Chapter 19 Specific Proteins

Front 1

endosmosis? which proteins are weakly anionic and swept up in end osmotic flow?

Back 1

electrophoresis:
**a charge is applied across a medium
that is composed of a solid support and a fluid
buffer.
**this charge creates an electromotive force
**the solid support has a slight negative charge and is drawn towards the positive pole (anode), but solid support cannot move .
**There is compensatory flow of the fluid buffer towards the negative pole (cathode) . This buffer flow is called endosmosis and has the capacity to carry with it substances suspended within the medium .
*If proteins are added to the medium and the charge
is applied, two forces act on each protein : electromotive and endosmotic; electromotive force tends to pull them towards the anode (positive pole) ; whereas, endosmosis pulls them towards the cathode .
**In the case of gamma globulins, which have a weak net negative charge, the endosmotic force displaces the proteins towards the cathode . In other proteins,electromotive force exceeds the
endosmotic force, and they move to anode

Front 2

what eletrophoretic technique resolves various forms of a single protein and is used in clinical laboratories?

Back 2

isoelectric focusing; SDS-PAGE is an alternative method, but it is used chiefly in research laboratories

Front 3

most common analyze measured by affinity chromatography? what chemical is used to bind the molecule of interest?

Back 3

quantization of glycosylated hemoglobin; idihydroxyboronate

Front 4

drop of serum is placed on a refractometer

Back 4

specific gravity

Front 5

acid digestion releases ammonium ions which are then quantitated using iodine

Back 5

kjeldahl technique

Front 6

copper salts in alkaline solution form a purple complex with substances with two or more peptide bonds

Back 6

biuret method

Front 7

most common dye-binding method to quantitate albumin

Back 7

bromcresol green

Front 8

used often to detect peptides after paper chromatography or ion exchange

Back 8

ninhydrin

Front 9

an acid such as tricholoroacetic forms a precipitate which clouds the solution

Back 9

turbidimetry

Front 10

chief physiologic function of pre albumin?

Back 10

binds vitamin A along with retinol-binding protein to transport vitamin A throughout the body

Front 11

clinical significance of a pre albumin band in CSF?

Back 11

normal findings; as a compact molecule prealbumin crosses the CSF barrier more readily than do other proteins

Front 12

do patents with analbuminemia suffer from as cities and edema, as do cirrhotics?

Back 12

no; the patient has compensatory mechanisms to maintain oncotic pressure

Front 13

Back 13

Front 14

Back 14

A, Serum protein electrophoresis in cirrhosis (Cir) shows more rapidly migrating albumin compared with normal serum (Nor) because of theadditional negative charge from covalently linked conjugated bilirubin (i.e., δ-bilirubin). The γ-globulins are broadly increased in the polyclonal elevation char-acteristic of cirrhosis of the liver. B, Protein electrophoretic patterns of serum (Ser) and concentrated urine (Ur) in a patient with nephrotic syndrome. Smaller molecular-sized proteins such as albumin are preferentially lost from blood into urine. Larger proteins such as α2-macroglobulin and β-lipoprotein are retained in the blood and constitute major bands in the serum pattern.

Front 15

Immunofixation with transferrin antibody to test for presence of cerebrospinal fluid (CSF). Ser, Normal serum showing position of transferrin (Tf; double-headed arrow); CSF, normal position of Tf and asialotransferrin (aTf, single-headed arrow); Pt Ser, patient serum included to rule out electrophoretic variant ofTf; Pt Fl, unknown fluid from patient demonstrating bands of both Tf and aTf that confirm the presence of CSF in that fluid.

Back 15

23 yo pregnant woman with an iron of 27microgram/dL and iron binding capacity of 603microgram/dL; increased transferrin

Front 16

Back 16

Serum protein patterns in (1) chronic inflammation with decreased albumin and increased γ-globulins; (2) acute inflammation with increased α2-fraction (haptoglobin) and decreased C3 due to activation and consumption of complement; (3) inanition post–spinal cord injury with hypoproteinemia of several fractions.

Front 17

1. 28yom HIV with marked peripheral edema; Glomerular proteinuria, transferrin

Back 17

Patterns of urine protein electrophoresis in different disorders. (1) Severe glomerular proteinuria with a major band of albumin plus a secondary one of transferrin (*). (2) Trace proteinuria with a faint band of albumin and other diffuse proteins.
(3) Immunoglobulin light chains (*).
(4) Tubular proteinuria with multiple bands that do not correspond to major serum proteins. (5) Hematuria with a majorband of hemoglobin (not to be confused with monoclonal gammopathy), in addi-tion to albumin.

Front 18

Back 18

Serum and urine protein electrophoretic patterns in a patient with multiple myeloma. Serum demonstrates a predominance of the larger complete immunoglobulin; the urine has a large amount of the smaller-sized light chains with only a small amount of the whole immunoglobulin.

Front 19

Back 19

Decreased albumin and variable decreases in all globulins except a-2 macroglobulin, consistent with nephrotic syndrome. May cause a "pseudo M~protein " No restriction band on IFE

Front 20

Back 20

IgM K M-protein . Note that IgM paraproteins tend to migrate nearer beta

Front 21

Back 21

IgA ~, M-protein . Note that IgA paraproteins tend to migrate into the beta region.

Front 22

Back 22

IgG kappa M-protein

Front 23

Back 23

Acute inflammation . Decreased albumin with increased a-1 & a-2 globulins

Front 24

Back 24

Chronic inflammation: mildly decreased albumin, increased a-1, a-2, and gamma globulins

Front 25

Back 25

Marked changes of chronic inflammation, beta-gamma bridging, (and no restriction band on IFE) in a patient with primary biliary cirrhosis (PBC)

Front 26

Back 26

CSF

Front 27

Back 27

UPEP

Front 28

What acute phase reactant rises most quickly and returns to normal most quickly in inflammatory states?

Back 28

C-reactive protein

Front 29

What methods are used to screen patients suspected of having the ZZ phenotype of AAT deficiency?

Back 29

Both nephelometry and serum protein electrophoresis are used in screening; confirmation must be performed with ancillary tests; the ZZ phenotype shows marked decrease levels of AAT

Front 30

What disease state is alpha 2 macroglobulin most increased?

Back 30

Nephrotic syndrome

Front 31

Does haptoglobin bind myoglobin in cases of rhabdomyolysis?

Back 31

No; haptoglobin scavengers hemoglobin in times of hemolysis but not myoglobin

Front 32

17 yo admitted after MVA; how would you determine the clear fluid draining from his left nasal passage?

Back 32

Transferrin

Front 33

38 yof on oral contraceptives being treated with heparin for pulmonary embolism has blood drawn in a red top tube serum protein electrophoresis (SPEP); a distinct band noted just anodal to the gamma fraction?

Back 33

Band is fibrinogen; heparin iced patients' blood does not completely clot