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68 Cards in this Set
- Front
- Back
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What are some functions of protein?
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- Energy production
- Water distribution - Buffer - Transporter - Antibodies - Cellular proteins - Structural proteins - Enzymes |
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Total protein reference range:
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6.5-8.3 g/dL
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Albumin reference range:
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3.5-5.0 g/dL
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What causes hypoproteinemia?
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- Urinary loss
- Gastrointestinal tract inflammation - Liver disorders - Malnutrition - Inherited immunodeficiency disorders - Extensive burns |
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What causes hyperproteinemia?
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- Dehydration
- Increased protein production associated with monoclonal and polyclonal gammopathies - Chronic inflammatory diseases associated with paraprotein production |
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What is an indicator of nutritional status and is one of the proteins that transports thyroid hormones?
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Prealbumin
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Decreased prealbumin?
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- Liver disorders
- Inflammation - Malignancy - Poor nutrition |
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Increased prealbumin?
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- Steroid therapy
- Chronic renal failure - Alcholism |
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What binds many analytes for transport in blood, including unconjugated bilirubin, steroids, ions such as calcium and magnesium, fatty acids, and drugs, and significantly contribues to plasma osmotic pressure?
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Albumin
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Decreased albumin?
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- Liver disorders because of decreased production
- Gastrointestinal disease associated with malabsorption - Muscle-wasting diseases - Severe burns caused by loss - Renal disease caused by loss (nephrotic syndrome, glomerulonephritis) - Starvation - Malnutrition |
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Increased albumin?
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Dehydration
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What is an acute-phase reactant and a protease inhibitor that neutralizes trypsin-type enzymes that can damage structural proteins?
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Alpha-1-antitrypsin
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Decreased alpha-1-antitrypsin?
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- Emphysema-associated pulmonary disease
- Severe juvenile hepatic disorders that may result in cirrhosis |
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Increased alpha-1-antitrypsin?
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- Inflammatory diseases
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What is synthesized during gestation in the yolk sac and liver of the fetus, peaking at 13 weeks and declining at 34 weeks?
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Alpha-1-fetoprotein (AFP)
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Decreased AFP?
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- Hepatocellular carcinoma
- Gonadal tumors |
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Increased AFP?
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- Neural tube defects
- Spina bifida - Fetal distress |
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What is an acute-phase reactant that binds to basic drugs?
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Alpha-1-acid glycoprotein (orosomucoid)
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Decreased alpha-1-acid glycoprotein?
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Nephrotic syndrome
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Increased alpha-1-acid glycoprotein?
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- Inflammatory disorders such as rheumatoid arthritis
- Pneumonia - Conditions associated with cell proliferation |
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What is an alpha2-globulin that binds free hemoglobin and is an acute-phase reactant?
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Haptoglobin
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Decreased haptoglobin?
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Intravascular hemolysis because of formation of a haptoglobin-hemoglobin complex for removal by the liver
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Increased haptoglobin?
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- Inflammatory conditions
- Burns - Trauma |
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What is an acute-phase reactant that is an alpha2-globulin, copper-containing protein with enzymatic activity?
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Ceruloplasmin
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Decreased ceruloplasmin?
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- Wilson disease
- Malnutrition - Malabsorption - Severe liver disease |
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Increased ceruloplasmin?
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- Pregnancy
- Inflammatory disorders - Malignancies - Intake of oral estrogen and oral contraceptives |
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What is a proteolytic enzyme inhibitor that inhibits thrombin, trypsin, and pepsin?
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Alpha2-macroglobulin
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Decreased alpha2-macroglobulin?
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- Acute inflammatory disorders
- Prostatic cancer - Acute pancreatitis |
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Increased alpha2-macroglobulin?
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- Nephrotic syndrome
- Contraceptive use - Pregnancy - Estrogen therapy |
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What is a beta-globulin that transports iron?
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Transferrin
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Decreased transferrin?
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- Infections
- Liver disease - Nephrotic syndrome |
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Increased transferrin?
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- Iron deficiency anemia
- Pregnancy |
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What is a beta-globulin that is an acute-phase reactant?
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C-reactive protein (CRP)
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Increased CRP?
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- Tissue necrosis
- Rheumatic fever - Infections - Myocardial infarction - Rheumatoid arthritis - Gout |
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Function of prostate specific antigen (PSA)?
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- Produced by epithelial cells of the prostate gland and secreted into seminal plasma
- Glycoprotein protease that functions in liquefaction of seminal coagulum - Men with prostate cancer will have lower % of free PSA than men with benign disease - Monitor therapeutic response and to follow radical prostatectomy |
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Clinical significance of alpha-1-fetoprotein (AFP)?
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Increased in:
- Hepatocellular carcinoma - Testicular and ovarian teratocarcinomas - Pancreatic carcinoma - Gastric and colonic carcinomas - Viral and chronic active hepatitis - Spina bifida - Neural tube defects - Fetal distress Decreased levels: - Increased incidence of Down syndrome |
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Clinical significance of carcinoembryonic antigen (CEA)?
