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Fichas

Proteins

Katherine Chin MDEMO Inglés 23 fichas

Fichas del conjunto (23)

  1. 1Describe albumin. Where is it produced? Half life? Role?Produced by the liver.
    Half life of 22 days
    Main protein in the serum so has has role in oncotic pressure.
    "Non-specific sponge" - binds compounds and molecules. Has role in transport of lipophilic drugs and molecules
  2. 2What causes hyperalbuminaemia? (3)Standing; venous stasis; dehydration.
    Rare.
    Not significantly relevant unless is an indicator of something else
  3. 3What are the 5 categories that cause hypoalbuminaemia?- Reduced synthesis.
    - Increased catabolism
    - Increased loss.
    -Haemodilution.
    - Redistribution.
  4. 4What can cause reduced synthesis of albumin? (2)- liver disease: although insensitive marker for liver function
    - Malnutrition/malabsorption: poor marker for malnutrition
  5. 5What can cause increased catabolism of albumin?Severe illness.
    Is associated with poor prognosis.
    Sepsis; inflammation; trauma; malignancy
  6. 6What can cause increased loss of albumin?- Renal losses: nephrotic syndrome
    - Gastrointestinal losses: protein losing enteropathy
    - Skin: burns; psoriasis
  7. 7What can cause haemodilution hypoalbuminaemia?- Iatrogenic: fluid overload
    - Oedema: CCF; CLD
    (Pregnancy or artefact)
  8. 8What causes redistribution hypoalbuminaemia?Common cause of acute change.
    There is increased movement from plasma to the interstitium.
    Acute phase reactant
    Marker of capillary permeability
  9. 9What are the consequences of hypoalbuminaemia? (3)- Reduced oncotic pressure: fluid enters interstitium = oedema (cause and consequence)
    - Reduced binding capacity: eg. calcium
    - Reduce binding capacity: eg. drugs (eg. phenytoin). Hypoalbuminaemia may mean increased free/active drug
  10. 10Why do we calculate adjusted calcium?50% of calcium is bound to albumin. - not physiologically active.
    Hypoalbuminaemia will reduced total calcium but not the amount of free calcium as PTH adjusts for this.
    Therefore if albumin is low then Ca measures low, even though the free Ca may be normal
  11. 11How do you measure globulin levels?Total protein - albumin
  12. 12What do you need to establish if there is hypergammaglobulinaemia? How do you do this?If it is polyclonal or monoclonal.
    Do this by serum protein electrophoresis. (Polyclonal vs. M-protein/paraprotein)
  13. 13What can cause paraproteins? (3)- B-cell malignancies
    - Waldenstrom's macroglobulinaemia
    - Monoclonal gammaopathy of undetermined significance (MGUS)
  14. 14What are the -ve acute phase reactants? (2)Albumin.
    Transferrin.
  15. 15What are the +ve acute phase reactants?CRP.
    Ferritin
    A1AT.
    Haptoglobin.
    Caeruloplasmin
  16. 16Describe C-reactive proteinNon-specific.
    Peaks at 48 hours.
    Half life 16hours - quick clearance.
    Marker of inflammation. Mainly rises in bacterial infections.
  17. 17Describe alpha-1 anti-trypsin.Inhibitor of neutrophil elastase and other proteolytic enzymes.
    Role in protecting the lung interstitium from proteolytic enzymes (which have been released in response to an insult).
    Deficiency is autosomal co-dominant. Associated with emphysema and CLD.
  18. 18Describe haptoglobin.Binds free Hb that has been released in intravascular haemolysis.
    This is then taken up by the reticuloendothelial system so that iron can be recycled.
    Drops in haemolytic anaemia; CLD; malignancy and sepsis. Acute drop after haemolysing event.
  19. 19Describe ceruloplasmin.Copper carrying protein.
    Role in efflux of iron into transferrin (iron export).
    Deficiency in Wilson's disease.
    Increases in the acute phase response (and in pregnancy or OCP - high oestrogen states).
  20. 20How can we measure proteinuria?- Urine dipstick: but only detects proteinuria >300mg/L
    - Clinical biochemistry
    - ACR - albumin:creatinine ratio. Normalises for urine flow as [albumin] is a product of urine flow.
    Nb. do not use in acute illness. But can be used as a prognostic marker (renal disease; CVD; diabetes).
  21. 21What are the 4 categories for causes of proteinuria?- Glomerular: eg. nephrotic syndrome
    - Overflow: increased plasma protein concentration = exceeds reabsorptive capacity
    - Tubular: impaired reabsorption
    - Post renal: UTI; semen; pus; blood; post renal tumour
  22. 22What is the difference between transudate and exudate?Transudate: low protein in fluid. Due to filtration across capillary endothelium from oncotic pressure. Usually benign
    Exudate: high protein in fluid. Due to inflammation = increased permeability.
  23. 23What criteria is used to determine if transudate or exudate?Lights criteria:
    Fluid albumin:serum albumin > 0.5 = fluid is exudate.

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(Rheumatology ) MDEMO Fichas sobre Proteins, creado por Katherine Chin el 07/06/2018.
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Katherine Chin
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