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Questions and Answers
What is the primary function of albumin in plasma?
What is the primary function of albumin in plasma?
Which factors may influence albumin levels in plasma?
Which factors may influence albumin levels in plasma?
In which animals is the albumin/globulin (A/G) ratio typically greater than 1.0?
In which animals is the albumin/globulin (A/G) ratio typically greater than 1.0?
What is true about gamma globulins?
What is true about gamma globulins?
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What happens to albumin levels during acute inflammation or injury?
What happens to albumin levels during acute inflammation or injury?
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Which of the following proteins is considered a negative acute-phase protein?
Which of the following proteins is considered a negative acute-phase protein?
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What could an alteration in the albumin/globulin ratio indicate?
What could an alteration in the albumin/globulin ratio indicate?
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What factors may lead to hypoproteinemia related to albumin?
What factors may lead to hypoproteinemia related to albumin?
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Which globulins are primarily synthesized in the liver?
Which globulins are primarily synthesized in the liver?
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Which of the following is NOT a function of plasma proteins?
Which of the following is NOT a function of plasma proteins?
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What condition is likely to cause an increase in total plasma protein concentration?
What condition is likely to cause an increase in total plasma protein concentration?
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Which method is often used to test total plasma protein in a fast and inexpensive manner?
Which method is often used to test total plasma protein in a fast and inexpensive manner?
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Which of the following statements about total serum protein is true?
Which of the following statements about total serum protein is true?
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What is the purpose of measuring total protein concentrations?
What is the purpose of measuring total protein concentrations?
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Which testing method measures the number of molecules containing more than three peptide bonds?
Which testing method measures the number of molecules containing more than three peptide bonds?
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Which condition could lead to hypoproteinemia?
Which condition could lead to hypoproteinemia?
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What does an increase in conjugated bilirubin indicate?
What does an increase in conjugated bilirubin indicate?
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What role do bile acids serve in the body?
What role do bile acids serve in the body?
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What percentage of bile acids are actively resorbed in the ileum?
What percentage of bile acids are actively resorbed in the ileum?
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What could elevated serum bile acid (SBA) levels indicate?
What could elevated serum bile acid (SBA) levels indicate?
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What happens to bile acids once they reach the ileum?
What happens to bile acids once they reach the ileum?
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What is one role of Serum Amyloid A (SAA) in domestic animals?
What is one role of Serum Amyloid A (SAA) in domestic animals?
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Which acute-phase protein is specifically measured using a handheld portable analyzer in horses?
Which acute-phase protein is specifically measured using a handheld portable analyzer in horses?
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What does an increase in fibrinogen levels typically indicate?
What does an increase in fibrinogen levels typically indicate?
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What condition is associated with hypoproteinemia?
What condition is associated with hypoproteinemia?
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Which acute-phase protein is measured with immunoassays in domestic animals?
Which acute-phase protein is measured with immunoassays in domestic animals?
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What is the normal percentage of fibrinogen in total plasma proteins?
What is the normal percentage of fibrinogen in total plasma proteins?
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Which condition is characterized by hemodilution?
Which condition is characterized by hemodilution?
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What indicates increased levels of C-reactive protein (CRP)?
What indicates increased levels of C-reactive protein (CRP)?
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Which of the following is a hepatic synthesis marker?
Which of the following is a hepatic synthesis marker?
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How does fibrinogen function in blood clot formation?
How does fibrinogen function in blood clot formation?
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What is the primary function of the gallbladder?
What is the primary function of the gallbladder?
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Which of the following is a clinical manifestation of hyperbilirubinemia?
Which of the following is a clinical manifestation of hyperbilirubinemia?
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Which substance is predominantly bound to albumin in the blood?
Which substance is predominantly bound to albumin in the blood?
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What role do bacteria in the GI tract play in relation to bilirubin?
What role do bacteria in the GI tract play in relation to bilirubin?
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Which of these liver functions is NOT part of its metabolic roles?
Which of these liver functions is NOT part of its metabolic roles?
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What is the relationship between liver damage and hepatocyte function tests?
What is the relationship between liver damage and hepatocyte function tests?
