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What does blood volume depend on?
size
What are the main 4 functions of the blood?
delivery
waste collection
communication route
defence
What are the main components of the blood?
plasma, white blood cells, platelets, erythrocytes (red blood cells)
What percentage of blood volume does plasma make up?
55%
What percentage of blood volume do white blood cells, platelets and buffy coat make up?
1%
What percentage of blood volume does erythrocytes make up?
45%
What is plasma made up of?
proteins
anions
small molecules
What small molecules are found in plasma?
glucose
amino acids
lactate
glycerol
urea
ketones
Serum
liquid component of blood when blood is allowed to clot
What is the difference between plasma and serum?
plasma contains clotting factors but serum does not
What are the functions of plasma proteins?
transport
inflammatory response and immunity
haemostasis
oncotic pressure
What do plasma proteins transport?
albumin, proteins which transport iron, copper, hormones, lipids, etc
What plasma proteins are involved in the inflammatory response and immunity?
immunoglobulins, complement proteins, acute phase proteins
Does water move in or out at the arterial end of blood vessels?
out
Does water move in or out at the venous end of blood vessels?
in
Why does water move into blood vessels at the venous end?
due to oncotic pressure
What happens to fluid when hydrostatic pressure > oncotic pressure?
fluid leaks out into interstitial space
What happens to fluid when hydrostatic pressure < oncotic pressure?
water moves back into capillary
What is the most abundant protein in plasma?
albumin
Characteristics of albumin
negatively charged at physiological pH
highly polar
large capacity to non-specifically bind ligands
Features of albumin bound molecules
solubilise
retained in blood stream
regulated
may be neutralised -antioxidant function of albumin
Why do fatty molecules bind to albumin?
they aren’t soluble in water so binding to albumin makes them more soluble
low levels of albumin
hypoalbuminaemia
What does hypoalbuminaemia do?
reduce oncotic pressure and lead to oedema
What are 3 causes of hypoalbuminaemia?
chronic liver disease
malnutrition
chronic renal disease
What are the symptoms of hypoalbuminaemia?
swelling of extremities
vomiting
weakness
diarrhoea
distended abdomen
breathing difficulty
What substance does transferrin transport?
iron
What substance does caeruloplasmin transport?
copper
What transport proteins are involved in transporting hormones?
thyroid hormone binding globulin
cortisol binding globulin
sex hormone binding globulin
Globulin
generic term given to many plasma proteins
What substance does haptoglobin transport?
haemoglobin
What substances do apoproteins transport?
lipids
What determines the concentration of proteins in the plasma?
blood volume
rate of synthesis
rate of breakdown and loss
What determines blood volume?
hydration
Where are proteins synthesised?
liver
cells of immune system
What determines breakdown of proteins?
uptake and degradation of proteins by cells
Where can proteins be lost?
via kidney and/or gut
What measurements can be made to use plasma proteins as diagnostic tools?
total protein conc (limited use)
serum electrophoretic pattern
enzyme measurements
What do serum electrophoretic patterns allow for?
separation and semi-quantitative assessment of individual proteins
What can enzyme measurements be used for?
detecting cell damage
Benefits of serum protein electrophoresis (SPE)
inexpensive
easy to perform
Serum protein electrophoresis (SPE)
agarose or polyacrylamide gel electrophoresis separates proteins on the basis of their charge and size
In serum protein electrophoresis, what does the size of band equal?
size of protein
When do albumin levels decrease?
prolonged malnutrition
chronic liver or renal disease
When do albumin levels increase?
in dehydration
What does increased alpha-globulins cause?
acute inflammatory diseases
What can increased beta-globulins be indicative of?
liver disease
What does the concentration of acute phase proteins increase in response to?
inflammation
What are acute phase proteins an important part of?
innate immune response
What do increased alpha 3 bands reflect?
increase in proteins indicating likelihood of infection
What do low levels of albumin indicate?
acute phase reaction
What do decreased gamma-globulins indicate?
immune suppression or immune deficiency conditions (hypogammaglobulinaemia)
What do increased gamma-globulins indicate?
chronic infection
When is a sharp, distinct increase in one area of the y band in serum protein electrophoresis seen?
in multiple myeloma
multiple myeloma
cancer caused by monoclonal expansion of a single type of antibody producing cell and hence a single antibody
What are some limitations of SPE?
important proteins produced in quantities too low to detect
changes in band density can be missed
What can abnormalities in sodium, potassium and chloride ions indicate?
metabolic disorders
dehydration
renal dysfunction
Is concentration of cellular enzymes in serum normally high or low?
LOW
When can enzyme activity in serum be increased?
by cell proliferation or damage (e.g. cancer, cell death, trauma)
What is analysis of the enzyme ALT indicative of?
liver damage
What is analysis of the enzyme ALP indicative of?
bone deposition, liver damage, hyperthyroidism, biliary disease, increased steroid levels
What is analysis of the enzyme GDH indicative of?
liver disease
What is analysis of the enzyme yGT indicative of?
liver disease
What is analysis of the enzyme CK indicative of?
muscle damage
What is analysis of the enzyme AST indicative of?
muscle and liver damage
What is analysis of the creatinine indicative of?
kidney malfunction
