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34 Cards in this Set
- Front
- Back
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What is the source of gamma globulins?
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Globular proteins, some gamma globulins are Immunoglobulins (most important sub-class)
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What is the difference between polyclonal gammopathy and monoclonal gammopathy?
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Poly - prolonged infection or inflammation (entire right side of globulin chart elevated
Mono - Neoplastic, malignancy of plasma cells (only one single spike on the right side of the globulin chart |
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What is prealbumin used to diagnose?
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Malnutrition
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When is albumin decreased?
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Malnutrition, malabsorption, increase in loss from renal disease, protein loss, gastroenteropathy, ascites
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When is albumin increased?
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Dehydration, torniquet
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What are the 4 acute phase reactants?
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Alpha 1 globulins: Alpha 1 antitrypsin
Alpha 2 globulins Beta globulins |
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What are Alpha 1 globulins/ Alpha 1 antitrypsin?
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A1G - protease inhibitor, counters effect of leukocyte elastase
A1A - major component of A1G |
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What does A1G/A1A deficiency cause?
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Pulmonary emphysema, cirrhosis of liver
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What are Alpha 2 globulins?
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Altered in response to acute inflammation, carrier of free hemoglobin, CRP
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What are Beta globulins?
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Lipoprotein, LDL, transferrin, fibrinogen
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What is C reactive protein?
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General scavenger molecule - elevated in inflammatory response to autoimmunity, disease progression in RA/SLE
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What are the 8 acute phase reaction responses?
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Neutrophilia
Thrombocytosis Fibrinogen inc Alpha-2-macroglobulin increased CRP inc Haptoglobin inc Albumin dec ESR inc |
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What is ESR?
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Erythrocyte sedimentation rate
Length of fall of RBC's in a column of blood given a time interval |
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What does increased ESR indicate?
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Nonspecific indicator of inflammation
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What is the difference between edema and effusion?
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Edema - fluid in interstitium
Effusion - fluid in serous / mesothelial lined cavities |
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What is the cause and lab findings of inc exudate?
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Via inc vascular permeability
High in protein (>3gm/dl) WBC's inc Infection / inflammation |
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When exudate is inc from angiogenesis, what are the 2 possibilities why?
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Repair or malignancy
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When are transudates increased?
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Hydrostatic pressure inc (heart failure)
Osmotic pressure dec (kidney disease) Retention of NaCl Lymph obstruction |
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What is the major cause of edema?
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Impaired venous outflow
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What is the difference between localized and generalized edema?
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Local - DVT
Generalized - heart failure |
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What is the pathology of dec plasma colloid osmotic pressure?
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Inc protein loss, nephrotic syndrome, ascites
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What is the initial symptom of dec plasma colloid osmotic pressure?
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Periorbital edema
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What is the definition of primary as seen in the notes?
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Cause for which there is no secondary cause, usually genetic or idiopathic
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Define lymphedema?
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Impaired lymph drainage leading to edema, commonly involved extremities
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What is the difference between primary and secondary lymphedema?
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Primary - inherited or developmental defect (Ex: Milroy's)
Secondary - Trauma to lymph channels, any damage or injury to lympthatics from cancer, radiation, infections, obesity |
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What is peau d'orange?
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Thickened skin due to advanced lymphedema, poor prognosis, sign of late disease
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What is dependent edema?
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Impaired venous return, may occur with long periods of standing / air/car travel
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What are causes and morpho of pulmonary edema?
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Causes - LV failure, renal failure, ARDS, pulmonary infection
Morpho - lungs 2-3x wt, frothy/blood tinged fluid thicker septae of lungs, fluid in alveoli |
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What is hyperemia, what is the other name and what are the causes?
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Erythema
Local increased volume of blood Red color from inc oxygenated blood Exercise, emotions, inflammation |
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Define congestion, what are some causes?
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Local inc volume of blood
Passive process due to impaired venous outflow from tissues Heart failure, local venous obstruction |
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What is the morphology of chronic pulmonary congestion?
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Chronic hypoxic injury from stasis --> cell death --> microscopic scarring
Rubbery brown, siderophages in alveloi, prussian blue + |
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What is the morpho of lower extremity edema?
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Brown induration from incompetent leg valves
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What is the cause and morphology of hepatic congestion?
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Right heart failure
Chronic passive congestion: Nutmeg liver (centrilobular hemorrhagic necrosis, red-brown depressed areas) AST / ALT elevated from necrosis of hepatocytes |
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What are the causes of congestive splenomegaly?
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RH failure
Portal vein occlusion Hepatic cirrhosis |
