Plasma Proteins and Enzymology Cases

download Plasma Proteins and Enzymology Cases

If you can't read please download the document

Transcript of Plasma Proteins and Enzymology Cases

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    1/12

    Plasma Proteins, Enzymology

    Clotting Factors

    Case Studies

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    2/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    3/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    4/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    5/12

    -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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    6/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    7/12

    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?

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    8/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    9/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    10/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    11/12

    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

  • 7/27/2019 Plasma Proteins and Enzymology Cases

    12/12

    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