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28 Cards in this Set
- Front
- Back
What are the five main proteins in plasma? |
y-globulin b-globulin a2-globulin a1 - globulin albumin |
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What does a fall in albumin lead to? |
Oedema Low albumin - water leaves blood |
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What causes a fall in albumin? |
Decreased synthetic - severe malnutrition Abnormal distribution e.g. over-hydration Abnormal excretion/degradation e.g catabolic states, burns, nephrotic syndrome |
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What is a1-antitrypsin? What does a deficiency predispose? |
Protease inhibitor Deficiency predisposes to emphysema – degrade lung lining |
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What is caeruplasmin? What does a deficiency result in? |
Cu2+ carrying molecule scavenges superoxide – v. radical. Mutations to DNA – cancer reduced in Wilson’s disease |
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What is haptoglobin? What does a deficiency result in? |
binds free haemoglobin after haemolysis complex removed by reticulo-endothelial system levels reduced in haemolytic conditions |
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What is transferrin? |
iron binding protein |
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Why are enzymes released into plasma from cells? |
cell damage increased cell turnover cell proliferation increased enzyme synthesis decreased enzyme clearance |
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Where is Alkaline phosphatase (ALP) high? When is ALP high? |
high in liver, bone (osteoblasts), placenta, intestinal epithelium High ALP in cholestatic liver disease, osteoblastic bone disease, 1' and 2' tumours of these tissues and during pregnancy and childhood |
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Where is Acid phosphatase (AP) high? |
high in prostate gland
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What is Aspartate aminotransferase (AST) and Alanine aminotransferase a genetic indicator of? |
liver damage |
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Where is y-glutamyl transferase found?
What is high y-GT indicative of? |
found in liver, pancreas, kidney High - hepato-biliary disease BUT will not distinguish between cholestatic or hepatocellular disease. High levels caused by anti-convulsants and alcohol liver disease |
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What does high Lactate dehydrogenase (LDH) indicate? |
High LDH in liver, skeletal muscle, and kidney damage High LDH in anaemia and indicates poor prognosis in lymphoma |
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What does high levels of amylase indicate? |
Acute pancreatitis |
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What is the structure of Creatine kinase (CK)? |
dimer of M and B monomers, 3 isozymes (MM, BB, MB) |
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Where are the different isozymes of Creatine kinase (CK)? |
BB brain, plasma levels rarely increase MM main plasma isozyme MB makes up 30% of cardiac. High plasma - myocardial infarction CK high plasma |
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What does a defect in Cholinesterase result in? What is it caused by? |
unable to hydrolyse the anaesthetic succinyl choline causes scoline apnea (paralysis of respiration due to failure to metabolise the drug) |
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What are the three diagnosis points for Myocardial Infarction? |
history of chest pain ECG changes cardiac muscle enzyme release |
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Three causes of Myocardial Infarction? |
reduced blood supply to cardiac muscle thrombosis atheromatous plaques |
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What is CK-MB useful for detecting? |
High peak useful for detecting re-infarction |
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Why are ALT levels unchanged? |
No cardiac |
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What happens to LDH1 with a myocardial infarction? |
LDH1 released from damaged cardiac muscle |
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Which enzyme rises fastest after myocardial infarction? |
Myoglobin - good early indicator |
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What is albumin? |
Synthesised and secreted by the liver Accountsfor 50% of the total hepaticprotein production. Biggest contribution to plasma oncotic pressure |
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Summary of enzymes which have diagnostic value |
ALT - hepatocellular damage AP - cholestatic liver disease and osteoblast activity in bonedisease Amylase - cell damage in acute pacreatitis AST - hepatocellular damage, or marker or muscle damage |
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What is the function of Caeruloplasmin and reason for assay |
Oxidizing enzyme Reduced in Wilson’s disease |
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Which isoenzyme is of CK is useful in early detection of myocardial infarction? |
CK-MB |
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What is the cause of a decrease in total protein concentration? |
Hypoalbuminaemia |