Clinical Chemistry Unit Two

What are the building blocks of proteins?

Amino acids

What substance is toxic to our kidneys and found in a crush victim?

Myoglobin

What is the major hemoglobin in babies under 6 months?

Hgb F

When a lab tech preforms a random or times urine specimen for PGB what disease is suspected?

Acute pAcute porphyria

When a patient is having a myocardial infraction what protein can the lab test in the first few hours to make the diagnosis?

Myoglobin

What is the preferred specimen for lipid studies?

Serum

What are sources of error in the measurement of triglycerides?

Endogenous glycerol 

Apolipoprotein A 1 is a major protein of which lipoprotein?

HDL

Diabetes mellitus is a secondary cause of what lipid disorder?

Hypertriglyceridemia

What is the normal range for Total protein- serum, plasma?

6.5-8.3 g/dL (65-83 g/L)

What is the normal range for Albumin- Serum, plasma?

3.5-5.5 g/dL (35-55 g/L)

What is the normal range for Albumin – globulin ratio (A/G)- serum, plasma?

1.1 - 1.8

What analyte can be increased when you are dehydrated?

Total protein

Prealbumin binds with what thyroid hormones?

Thyroxine (T4) and triiodothyronine (T3)

What protein is elevated in a mother who is carrying a child with spina bifida?

Alpha one fetoprotein (AFP)  

What does the complex protein ceruloplasmin transport?

Copper

What is the largest alpha 2 globulin?

Alpha 2 Macroblobulin

What does haptoglobin do in a transfusion reaction?

Decrease

What transports iron?

Transferrin

What is the largest protein found in blood plasma?

Fibrinogen

What are complement proteins?

A natural defense mechanism against infection, made in the liver 

What is the protein that binds the heme portion or hemoglobin?

Hemopexin

Gamma globulins are synthesized by what system?

Reticuloendothelial system

What proteins are made of light chains and no heavy chains?

Bence Jones Proteins

What is electrophoresis?

Separates proteins based on their electrical charge and density across a gel 

Which immunoglobulin is the most abundant, is found in blood plasma/lymph and can cross the placenta?

IgG

Which immunoglobulin is a first responder to antigenic stimulation, present in B lymphocytes and made only by neonates?

IgM

Which immunoglobulin is found in mucous secretions (Saliva, vaginal fluid, tears)?

IgA

Which immunoglobulin is made by B lymphocytes, is associated with parasites, autoimmune issues, as well as allergic and anaphylactic reactions?

IgE

Which immunoglobulin is present on the surface of most B lymphocytes in early development with an unknown function?

IgD

A woman went in for labs shortly after eating a large meal, her triglyceride levels were 260 mg/dL. Are these results normal? Why or why not?

Normal triglyceride levels range from 60-150 mg/dL, these results are high because of the recent large meal. Patients should be fasted prior to checking triglycerides.

How long should a patient fast prior to an HDL profile being drawn?

12-14 hrs

What is the substance that is measured to estimate the serum concentration of triglycerides in MOST methods?

Glycerol

What elevated serum cholesterol concentrations are associated with heart disease?

LDL

What is the reference method for cholesterol measurement?

Gas chromatography mass spectrometry

What disease has a decreased or absent HDL?

Tangier disease

What is the enzyme that breaks down triglycerides?

Lipase

What are chylomicrons mostly composed of?

Triglycerides

Exogenous triglycerides are transported in the plasma in what form?

Chylomicrons 

Which lipoprotein serves to transport endogenous triglyceride?

VLDL (Very Low Density Lipoprotein) 

Which lipoprotein deposits lipids on your arterial wall and is also known as the “Bad” lipid?

LDL (Low Density Lipoprotein)

Which lipoprotein serves to deliver dietary lipids to hepatic and peripheral cells, and is also the largest and least dense lipoprotein?

Chylomicrons

Which lipoprotein removes excess cholesterol from peripheral cells, and is also called the “Good lipoprotein”?

HDL (High Density Lipoproteins)

What is the normal range for cholesterol?

140-200 mg/dL (3.6-5.2 mmol/L)

What is the normal range for triglycerides?

60-150 mg/dL (0.7-1.7 mmol/L)

What is the VLDL formula?

Triglyceride level / 5 (When in mg/dL)

What is the LDL-C formula?

Total cholesterol – HDL – Triglyceride/5 (VLDL VALUE)

What are triglycerides made up of?

Fatty acids and glycerol

What is the dye binding method of albumin?

Bromocresol green

What are phospholipids made of?

Two fatty acids and a phospholipid head group

What protein is useful when diagnosing a heart attack (AMI)?

Troponin

What is a condition characterized by a monoclonal spike?

Multiple myeloma

What is the major protein in beta globulin?

Transferrin

What measured the intensity of light scattered?

Nephelometry

What is the name for the amino acid that has positive, negative, and neutral functional groups, but their net charge is neutral?

Zwitterion

List the animo acids that fall into the essential amino acid category

Histidine, Isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine

List the amino acids that fall into the nonessential amino acid category

alanine, asparagine, aspartic acid, glutamic acid, selenocysteine, serine

List the amino acids that fall into the conditionally essential amino acid category

arginine, cysteine, glutamine, glycine, proline, tyrosine

What is haptoglobin and its function? Is it increased during anemia or decreased? 

It binds free hemoglobin to prevent the loss of iron into urine, it is decreased

What is the function of fibrinogen?

It forms a fibrin clot when activated by thrombin

What total protein abnormality is associated with dehydration? In this condition, is the protein elevated or decreased?

Hyperproteinemia, elevated.

60-75% of plasma cholesterol is transported by what?

LDL

What is the name of the method used to calculate LDL?

Friedenwald calculation

What does a decrease in transferrin lead to?

Anemia

What is the most abundant plasma protein?

Albumin

When do levels of fibrinogen significantly increase?

During an inflammatory process

In routine electrophoresis of serum, transferrin will migrate into which fraction?

Beta

When are Pro BNP and BNP elevated?

Congestive heart failure and acute coronary syndromes  

What is fetal fibronectin (fFN) used to detect?

Short-term risk of premature delivery

What is the charge of the anion and what terminal and charge does it move towards in electrophoresis?

Anion- negative moves toward anode + charge

Hemopexin and transferrin make up which band in electrophoresis?

Beta 1

Lipoproteins and compliment C3 make up which band in electrophoresis?

Beta 2

What is the protein that has the highest dye binding capacity, as well as moves the fastest towards the anode in electrophoresis?

Albumin

The presence of a narrow band between the Beta and Gamma regions on SPE would most likely indicate which preanalytical error had occurred?

Sample was plasma not serum

What is the name of the protein we are looking for in urine electrophoresis?

Bence-jones protein  

Which condition is characterized by the beta gamma bridge?

Liver cirrhosis

Which pattern is pictured?

Nephrotic syndrome

Which pattern is pictured?

Acute phase protein

Which pattern is pictured?

Alpha 1 antitrypsin deficiency

Which pattern is pictured?

Hypogammaglobulinemia

Which pattern is pictured?

Monoclonal gammopathy

Which pattern is pictured?

Polyclonal gammopathy

Which pattern is pictured?

Severe hepatic disease

Which pattern is pictured?

Liver cirrhosis