NBME 26

NBME 26 serum electrophoresis -- First peak is albumin alpha 1 globulins = alpha antitrypsin, alpha 1 antichymotrypsin, TBG, alpha 2 globulins = haptoglobulin, macroglobulin, ceruloplasmin, TBG, protein C, angiotensinogen beta = beta 2 microglobin, plasminogen, angiostatins, SHBG, transferrin gamma = Ig serum electrophoresis in multiple myeloma -- gamma spike serum electrophoresis blurring beta 2 and gamma regions -- increased CRP increased IgA a/w respiratory infections, arthritis, cirhosis serum electrophoresis wide gamma region -- hypergammaglobulinemia a/w chronic liver disease, connective tissue disease, inflammatory disease Lesch Nyhan syndrome -- hypoxanthine-guanine phosphoribosyltransferase aka hypoxanthine and guanine have defective salvage a/w rhabdomyolysis / compartment syndrome -- myoglobinuria & acute renal failure via acute tubular necrosis anchoring fibrils -- type VII collagen; connecting basal lamina to reticular lamina part of hemidesmosomes if defective - blistering can form autoimmune hemolysis -- a/w CLL anemia reticulocytosis unconjugate hyperbilirubinemia spherocytes amphetamines -- -increase release of dopamine, norepinephrine & serotonin and decrease their reuptake