Globulin Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Globulin and links to relevant pages within the course.
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| The reagent strip method for protein primarily tests for which type of protein? | View Page |
| Protein Error of Indicators Testing for protein is based on the phenomenon called the "Protein Error of Indicators" (ability of protein to alter the color of some acid-base indicators without altering the pH). In a solution void of protein, tetrabromphenol blue, buffered at a pH of 3, is yellow. However, in the presence of protein (albumin), the color changes to green, then blue, depending upon the concentration. This method is more sensitive to albumin than to globulin, detecting as little as 5 mg albumin/dL urine. Bence Jones protein and mucoprotein are examples of globulin components that are sometimes present in urine, but are not distinguishable by the dipstick method for protein. | View Page |
| Rh immune globulin therapy in postpartum women provides: | View Page |
| What is Coombs sera comprised of: | View Page |
| A solution of gamma globulins containing anti-Rh (D) is given to an Rh (D) negative mother to: | View Page |
| IgG coated red cells are added to negative antiglobulin tests to detect which of the following sources of error: | View Page |
| A false-negative reaction while performing the DAT technique may be the result of: | View Page |
| What additional fraction would be seen if plasma rather than serum was subjected to electrophoresis: | View Page |
| Which one of the following are not associated with a polyclonal (broadbased) increase in gamma globulins? | View Page |
| Bence-Jones proteinuria can be seen in all of the following conditions except: | View Page |
| Which of the following is most responsible for increasing the erythrocyte sedimentation rate (ESR): | View Page |
| The Kleihauer-Betke test is used to: | View Page |
| Serum proteins can be separated by cellulose acetate electrophoresis into how many basic fractions: | View Page |
| The RBCs found in this illustration are the result of: | View Page |
| Persons with type 1 or type 2 diabetes should periodically have their urine monitored for: | View Page |
| ABO Antibodies and Aging ABO antibodies are not usually produced by an infant until 3 to 6 months of age. Antibodies found in the sera of newborns are almost always IgG, passively acquired from the mother. Thus, serum testing of newborns is not performed. Anti-A and anti-B titers are highest at ages 5-10 years and then they gradually decrease. Thus, in elderly patients, ABO antibodies may be difficult to detect. In patients with hypogammaglobulinemia, some leukemias, lymphomas or patients who are taking immunosuppressive drugs, the expected antibodies may be weak or even absent, reflecting the low levels of gamma globulin in the patient’s serum. As previously mentioned, these and other ABO typing discrepancies must be resolved before true ABO type can be determined. | View Page |
| Glossary of Terms A through M. Antibody - A modified type of serum globulin synthesized by lymphoid tissue in response to antigenic stimulus. By virtue of specific combining sites each antibody reacts with only one antigen. Anucleate - Having no nucleus. Azurophilic granules - The well-defined large reddish granules (lysosomes) which may be present in large lymphocytes. They are called "azurophilic granules" because they stain blue with the azure stains which were originally used. Basophilic granules - Specific granules present in the cytoplasm of basophils. These granules are large and stain purple-black due to their strong affinity for basic stain. B-cell - Bone marrow derived lymphocytes which produce humoral antibodies. Biconcave - Having two concave surfaces. Cellular Immunity - The capacity of a small proportion of lymphoid population to exhibit response to a specific antigen. Chromomere - The centrally located granular portion of the platelet. Clone - A population of cells descended from a single cell. Delayed Hypersensitivity - (part of cellular immunity) that develops slowly over a period of 24-72 hours after an antigenic stimulus. It consists of an accumulation of cells around small vessels and/or nerves. Example: Tuberculin skin test reaction. Digestive Enzyme - A substance that catalyzes or accelerates the process of digestion. Eosinophilic Granules - Specific granules present in the cytoplasm of eosinophils. These granules are large, refractile spheres which stain reddish-orange due to their strong affinity for acid stain. Erythrocyte (red blood cell, RBC) - One of the elements found in peripheral blood. Normally the mature form is a non-nucleated, circular, biconcave disk adapted to transport respiratory gases. Fixed Macrophage - A phagocyte that is non-motile. Free Macrophage - An ameboid phagocyte present at the site of inflammation. Graft Rejection - A transplanted tissue that is rejected by the body's antibodies. Graft vs. Host Reaction - A complication that occurs when an implanted piece of tissue, which contains antibodies, rejects the host's tissue. Granulocyte - A leukocyte which contains granules in its cytoplasm, i.e., neutrophilic, eosinophilic, or basophilic granules. Half-life - is the length of time it takes for half of the cells circulating at a given time to leave the blood for the tissues. Hemocyte - Any blood cell or formed element of the blood. Hemostasis - A mechanism of the vascular system to arrest an escape of blood. It involves an interaction between blood vessels, platelets, and coagulation. Heparin - A mucopolysaccharide acid which, when present in sufficient amounts, functions as an anticoagulant by inhibiting thrombin. Histamine - A powerful dilator of capillaries and a stimulator of gastric secretions. Humoral Immunity - Acquired immunity produced after response to an antigenic stimulus in which B cells produce circulating antibodies. Hyalomere - the clear, blue non-granular zone surrounding the chromomere of a platelet. Immune Response - The interaction of a cell and an antigen that results in a proliferation of the cell and a capacity to produce antibodies. Isotonic Fluid - A fluid whose elements have an equal osmotic pressure. Leukocyte (white blood cell, WBC) - One of the formed elements of the blood; involved primarily with the body's defense. Lysosome - A microscopic body within cell cytoplasm; contains various enzymes, mainly hydrolytic, which are released upon injury to the cell. Megakaryocyte - A giant cell of the bone marrow from which platelets are derived. Mononuclear - A cell having a single nucleus. | View Page |
