plasma proteins and enzymology cases
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7/27/2019 Plasma Proteins and Enzymology Cases
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Plasma Proteins, Enzymology
Clotting Factors
Case Studies
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Protein Disease Investigation
Albumin Malnutrition, infections, malignancy,
liver, kidney and GI disease
-Fetoprotein Neural tube defects, tumor marker
1-Antitrypsin API deficiency
Prothrombin Coagulation screen, liver functiontest
Ceruloplasmin Wilsons disease, malnutrition,
nephrotic syndrome
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Haptoglobin Hemolytic disorders
2-Macroglobulin ProteinuriaThyroxine
binding globulin
Diseases of thyroid
C-Reactiveprotein
Infection, used with ESR
2-Microglobulin Mylomas, renal failureTransferrin Iron deficiency
Immunoglobulins Liver disease, infections,
paraproteinemias
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Enzyme Disease Investigation
Alanine
transaminase
Hepatocellular damage
Aspartate
transaminase
Hepatocellular damage, marker
of MI
Alkaline
phosphatase
Cholestatic liver disease,
osteoblast activity in bone
disease
Amylase Cell damage in acute pancreatitis
Creatine kinase Marker of muscle, MI and brain
tumor
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-Glutamyl transferase Sensitive marker of livercell damage
Lactate dehydrogenase Marker of muscle damage ,
MI
Cholinesterase Scoline apnea,
organophosphorous
poisoning
Acetyl cholinesterase In nerve endings and
erythrocytes, never in
plasma
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Acute phase
protein
Function Increase
C-reactive
protein
Binds extracts of
pneumococcal cell wall
lpha-1-
antitripsin
Protease inhibitor
Ceruloplasmin Copper transport,superoxide scavenger
1-Acidglycoprotein
Tissue repair
Fibrinogen Clotting
Haptoglobin Binds hemoglobin
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Case One
Eight months after an acute attack of glomerulonephritis,
a 38-year-old female was hospitalized for investigation of
bilateral leg edema. On examination she was
normotensive and exhibited pitting edema of both ankles.
Her face was pale and puffy and she admitted to frequent
minor intercurrent infections.
What is your tentative diagnosis? What biochemical analysis would you request?
What results would be consistent with you
diagnosis?
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Case TwoA 52-year-old male is admitted to hospital after
several episodes of bizarre behavior. The patients
history indicates a long standing problem with
alcoholism.
Laboratory findings are as follows:
Plasma Analysis Result Reference Range
Albumin 30 35 45 g/L
ALP 80 40 110 U/L
ALT 85 10 40 U/L
AST 65 5 45 U/L
- GT 150 10 55 U/L
PTT (activated) 60 25 40 seconds
PT 35 11 15 seconds
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1. Ceruloplasmin a. High activity in lung
2. Haptoglobin b. High concentrations observed in
hepatocellular cancer
3. Albumin c. Reduced in hemolytic conditions
4. Alpha1-antitrypsin d. Iron storage protein
5. Alpha-fetoprotein e. Reduced in Wilsons disease
6. Ferritin f. Reduced concentrations results in
edema
Match the described properties with the correct protein
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1. ALP a. Increased in diseases of the
pancreas
2. AST ALT b. Increased in certain tumors of thebrain
3. CK-BB c. Affected by organophosphate
ingestion
4. Amylase d. Increased in myocardial infarction
5. Troponin I e. Increased in biliary ductobstruction
6. Cholinesterase f. Increased in hepatocellular
disease
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Match the following described properties with the right
proteins/diseases:
1. G-protein coupled thrombin receptors a. Factor I
2. Hydrolyses fibrinogen to fibrin b. vWF
3. A substance responsible for degradingthe fibrin clot c. Vitamin K
4. High levels of this factor found in
patients with CHD and diabetes
d. Factor IIa
5. Binds to and stabilizes factor VIII e. Urokinase
6. Is necessary for the function of factors
II, VII, IX and X
f. PAR 1,3,4
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7. Requires factor IXa for activation g. Factor IIa
8. Factor that activates VII to VIIa h. LACI
9. High levels of this factor will degrade
factors Va and VIIIa
i. Antithrombin III
10. Cofactor of protein C; both containg laresidues
j. Serotonin
11. Inhibitor of factors Xa and VIIa k. Tissue factor III
12. The most important coagulation
inhibitor
l. Protein S
13. Secreted by activated platelets m. Factor X
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