Plasma Proteins & Enzymology

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medstudent2017
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312104
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Plasma Proteins & Enzymology
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2015-11-26 07:53:24
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Plasma Proteins & Enzymology
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  1. The liver is the site of the production of
    All proteins, with the exception of immunoglobulins
  2. Citrate and EDTA are anticoagulants that specifically bind
    Calcium and magnesium
  3. How does plasma differ from serum
    Serum has no fibrinogen, Plasma does
  4. What is in the buffy coat
    White cells, platelets, leukocytes
  5. What white blood cell is found in the highest amount in the body
    Neutrophils at about 60% and Lymphocytes come second with around thirty percent. The rest are found in very small amounts
  6. Albumin is the only protein
    With no sugars added to it
  7. Asialoglycoprotein receptors recognize
    Proteins with galactose residues on them and remove them from circulation
  8. Why would it be important to have a good amount of Albumin in the blood when administering drugs
    Because Albumin often is their carrier, and the drugs can be toxic if not bound to a carrier
  9. Electrophoresis seperates proteins by their
    Charge
  10. On a density plot as well as serum electrophoresis, what appears most obviously and why
    Albumin because it has the most negative charge
  11. An α1-Globulin band contains what important proteins
    Alpha 1 Antitrypsin or protease
  12. The α2 Globulin band contains what important proteins
    • Mainly alpha 2 macroglobulin (protease inhibitor)
    • Haptoglobulin (binds hemoglobin)
    • Ceruloplasmin (copper transport)
  13. What is the most important protein found in a Beta 1 band
    Transferrin (transports iron)
  14. Beta 2 Globulin bands contain
    • Compliment protein (Immune system)
    • Fibrinogen
  15. Gamma Globulin bands contain
    Immunoglobulins
  16. Albumin has what functions
    • Maintain oncontic pressure
    • Transport (fatty acids, bilirubin, drugs, and other waste products)
  17. What are some examples of drugs that are transported by Albumin
    • Salicylates (aspirin)
    • Barbiturates (anticonvulsant)
    • Warfarin (anticoagulant)
    • Penicillin
  18. What should not be taken along with Salicylates (Aspirin) and why
    • Warfarin, because it will diminish its effects
    • Salicylates are an inhibitor of Warfarin
  19. What is one reason for edema
    • Hypoalbuminemia, Low albumin
    • The blood no longer retains water as well
  20. In cirrhosis of the liver what will be found in low levels
    Albumin, this is because the liver makes it.
  21. What are some of the causes of low albumin synthesis
    • A high amount of Interleukin 6 (IL6)
    • Stress and inflammation
  22. The distribution of Albumin can be negatively effected by
    • An increase in capillary permeability
    • Decrease being cleared from the lymph
  23. An increase in the metabolism (breakdown) of Albumin can be a result of
    • Chronic infections
    • Trauma
  24. There are dramatic losses in Albumin when what happens
    • Severe burning on a patient
    • Renal disease
    • GI loss
    • Excessive hemorrhaging
  25. An acute response to infection would display how in Albumin
    A low Albumin
  26. How large of a drop in Albumin can negatively effect a patient
    A drop as low as 2%
  27. When there is an absence of Albumin, what can compensate in some cases
    Alpha 2 macroglobulin (It helps to maintain osmotic pressure)
  28. What is Analbuminemia
    A genetic impaired synthesis of albumin
  29. Hyperalbuminemia is not found very often but can be caused by
    • Dehydration
    • Excessive and extended pressure on a cuff during venipuncture
  30. Thyroxine binding globulin is important protein binding unit for
    • Thyroid Hormones (T3 and T4)
    • These bind to hormones in the blood and take them to target organs
  31. Cortisol-binding globulin (Transcortin) binds to
    Glucocorticoids and many other steroid hormones
  32. What is found in very low amounts in trisomy 21 and is therefore a good marker for such
    Alpha Fetoprotein
  33. Alpha Fetoprotein is produced by the liver, is found only in, and can be used to detect
    Only found in fetus, and looks for neural tube defects, and as a tumor marker for hepatocellular cancer
  34. α1 Antiprotease is a protease inhibitor that if not managed well
    Can do a lot of damage in the cell because it needs to control protease which is used when infection is present
  35. α2 Macroglobulin found high in what conditions, and has what function
    Protease inhibitor and is found high in renal disease. It is important in times of infection
  36. Beta 2 Microglobulin is used in the detection of
    Nephrotic syndrome
  37. A low plasma haptoglobin and blood in the urine indicates
    Hemoglobinuria
  38. Normal haptoglobin in the plasma but blood in the urine indicates usually
    Myoglobinuria
  39. If myoglobin and haptoglobin are at normal levels, but blood is found in the urine what is going on