| Protein Binding Most drugs are bound to proteins when they circulate in the body. Albumin is a major drug-binding protein in serum. Albumin is an alkaline protein, so acidic and neutral drugs primarily bind to it. If albumin binding sites become saturated, acidic and neutral drugs can bind to lipoproteins. Alkaline drugs tend to bind to globulins, particularly to the globulin, alpha-1 acid glycoprotein. Only free, unbound drugs are able to bind drug receptors and have therapeutic effects. An equilibrium exists in the systemic circulation between a free and protein-bound drug and between a free and receptor-bound drug. This is illustrated in the image to the right. | View Page |
| Plasma proteins Numerous types of proteins are dispersed in the plasma. These include:
Coagulation proteins (blood clotting factors), which, if activated, will form a blood clot , and
Serum proteins, which are left dispersed in liquid after the clot is formed. Serum proteins include:
Albumin, a marker of nutrition, and
Globulins, or antibodies. | View Page |
| Warm antibody hemolytic disease A 49-year-old male with pneumonia was treated with penicillin. He became jaundiced with yellow sclera. Observe the photograph of his peripheral blood smear. Anisocytosis was observed with pale-centered microcytes and polychromatophilic macrocytes. Since penicillin is a classic offender for autoimmune hemolytic disease, the clinician asked for an antihuman globulin (AHG) test, also known as the Coombs test. A positive AHG reaction occurs when the antibody stimulated by penicillin becomes attached to red blood cells. Hemolysis follows, leaving the patient with jaundice and a peripheral blood smear, as demonstrated in the photograph. | View Page |
| Hemoglobin H disease Hemoblobin H disease follows deletions of 3 of the 4 alpha globulin chains. Beta chains, unable to bind with insufficient numbers of alpha chains, form beta chain tetramers, or HbH.These beta chain tetramers appear as numerous dot size inclusions in erythrocyte cytoplasm, best seen in supravital brilliant cresyl blue stains (lower photograph).The most common molecular defect in alpha thalassemia is DELETION, not MUTATION; whereas, in beta thalassemia, the molecular defect is MUTATION.Leptocytes, as illustrated in the upper photograph,(lepto, derived from a Greek word meaning thin, fine, or slight), are characteristic of HbH disease. They have thinner cell membranes than the cells we recognize as target cells. They stain more lightly than normal erythrocytes and their centers are almost colorless.Subtle changes perhaps, but worth keeping in mind | View Page |
| The arrangement of erythrocytes on this peripheral blood smear may be seen in each of the following conditions except: | View Page |
| The arrangement of the erythrocytes in this peripheral smear should be reported out as rouleaux formation. | View Page |
| True Rouleaux This field shows an example of rouleaux. Notice that most of the red cells seen in the field, in the proper viewing area, are stacked together like coins. Four or more cells make up each formation in this slide, leaving much of the field empty of cells (increased white space).
Rouleaux is clinically significant when increased globulins are present, as in multiple myeloma. | View Page |
| True Rouleaux Another example of rouleaux is seen in this slide taken from a patient with multiple myeloma. Frequently, the darkly stained macroscopic appearance of the slide will be a clue to the presence of rouleaux on the smear. Increased globulins in the plasma oftne cause the background of the stained smear to be somewhat bluer than the other slides stained at the same time. | View Page |
| The globular inclusions in this cell are fat droplets. | View Page |
| The upper photograph of a peripheral blood smear reveals RBC rouleaux formation. Nucleated cells evident in both upper and lower photographs comprise approximately 5% of the total white blood cell count. The most probable underlying condition is: | View Page |
| The cell photographed here is known as a MOTT cell. The condition in which these cells are associated is: | View Page |
| Multiple myeloma Plasma cells are uncommonly observed in the peripheral blood smear.They are normal constituents of lymph nodes, spleen, connective tissue and bone marrow. The presence of plasma cells in the peripheral blood is indicative of a large number of conditions mostly related to infections , immune disorders, malignancies, toxic exposures, hypersensitivity reactions and their responses.Although mature plasma cells have a distinct appearance, they still may be confused morphologically with immature plasma cells and other cells with inclusions, reactive changes or nucleated red bloods cell with altered identities.In the upper and lower photographs are plasma cells with features mindful of myeloma cellsThe large myeloma cell in the upper photograph has an eccentric immature nucleus with a muddy chromatin pattern.Note also clumping and stacking of the erythrocytes, bordering on rouleaux formation ,implicating an increase in plasma gamma globulin.The plasma cell with the double nucleus in the lower photograph is particularly suggestive of myeloma.Further studies are in order including a bone marrow examination where at least 30% of bone marrow cells should be variations of mature and immature plasma cells.Serum electrophoresis will reveal a monoclonal globulin spike, and light chains in excess of 1.0 gm/24 hours may be seen in the urine.The presence of lytic bone lesions is a convincing clinical clue.With these findings in combination, a diagnosis of myeloma can be made with assurance. | View Page |