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Which of the following conditions can result from malfunctions in the liver or gallbladder?
Which of the following conditions can result from malfunctions in the liver or gallbladder?
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How is bilirubin processed in the liver?
How is bilirubin processed in the liver?
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What signifies the increase of bilirubin in the blood?
What signifies the increase of bilirubin in the blood?
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Which of the following tests is considered less sensitive in detecting liver problems?
Which of the following tests is considered less sensitive in detecting liver problems?
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Study Notes
Animal Medical Biochemistry Study Notes
-
General:
- The liver is the largest internal organ in animals, with complex structure, function, and pathologic characteristics.
- Liver functions include the metabolism of amino acids, carbohydrates, and lipids; synthesis of albumin, cholesterol, plasma proteins, and clotting factors; digestion and absorption of nutrients; secretion of bilirubin or bile; and elimination or detoxification of toxins and catabolism of certain drugs.
- The gallbladder is closely associated with the liver, both anatomically and functionally. Its primary function is bile storage.
- Malfunctions in the liver or gallbladder can lead to hyperbilirubinemia (jaundice), hypoalbuminemia, hemostasis problems, hypoglycemia, hyperlipoproteinemia, and hepatoencephalopathy.
Plasma Proteins
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Albumin:
- One of the most important proteins in plasma or serum, making up 35% to 50% of the total plasma in most animals.
- Hepatocytes synthesize albumin.
- Any diffuse liver disease can lead to decreased albumin levels.
- Renal disease, dietary intake, and intestinal protein absorption can also influence albumin levels.
- Albumin is a major binding and transport protein.
- Maintains osmotic pressure of plasma (aka oncotic pressure).
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Globulins:
- Alpha globulins are synthesized in the liver, primarily for transport and binding of proteins.
- Include high-density lipoproteins (HDL).
- Include very low-density lipoproteins (LDL).
- Include beta globulins: complement (C3, C4), transferrin, and ferritin (responsible for iron transport and heme binding).
- Gamma globulins (immunoglobulins) are synthesized by plasma cells and responsible for antibody production (immunity).
- Include IgM, IgG, IgD, and IgA.
- Alpha globulins are synthesized in the liver, primarily for transport and binding of proteins.
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Albumin/Globulin Ratio:
- Ratio analysis is used to identify protein abnormalities.
- Most pathologic conditions may alter the A/G ratio.
- A/G ratios in dogs, horses, sheep, and goats are usually greater than 1.0 (albumin greater than globulins).
- A/G ratios in cattle, pigs, and cats are typically less than 1.0 (albumin equal to or lower than globulins).
Acute Phase Proteins
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General:
- Synthesized by hepatocytes immediately after injury or inflammation.
- Albumin and transferrin are negative acute phase proteins because their plasma concentrations decrease with injury or inflammation.
- 30 known recognized acute phase proteins.
- Examples include serum amyloid A (SAA), C-reactive protein (CRP), fibrinogen, haptoglobin (HP), ceruloplasmin, a1-Acid glycoprotein (AGP), and Major acute-phase protein (MAP).
- Different species produce different acute phase proteins at different levels.
- Elevated levels are commonly seen within 6-48 hours of an inflammatory event.
Fibrinogen
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General:
- Synthesized by hepatocytes.
- Insoluble protein that forms the matrix of blood clots and is converted to fibrin by thrombin.
- Low fibrinogen levels are associated with little to no clotting.
- Makes up 3% to 6% of total plasma proteins.
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Clinical Significance:
- Acute inflammation or tissue damage may elevate fibrinogen levels.
- Not a routinely measured value in small animal chemistries by most methods.
Total Protein
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General:
- Total plasma protein includes fibrinogen.
- Total serum protein does not include fibrinogen.
- TPP and TSP may differ slightly.
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Clinical Significance:
- Used in patient hydration status, determining whether a patient is dehydrated (high) or overhydrated (low).
- Useful for screening patients with edema, ascites, diarrhea, weight loss, hepatic and renal disease, and blood clotting problems.
