Chem exam B

Describe the Kjeldahl technique

determines protein concentration through measuring nitrogen, one of the primary components of proteins;

converts organic N to ammonia by adding sulfuric acid then titrating the released ammonia gas with the acid

Albumin NR, and clinical significance

3.5-5.5 g/dL

albumin of <3.5 g/dL is associated with?

>3.5 are associated with: nephrotic syndrome, starvation, malabsorption, cirrhosis, inflammation

albumin of >5.5 g/dL is associated with?

high protein diet, dehydration, drugs/medication

Albumin/Globin ratio calculation'; NR of A/G ratio

albumin / (total protein- albumin); 1.1- 2.5

Describe a Biuret reagent

it is used in protein and peptide detection by having copper ions bind to nitrogen atoms within peptide bonds, leading to a purple/blue color change in the solution

Protease inhibitor proteins

alpha- 1 antitrypsin and alpha-2 antitrypsin

increased levels of the protein ceruloplasmin is associated with?

Wilson’s disease; accumulation of copper

define haptoglobin, what are disease conditions related to decreased levels?

Haptoglobin binds to free hemoglobins that are released into the bloodstream during hemolysis.

Decreased haptoglobins is associated with (intravascular) hemolysis and liver cirrhosis

Define Troponin and list three isoforms that make up the troponin complex.  Describe the  

  advantages of troponin over CKMB and name the method currently available to measure cTnI. 

Troponin is part of the heart muscle that regulates muscle contraction, and the three forms that it makes up include Troponin 1, Troponin C, and Troponin T. Comapred to CKMB, Cardiac troponin is preferred because it has a higher sensitivity. A method currently available to measure cTnI is ELISA

List the currently used marker for congestive heart failure. 

Β-type natriuretic people (BNP)

what is the purpose of precipitating reagents in a protein free filtrate method?

They function to isolate the targeted proteins in a liquid solution

common precipitating reagents used?

Trichloracetic acid

tungstic acid

perchloric acid

Relate uric acid production to purine catabolism

When cellular nucleic acid purines ( adenosine and guanine) are broken down, uric acid is a product of it.

Explain the clinical significance of BUN ratio

BUN is used to assess kidney function and how well the body can metabolize products. In renal BUN the BUN/Cr ratio ranges from 10:1-20:1 and is associated with conditions that directly harm kidney tissue.

-The prerenal BUN/Cr ratio is >20:1 and it is associated with conditions that decreases blood flow towards the kidneys.

-Post renal BUN/Cr ratio would be <15:1 and it is associated with conditions that obstruct excretion.

myoglobin as a cardiac marker

• it has a detectable rise within 1-3 hours of a heart attack, much faster than with CK-MB and Troponin; it has a short half life as it peaks at 6-9 hrs then goes down to normal levels within 24 hours

• not as specific as other markers since it is also found in skeletal muscles

myoglobin in urine

makes urine dark; indicates rhabdomyolysis, extreme muscle damage

What type of electrophoretic patterns can be expected in nephrotic syndrome?

Due to low protein associated with this disease, there would be significantly decreased albumin, decreased alpha 1, gamma and normal to low beta globulins; alpha 2 is INCREASED!!

What type of electrophoretic patterns can be expected in multiple myeloma?

there would be an M spike that is narrow in the gamma or beta region since there is just one type of protein being excessively produced.

What type of electrophoretic patterns can be expected in liver disease?

bridging between the beta and gamma bands will be seen, and it can look like they are combining into one larger peak; this is due to the increase in IgA immunoglobulins

What type of electrophoretic patterns can be expected in chronic infection?

elevated alpha 1 and alpha 2 antitrypsin levels and the gamma regions would be wider on electrophoresis since there is heterozygous Ig production occurring

What type of electrophoretic patterns can be expected in acute phase reaction?

decrease in serum albumin and increased alpha 1 and alpha 2 globulins, which is the main trait associated with this condition on electrophoresis

What type of electrophoretic patterns can be expected in

the total serum protein would be decreased, which leads to decreased albumin since it makes up the majority of total protein, and that would be reflected on electrophoresis. There would also be decreased levels in beta and alpha globulins

Bisalbuminemia cause on protein electrophoresis?

two types of albumin with differences in their migration patterns either from their form or their charge- leading to the double peaks in the albumin region.

bands running off of gel

voltage too high, run time too long, gel percentage too low

What is the clinical significance of BUN? (renal, prerenal, postrenal). What creatinine values  are expected in these conditions

-In renal BUN the BUN/Cr ratio ranges from <10:1-15:1 and is associated with conditions that directly harm kidney tissue. (ie tubular necrosis, severe kidney disease)

-The prerenal BUN/Cr ratio is >20:1 and it is associated with conditions that decreases blood flow towards the kidneys. (heart failure, shock, severe dehydration)

-Post renal BUN/Cr ratio would be <15:1 and it is associated with conditions that obstruct excretion. (obstruction excretions)

What are normal values for BUN and creatinine? What is the normal ratio of BUN to creatinine? When is the ratio altered

BUN normal range is from 7-20 mg/dl

Creatinine is about 0.7-1.3 mg/dl.

The normal ratio ranges from 10:1-20:1. The ratio is altered when either BUN or creatinine is disproportionately higher (above 20:1) or lower (rare).

Describe two methods for detecting phenolketonuria?  Why are these tests required by state  law?

Tandem Mass Spectrophotometry, Fluorometric Assay Guthrie Bacterial Inhibition Assay- both take a blood sample to measure phenylalanine in the newborn to screen for the disease

required by state law for public health protection, because it is asymptomatic at birth, and to prevent severe disability

What is alpha-fetoprotein? What does its presence signify? How is it detected? 

protein that is produced in the fetus that is at its highest levels during pregnancy. The presence of it signifies that there may be possible neural tube or abdominal wall defects during pregnancy. Though, in adults that are not pregnant, it could indicate cancers or tumors in mostly the liver, pancreas and stomach.

Discuss prostatic disease and acid phosphatase levels in serum. 

Elevated phosphatase levels in serum are associated with prostatic disease, which allows for phosphatase to be a useful diagnostic marker and monitor for this disease condition.

 

What is standard operating procedure when an anion gap is unacceptable? 

An unacceptable gap would be a gap indicating a pH that suggests electrolyte imbalance and/or blood pH being too acidic or alkaline. The standard operating procedure when an anion gap is unacceptable is repeating the electrolyte measurements prior to reporting these results