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Increased in:
- Adenocarcinoma of digestive tract - Colorectal carcinoma Useful in monitoring therapeutic response of cancer patients to treatment protocols |
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Increased human chorionic gonadotropin (HCG)?
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- Trophoblastic tumors
- Choriocarcinoma - Nonseminomatous testicular tumors - Ovarian tumors |
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Clinical significance of CA 15-3?
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Useful for monitoring therapeutic response and for detecting recurrence of breast cancer in patients previously treated
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Clinical significance of CA 125?
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Marker for ovarian and endometrial cancer
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Clinical significance of CA 19-9?
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Marker for pancreatic, colorectal, lung, and gastric carcinomas
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What is urea?
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A major nitrogen-containing compound in the blood that results from protein catabolism and is synthesized in the liver from the deamination of amino acids. Excreted by the kidneys.
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Decreased serum urea?
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- Severe liver disease
- Vomiting - Diarrhea - Malnutrition |
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Increased serum urea?
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- Renal failure
- Glomerular nephritis - Urinary tract obstruction - Congestive heart failure - Dehydration - Increased protein catabolism |
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What is creatinine?
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A waste product of muscle contraction that is formed from phorphocreatine. Regulated by kidney extraction.
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Clinical significance of serum creatinine?
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Renal disease and renal failure
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Creatinine clearance formula?
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UV(1.73)
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What is uric acid?
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A major waste product of purine catabolism. Synthisized in the liver.
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Decreased serum uric acid?
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- Severe liver disease
- Tubular reabsorption disorders - Drug induced |
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Increased serum uric acid?
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- Gout
- Renal disorders - Treatment of myeloproliferatieve disorders - Lead poisoning - Lactic acidosis - Toxemia of pregnancy - Lesch-Nyhan syndrome |
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Clinical significance of ammonia?
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Increased in hepatic failure and Reye syndrome
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What are the hormones that affect blood glucose level?
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- Insulin
- Somatostatin - Growth hormone and adrenocorticotropic hormone (ACTH) - Cortisol - Epinephrine - Glucagon - Thyroxine |
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What is insulin?
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- Produced by the beta cells of the pancreatic islets of Langerhans
- Promotes the entry of glucose into liver, muscle, and adipose tissue to be stored as glycogen and fat - Inhibits the release of glucose from the liver |
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What is somatostatin?
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- Syntheisized by delta cells of the pancreatic islets of Langerhans
- Inhibits secretion of insulin, glucagon, and growth hormone, resulting in an increase in plasma glucose level |
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What is growth hormone and ACTH?
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Hormones secreted by the anterior pituitary that raise blood glucose levels
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What is cortisol?
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- Secreted by the adrenal glands
- Stimulates glycogenolysis, lipolysis, and gluconeogenesis |
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What is ephinephrine?
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- Secreted by the medulla of the adrenal glands
- Stimulates glycogenolysis and lipolysis - Inhibits the secretion of insulin |
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What is glucagon?
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- Secreted by the alpha cells of the pancreatic islets of Langerhans
- Increases blood glucose by stimulating glycogenolysis and gluconeogenesis |
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What is thyroxine?
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- Secreted by the thyroid gland
- Stimulates glycogenolysis and gluconeogenesis - Increases glucose absorption from the intestines |
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What is type 1 diabetes mellitus?
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Characterized by insulinopenia and require treatment with insulin to sustain life. Ketosis prone.
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What is type 2 diabetes mellitus?
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Defect in insulin secretion and cellular resistance to insulin. Individuals aren't dependent on treatment with insulin. Non-ketosis prone.
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Normal glucose renal threshold
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160-180 mg/dL
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Normal fasting plasma glucose
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<100 mg/dL
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Impaired fasting plasma glucose
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Between 100 and 125 mg/dL
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Diagnosis of diabetes mellitus?
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- Casual plasma glucose level >200 mg/dL
- Fasting plasma glucose >126 mg/dL (no caloric intake for 8 hours) - Plasma glucose of >200 mg/dL at 2 hour point of an oral glucose tolerance test |
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What is OGTT?
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Patient ingests glucose and plasma glucose specimen is collected fasting at 10 minutes before glucose load and at 120 minutes after ingestion of glucose
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What is the significance of glycated/glycosylated hemoglobin?
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Measurement of glycated hemoglobin reflects blood glucose levels for the past 2-3 months. It's useful for monitoring effectiveness of treatment and compliance of diabetic individual to treatment protocol.
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Clinical significance of lactate?
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Type A lactic acidosis is caused by depressed oxygen levels that may occur in acute myocardial infarction, congestive heart failure, shock, pulmonary edema.
Type B lactic acidosis is caused by metabolic processes that may occur in diabetes mellitus, renal disorders, liver disease, ingestion of toxins. |