- TP concentrations can be affected by conditions categorized as altered hepatic synthesis, altered protein distribution/excretion, dehydration, and overhydration.
Total Protein Testing
- Refractometer: Estimates refractive index of serum or plasma often obtained as part of a PCV. Fast, inexpensive, and accurate.
- Biuret: Measures number of molecules containing more than three peptide bonds in serum or plasma. Used in analytic instruments. Simple and accurate.
- Other Testing Methods (Research/Reference): Gel electrophoresis, salt fractionation, and chromatography.
Hepatic Markers
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Hepatic Clearance:
- Bilirubin
- Bile acids
- Ammonia
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Hepatic Enzymes:
- Leakage enzymes: ALT, AST
- Inducible enzymes
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Hepatic Synthesis Markers:
- BUN, Cholesterol
- Albumin (proteins)
- Glucose (an especially important marker).
Bile Acids
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General:
- Serve many functions, including aid in fat absorption and modulating cholesterol levels.
- Synthesized in hepatic cells from cholesterol and conjugated with glycine and taurine.
- Secreted across the canalicullar membrane and reach the duodenum via the biliary system.
- Stored in the gallbladder until contraction associated with feeding (except in horses and rats).
- Postprandial serum bile acid (BA) concentrations are higher than fasting concentrations; processes that interfere with bile acid circulation result in elevated numbers.
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Elevated Levels:
- Usually indicate liver diseases (e.g., congenital portosystemic shunts, chronic hepatitis, hepatic cirrhosis, cholestasis, neoplasms).
- Elevated levels can arise from extrahepatic diseases that secondarily affect the liver.
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Decreased Levels:
- May be seen with intestinal malabsorptive diseases.
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Testing:
- Paired serum samples are performed after 12 hours of fasting and 2 hours after eating.
Ammonia
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General:
- Major source of ammonia is the intestinal tract via bacterial flora.
- Ammonia is removed by hepatocytes and converted to urea.
- Urea is released into circulation and cleared by the kidneys.
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Hyperammonemia:
- Associated with decreased functional hepatic mass.
- Associated with decreases in presentation of ammonia to the liver (often with PSS).
- Associated with urea toxicosis in ruminants (dietary urea too high).
Liver Enzymology
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Enzyme Types:
- Leakage enzymes (released from damaged hepatocytes)
- Alanine transaminase (ALT)
- Aspartate transaminase (AST)
- Dehydrogenase enzymes (Iditol dehydrogenase (ID), Glutamate dehydrogenase (GLDH))
- Inducible enzymes (membrane-bound and slower to increase in blood)
- Alkaline Phosphatase (ALP/ALKP)
- Gamma Glutamyltransferase (GGT)
- Leakage enzymes (released from damaged hepatocytes)
- Significance: Increases in these values indicate potential liver damage.
Bilirubin
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General:
- Hyperbilirubinemia is an increase in bilirubin in the blood.
- Jaundice/Icterus is the clinical manifestation of hyperbilirubinemia.
- Bilirubin is an insoluble molecule derived from hemoglobin; it binds to albumin for transport to the liver.
- Hepatic cells metabolize and conjugate bilirubin, producing bilirubin glucuronide. This is secreted in the bile.
- Bacteria in the gastrointestinal tract act on the bilirubin glucuronide, and convert it to urobilinogens, which are excreted in the feces.
- Testing: Measurement of unconjugated and conjugated bilirubin can help determine specific causes of jaundice.
Hepatocyte Function Tests
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Routine: Primarily run in veterinary settings.
- Bilirubin
- Bile acids
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Other: Less sensitive than routine tests, and problems may not be indicated until substantial amounts of the tissue is damaged.
- Albumin
- Cholesterol
Other Markers of Hepatic Synthesis
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Liver synthesis markers:
- BUN (synthesized by hepatocytes from ammonia).
- Glucose
- Cholesterol
- Albumin/Globulin
- Coagulation factors
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Description
Test your knowledge on the roles and functions of albumin and other plasma proteins. This quiz explores factors influencing albumin levels, the A/G ratio, and the clinical significance of protein concentrations in plasma. Ideal for students studying veterinary or human medicine.