    There is tissue or organ damage somewhere
  40. Why is immunoglobulin A high when there is liver cirrhosis
    Because the liver looses its ability to regulate it in the intestines
  41. Both α2 Macroglobulin and Beta 2 microglobulin can be used to detect
    Nephrotic syndrome
  42. Low ceruloplasmin is used in the detection of
    • Wilsons disease, when copper levels are high.
    • Green rings around ones eyes can be a physical manifestation due to the storage of copper in tissue
  43. Hemopexin binds to
    Heme
  44. Transferrin binds to
    Iron
  45. Why don't you want hormones free in the blood in their active state
    It can cause issues
  46. The immune protein fibrinogen is important for
    Blood clotting
  47. What is the first to rise in an acute inflammation an what does it do
    C-Reactive protein, it binds to the cell walls of bacteria
  48. What is the role of Haptoglobin
    It transports free hemoglobin from dead RBC's to be degraded
  49. What is the role of Hemopexin
    It delivers free heme to the liver preventing it from harming the body
  50. What could free Hemoglobin do to the body
    It causes kidney tubule damage
  51. α1-Antitrypsin is formed where
    In the liver, therefore, low numbers would indicate liver damage
  52. α1-Antitrypsin is very important where
    In the lungs where it breaks down proteins, so low amounts of it can cause emphysema
  53. After an infection what is the first marker to rise
    α2-Macroglobulin and a decrease in the Albumin
  54. After 5-6 days following an infection what is noted in the markers of serum protein pherisis
    There is a decrease in Albumin and an increase in α2 and gamma (immunoglobulins)
  55. What is a typical pattern in protein banding when cirrhosis of the liver is present
    • A decrease in Albumin, and increase in α2 and a large increase in gamma
    • (liver loses the ability to limit IgA secretion)
  56. In nephrotic syndrome the protein phersis shows
    Very low Albumin, very high Alpha 2 and low immunoglobulins because they are escaping the renal tubules
  57. Administration of albumin is common in what conditions
    • Hypovolemic shock (5% concentration admin.)
    • Cerebral edema (25%)
  58. A chronic infection would display what in the protein banding
    A rise on all accounts but albumin, most obviously in gamma
  59. What degrades anesthetics and cocaine
    Cholinesterase
  60. Where is Cholinesterase found predominantly
    Nervous system and erythrocytes
  61. Scoline apnea is when
    A patient doesn't have Cholinesterase, so they are strongly effected by anesthetics
  62. Ingestion of organophosphatase causes
    Inhibition of cholinesaterase
  63. Atropine Sulphate
    Is an inhibitor of cholinesterase
  64. An increase in the amount of cholinesterase can be due to
    • Rapid liver regeneration
    • Nephrotic syndrome
  65. What is a transaminase
    A group of enzymes that turn an amino group from amino acids into an alpha ketoacid
  66. What are the two subgroups of transaminase
    • Aspartate Transaminase AST
    • Alanine Transaminase ALT
  67. AST has a high concentration in what cells
    • Cardiac and skeletal muscle (most important)
    • Liver (most important)
    • Kidney
    • Erythrocytes
  68. High AST indicates
    • MI
    • Circulatory failure
    • Hepatitis
  69. ALT is found in high concentrations in
    • Liver (primarily)
    • Skeletal and cardiac muscle (low levels)
    • Kidney (low levels)
  70. A large increase in ALT can be due
    • High increase
    • Circulatory failure
    • Hepatitis
    • Low increase
    • Liver Cirrhosis
    • Jaundice
    • Post cardiac Surgery
    • Skeletal Muscle disease
  71. Presence of high Alkaline phosphatase (ALP) indicates
    • Bone issues (most important)
    • Bile Duct issues
  72. Physiologically Alkaline Phophatase (ALP) is high when
    • Pregnancy
    • Childhood (bone development)
    • Fatty meals
  73. Acid phosphatase (AP) is found in cells of
    • BLEPP
    • Bone
    • Liver
    • Erythrocytes
    • Platelets
    • Prostate
  74. What is the most important marker for prostate issues
    Prostate specific antigen PSA
  75. Lactate Dehydrogenase (LDH) will show elevated levels when
    • There is an acute MI (rise in 1 and 2)
    • Acute hepatitis (rise in all, especially 5)
  76. Creatine Kinase is found in muscles but what are the isoenzymes
    • CK BB Brain tumor
    • CK MB Heart muscle
    • CK MM Skeletal muscle
  77. Gamma GT is found mainly in what cells
    • Liver
    • Kidneys
    • Pancrease

    Higher in males then in females
  78. Gamma GT primarily shows damage to the
    • Liver from alcohol consumption
    • Anticonvulsants (phenobarbitol) increase it as well
  79. If Alkaline Phosphatase (ALP) and Gamma GT are both high it indicates
    There is an issue with the bile duct
  80. Normal Gamma GT and high Alkaline Phosphatase (ALP) indicates
    Bone Disease
  81. Amylase is found primarily in
    The pancreas and salivary glands
  82. Following an MI what will be the sequence of rised levels in the days following the incident
    • Peaks at
    • 1st day CK
    • 2nd day AST
    • 3rd day LDH
    • All elevated by first day though

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