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Clinical Chemistry Exam 1 Lecture 4
Proteins of Clinical Significance
53
Chemistry
Undergraduate 3
01/29/2015

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Term
What is the reference range for the total protein in the plasma?
Definition
6.5-8.5 g/dL
Term
There are more than ______ proteins identified so far
Definition
500
Term
List the 9 Mechanisms that control protein levels in plasma:
Definition
Nutrition
Liver function
Renal function
Metabolic errors
Disease
Blood Loss
Hemolysis
Burns
Dehydration
Term
Globulin
Definition
All proteins except Albumin
Term
How do you calculate Globulin?
Definition
Globulin = Total protein - Albumin
Term
Prealbumin
Definition
Transports thyroid hormones T3 and T4, and Vit A
Term
What is the half life of Prealbumin?
Definition
2-3 days
Term
Albumin
Definition
Maintains osmotic pressure (80%)
Carrier for bilirubin, fatty acids, Ca, Mg, drugs, and other substances
Term
Which Plasma Protein is in the highest concentration?
Definition
Albumin
Term
Antitrypsin (alpha 1)
Definition
Neutralizes elastase enzymes released from neutrophils
Term
If unchecked what will Elastin cause?
Definition
Structural damage to alveoli
Term
What will a deficiency in Antitrypsin lead to?
Definition
Emphysema (as early as age 20) and cirrhosis
Term
Fetoprotein (alpha 1)
Definition
Hepatocellular tumor marker
Low amounts and no purpose in adult serum
Term
What are High levels of Fetoprotein in amniotic fluid and maternal serum consistent with?
Definition
NTDs
Term
Haptoglobin (alpha 2)
Definition
Binds free hemoglobin after cell lysis to prevent loss into the urine.
Term
What organ recycles the iron and amino acids after RBCs have been lysed?
Definition
Spleen
Term
Low levels of Haptoglobin is often associated with?
Definition
Hemolytic anemia
Transfusion reactions
Term
Increased levels of Haptoglobin is often associated with?
Definition
Inflammation (acute phase protein)
Term
"Acute phase reactants"
Definition
Increase in response to tissue injury
General and non-specific
Act to destroy or inhibit microbes
Term
The following are all considered what type of reactants?
CRP, A1AT, Haptoglobin, Fibrinogen, C3, C4, others
Definition
"Acute phase reactants"
Term
What is the reference range of Urinary proteins?
Definition
100-250 mg/24 hours
Term
Microalbumin in the urine is an early indicator of what?
Definition
diabetic neuropathy
Term
Bence Jones Protein (free light chains) may occur in what disease?
Definition
Multiple Myeloma
Term
What protein produced in tubules is the basic matrix of urinary casts?
Definition
Tamm-Horsfall protein
Term
What is the reference range or CSF Proteins?
Definition
15-45 mg/dL (1/200 of plasma level)
Term
Cerebrospinal fluid proteins
Definition
Indicates either increased permeability of the blood-brain barrier or increased production within the Central Nervous System
Term
CSF IgG Index
Definition
Determines the source of an elevated CSF IgG protein
Term
Formula for the CSF IgG Index
Definition
(CSF IgG x Serum albumin) / (Serum IgG x CSF albumin)
Term
In what type of diseases will you see a nonspecific elevation of CSF Proteins?
Definition
Meningitis
Traumatic Tap
Multiple Sclerosis
Others
Term
What is the reference range of the CSF IgG index?
Definition
0.3-0.8
Term
If the CSF IgG Index is >0.8 what does this indicate?
Definition
Increased IgG production within the CSF
Term
If the CSF IgG Index is >0.8 what is this consistent with?
Definition
Multiple Sclerosis
Some bacterial infections and inflammatory diseases
Term
Ceruloplasmin (alpha 2)
Definition
Transports plasma copper
Term
What does decreased copper cause?
Definition
Anemia
Term
Wilson's disease:
Definition
Low ceruloplasmin causes accumulations of copper in skin, liver, brain, and cornea. Cirrhosis, neurologic damage, and Kayser-Fleischer rings
Term
Beta 2 Microglobulin
Definition
Present on the surface of all white cells, especially lymphs.
At the time of diagnosis, levels reflect stage of disease and likely prognosis
Term
Overproduction of what causes increased levels of Beta 2 Microglobulin?
Definition
WBCs
Term
High levels of what in HIV indicate the virus is killing lymphs?
Definition
Beta 2 Mircoglobulin
Term
What do high levels of Beta 2 Microglobulin after kidney transplants indicate?
Definition
Possible organ rejection
Term
Transferrin (Beta)
Definition
Transports plasma iron to storage sites and bone marrow
Prevents loss of iron into urine
Term
When Transferrin is increased what is often associated with?
Definition
Iron Deficiency Anemia
Term
Complement (Beta)
Definition
A group of proteins that bind to ag-ab complexes to cause cell lysis
Term
What does a decrease in Complement cause?
Definition
Increased susceptibility to infections
Term
What is Complement decreased in?
Definition
SLE
Term
Firbinogen (Beta)
Definition
Forms a fibrin clot when activated by thrombin
Term
Is Fibrinogen seen in serum?
Definition
No, because it is used up in the clotting process
Term
When Fibrinogen is increased what is potentially happening?
Definition
Inflammation
Term
C-Reactive Protein (Beta)
Definition
Non specific
Inflammatory conditions: tissue necrosis, infections, AMI, rheumatoid arthritis
Term
HS-CRP
Definition
Predictor for risk of heart attack and stroke.
Requires high-sensitivity testing methods
Term
Immunoglobins (delta)
Definition
Synthesized in plasma cells in response to antigens
IgG, A, M, D, E
Term
Monoclonal increases in Immunoglobulins are consistent with which 2 diseases?
Definition
Multiple Myeloma
Waldenstrom's
Term
Myoglobin and Troponin - cardiac markers
Definition
Skeletal and cardiac muscle proteins
Term
True or False:
The degree of elevation of Myoglobin and/or Troponin may be indicative of the extent of cardiac damage
Definition
True
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