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Chemical Composition of Blood Plasma

Chemical Composition of Blood Plasma. Terms. Mechanics of investigation. High- and low- MW compounds of bl.pl. Interpretation of investigations in clinical practice: “Basic set” Disorders of the kidneys and internal environment Inflammation Liver disorders.

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Chemical Composition of Blood Plasma

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  1. Chemical Composition of Blood Plasma • Terms. Mechanics of investigation. • High- and low- MW compounds of bl.pl. • Interpretation of investigations in clinical practice: • “Basic set” • Disorders of the kidneys and internal environment • Inflammation • Liver disorders

  2. Basic terms and mechanics of investigation • Serum = liquid remaining after clotting • usefull for most biochem. tests • Plasma = whole blood - cells • emergency tests • small samples (yield is greater) • clotting tests • The mechanics of investigations • Blood collection: venepuncture

  3. Biochemical abnormalities are important markers of disease • Diagnosis = history + examination + biochemical tests + imaging techniques • Treatment: monitoring of the response to therapy in both acute and chronic disorders • Prognosis and secondary prevention • Screening: detecting the non-apparent disease, eg. PKU or hypothyreosis

  4. Low-molecular weight compounds of blood plasma • Cations: Na+, K +, Ca + + • Anions: Cl-, HCO3-, HPO42-, HSO4- • Metabolites: urea, creatinine, uric acid, bilirubin • Nutrients: glucose, FFA, ketones • Other +

  5. High MW compounds of blood plasma (= proteins) • According to the function • oncotic pressure • clotting factors and fibrinolytic agents • transport: binding proteins, apoproteins • antibodies and complement: IgG, IgM • buffers • none: enzymes used for diagnostics • Electrophoretic separation: prealbumin, albumin, α-, β-, γ-globulines

  6. Internal environment and the blood buffers • Basic life conditions: • isoionia: concentrations of certain ions must be kept in narrow range • isoosmia: osmotic pressure is allways the same in ECS and in cells (in dehydratation osmotic pressure rises) • isohydria: pH = 7.35 - 7.45 • Blood buffers: bicarbonate, hemoglobine, proteins and phosphate

  7. Internal environment investigation • Water metabolism: osmolality, Na+ • Acid-base balance disordes: “Astrup“ • taken from arterial blood • pH, pO2, pCO2, HCO3-, BE, BB, AG, lactate • Kidney failure: K+, urea, creatinine, phosphate and sulphate retention • Respiration failure: pO2 decrease with/without pCO2 increase

  8. Inflammation • History + examination • Changes in the blood count (eg. leucocytosis) and sedimentation rate • Non-specific inflammatory markers: eg. CRP and fibrinogen • Specific antibodies: IgG or IgM (ELISA) • Antigen assays: eg. HBsAg

  9. Assays for liver and billiary tract function and disease • Parenchyme damage: • increase in enyzme activity in plasma: ALT, AST, ALP, GMT • Alteration of liver function: • bilirubin accumulation (jaundice) • alteration of protein synthesis: hypoalbuminaemia, clotting disturbancies

  10. „Basic set“ • Takenfrommost of the patients admitted to hospital • Give to the physician basic overview about patient’s metabolic state and organ functions • Contains: • Na, K, Cl, glycaemia • liver set: ALT, AST, bilirubin, (ALP, GMT) • kidney set: urea, kreatinine • blood count and FW • urine examination + sediment

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