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27 Cards in this Set
- Front
- Back
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plasma proteins
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-macromoleculs composed of aa's linked by peptide bonds
-made mostly in liver and plasma cells -catalyzed in GI tract, kidneys, liver |
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functions of plasma proteins
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1. Transport ex. albumin
2. Colloid osmotic pressure 3. Immune defense ex. immunoglobulins 4. Inflammatory response 5. Blood clotting 6. Signaling |
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serum protein electrophoresis (SPEP)
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-separation based on net electrical charges and size of protein molecules, properties or medium and temp
-fractionated -patterns characteristic of disease (look at diagram- 52-68% of our proteins is albumin) |
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Albumin
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-reference range: 3.5-5.- g/dL (serum)
-functions: plasma oncotic P (tends to pull water into circulatory system), transport protein, blood product volume expander |
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Causes of hypoalbuminemia
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1. decreased albumin synthesis
2. increased loss of proteins 3. acute/chronic inflammation and infections (ex. lupus) |
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decreased albumin synthesis
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1. liver disease/failure (albumin good for dx and prognosis of liver disease)
2. decreased dietary protein 3. congenital "analbuminemia" |
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increased loss of proteins
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1. renal disease with proteinuria
2. bruns and other skin disease 3. GI disease with protein losing enteropathy 4. orthostatic proteinuria (protein loss through kidneys when standing) 5. hemorrhage |
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hypoalbuminemia:
decrease albumin levels also seen in... |
1. last trimester of preg
2. OC use 3. prolonged bed rest 4. overhydration -low levels assoc as independent risk factor for mortality in elderly -EDEMA hallmark finding |
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causes of hyperalbuminemia
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1. severe dehydration
2. prolonged tourniquet application 3. administer too much |
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prealbumin
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-reference range: 10-45 mg/dl
-reflects current nutritional status -short half life-2 days -test/follow in all hospital pts -obtain nutrition consult if <15mg/dl -transport protein (vit A) -useful to evaluate nasal fluids (CSF fluid has high prealbumin) |
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Alpha 1 antitrypsin
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-RR: 100-300 mg/dl
-inactivates trypsin and other proteolytic enzymes -inhibits thrombin (makes clots) and plasmin (degrades clots) -acute phase reactant -congenital deficiency syndrome: premature emphysema, childhood cirrhosis of liver |
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alpha2 macroglobulin
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-inactivates many proteases
-inhibits thrombin and plasmin -large molecular wt: retained with proteinuria -nephrotic syndrome: body compensates by increasing this |
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ceruloplasmin
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-copper binding protein made in the liver
-if you dont have enough you can develop wilsons disease |
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antithrombin III
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-natural anticoagulant
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haptoglobin
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-RR: 37-184 mg/dl
-alpha 2 globulin fraction -acute phase reactant -binds free hemoglobin and preserves irons -depleted in severe intravascuar hemolysis (caution-hemolysis may be present although haptoglobin may be within RR-acute inflamm episode, steroid therapy) -slight decrease after blood transfusion |
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haptoglobin test limitations
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-decreased haptoglobin concentration
1. OC's 2. strenuous exercise |
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transferrin
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RR: 2-3.6 g/L
-beta globulin fraction -small molecular weight -iron transport protein in serum: increased in iron deficiency anemia |
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C reactive protein
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-acute phase reactant
-sensitive marker for inflammation 1. rises w/in 4-6 hrs and cleared rapidly 2. signals postoperative infections 3. signals transplantation rejection 4. high sensitivity CRP elevation associated with risk of cardiac event |
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C reactive protein additional info
-elevated results |
-lipemia or hemolysis may give false elevated results
-obese individuals and women taking hormone replacement therapy have higher CRP levels |
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gamma globulin-immunoglobulins
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-made by plasma cells
-functions: 1. neutralize toxic substance 2. support phagocytosis 3. destroy microorganisms |
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types of immunoglobulins
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1. IgG (most abundant); dominates in secondary immune response, crosses placenta
2. IgA: serum and secretion protection 3. IgM: dominant AB produced in primary immune response; ABO group Ab; doesnt cross placenta 4. IgD: signal B cell function 5. IgE: allergic rxns |
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clinical changes in gamma globulin concentrations: increased levels:
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1. chronic infxs and malignancies
2. liver disease 3. monoclonal gammopathies -Waldenstrom's macroglobulinemia (IgM spike) -Multiple myeloma (non IgM splike) 4. AI rxns |
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multiple myleoma
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-at least 10% plasma cells in the bone marrow and lytic bone lesions
-recurrent infections -anemia, weakness -kidney disease -Rouleaux formation: stacking of RBCs (look at slide) |
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decreased levels in gamma globulins
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1.primary immunodeficiencies
-agammaglobulinemia -hypoglubulinemia 2. Nephrotic syndrome (losing a lot of proteins) |
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acute phase reactants
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-Plasma proteins that increase in response to illness, infection, trauma and tissue necrosis
1. Alpha1 antitrypsin 2. Antithrombin III 3.Ceruloplasmin 4. Complement 3 5. Haptoglobin 6. Fibrinogen 7. C-reactive protein |
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total protein (RR 6-8.3 g/dL)
elevate levels seen in |
1. dehydration
2. excess production of gamma globulin 3. chronic inflammation or infection |
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total protein
-decreased levels seen in |
1. renal disease
2. blood loss 3. malnutrition 4. liver disease 5, severe skin disease or burns 6. prolonged immobilization |
