
  63. Highest incidence of  Multiple Myeloma in ____, lowest ______
    • African Americans
    • Asians
  64. Workup of suspected multiple myeloma includes:
    • Skeletal survey
    • Bone marrow biospy
    • Flow cytometry
    • Chemistry
  65. Chemistry Workup for suspected multiple myeloma includes?
    • CBC
    • ABC with diff
    • β2- Microglobulin
    • Quantitative immunoglobulines
    • SPEP, UPEP
  66. Flow cytometry Workup for suspected multiple myeloma
    • CD56, CD38, CD138 positive
    • CD19, CD45 negative
    • Bone Marrow Plasmacytosis >10% of Plasma Cells
    • Serum Monoclonal Protein
    • End Organ Damage
    • Lytic Bone Lesions
    • Renal Insufficiency Anemia
    • Increased Calcium
  68. Serum monoclonal proteins
    Polyclonal Immunoglobulin: Decreased
    Proteinuria, Bence-Jones Protein present in urine
    BUN, Creatinine ↑
    Calcium ,N ↑
    Multiple Myeloma
  69. Hemoglobin Decreased
    Anemia - Normochromatic,
    ESR Increased
    Rouleaux Formation
    Multiple Myeloma
  70. Characteristics:
    Monoclonal protein < 3 g/dl
    Bone marrow: < 10% clonal plasma cells
    No related organ or tissue impairment
    Risk of progression to malignance1% per year
    Management: observation
    MGUS(Monoclonal gammopathyof undetermined significance)
  71. Monoclonal protein > 3 g/dl
    Bone marrow: >10% clonal plasma cells
    No related organ or tissue impairment
    Risk of progression to malignance10% to 20 % per year
    Asymptomatic or smoldering Myeloma

    Managment: Observation with treatment beginning at disease progression
  72. Monoclonal protein in serum and/or urine
    Bone marrow clonal plasma cells or plamacytoma
    Related organ or tissue impariment
    • Symptomatic Myeloma
    • Managment: Immediate treatment