رايط الشرح علي اليوتيوب https://youtu.be/y-GgJW2JMDI

1. BY
dr: Mohammed Bahgat Mohammed Sofyan
Assistant lecturer of medical biochemistry,
Faculty of medicine, Al-Azhar university
(Assiut branch)
1

2. ‫كريم‬ ‫رمضان‬
2

3. ‫يارمضان‬ ‫أهال‬
3

4. ‫صورة‬ ‫كل‬ ‫على‬ ‫اضغط‬
‫عرض‬ ‫وضع‬ ‫في‬
‫على‬ ‫وادعمنا‬ ‫الشاشة‬
‫اإلنترن‬ ‫على‬ ‫قنواتنا‬
‫ت‬

5. ‫على‬ ‫ملفي‬ ‫في‬ ‫هنا‬ ‫أرفعها‬ ‫التي‬ ‫شرائحي‬ ‫ومذاكرة‬ ‫بالتعلم‬ ‫وأسعد‬ ‫وأرحب‬ ‫أسمح‬
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‫وال‬
‫مانع‬
‫أيضا‬
‫من‬
‫نسخ‬
‫شريحة‬
‫او‬
‫اثنين‬
‫عند‬
‫الضرورة‬
،
‫وال‬
‫مانع‬
‫من‬
‫شرح‬
‫البورب‬
‫وينت‬
‫الخاصة‬
‫بي‬
‫للغير‬
‫بشرط‬
‫عدم‬
‫إزالة‬
‫اسمي‬
‫من‬
‫البوربوينت‬
،
‫فال‬
‫أسمح‬
‫أبدا‬
‫بإزال‬
‫ة‬
‫اسمي‬
‫من‬
‫على‬
‫الباوربوينت‬
‫ووضع‬
‫اسمك‬
‫بدال‬
‫منه‬
‫لتصبح‬
‫وكأنك‬
‫من‬
‫صممتها‬
‫فهذه‬
‫سرقة‬
‫ال‬
‫أسمح‬
‫بها‬
‫وتضييع‬
‫لحق‬
‫من‬
‫تعب‬
‫في‬
‫عملها‬
.
‫وفقكم‬
‫هللا‬
‫وإياي‬
‫للتعلم‬
‫ونفع‬
‫اآلخرين‬
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There is also no objection to copying one or two slides when
necessary, and there is no objection to explaining my PowerPoint to
others on the condition that my name is not removed from the
PowerPoint. I never allow my name to be removed from PowerPoint
and to replace it with yours, Make it look like you designed it. This is
theft that I do not allow and a waste of the right of those who are
tired in this work. May God bless you and me for learning and
benefiting others
5

6. Blood is a specialized body
fluid. It has two main
components: plasma and
cells .
Cells composed of
red blood cells,
white blood cells, and
platelets.
Plasma contains about 90 percent
water, with 10 percent being made
up of proteins, ions, dissolved
gases, nutrient molecules, and
wastes.
The proteins in plasma (
PLASMA PROTEINS) include
albumin, globulin , and
coagulation factors.

7. 7

8. PLASMA
PROTEINS
Albumin ➡ 60%
Globulin ➡ 35%
Fibrinogen ➡ 4%
Other ➡ less than 1%
8

9. PLASMA PROTEINS
‫عينة‬ ‫سحبت‬ ‫لو‬
serum
‫ال‬ ‫يبقي‬
Plasma Protein in the serum is made up
of albumin and globulin.
The globulin in turn is made up of α1, α2, β, and γ globulins.
These fractions can be quantitated using protein
electrophoresis.
‫راجعه‬ ‫سابق‬ ‫بوست‬ ‫في‬ ‫األلبيومين‬ ‫شرحنا‬
.
9

10. PLASMA GLOBULINS
Globulins make up the about 35% of proteins in the blood. Most of
proteins are synthesized from liver, The gamma globulins are
produced by the liver and some by the immune system (B cell).
They help fight infection and transport nutrients.
10

11. Serum proteins in electrophoresis
11

13. Measurment of proteins
Speciment ➡ serum
Normal range of total protein ➡
6_8 gm/dl
13

14. SEPRATION OF
SERUM FROM
BLOOD
14

15. Measurment of proteins
1 _ total proteins in serum is measured traditionally by Biruet test, but other
chemical methods such as KJeldahl and lowry's method.
Principle of biuret test :
Alkaline CuSO4 reacts with compounds containing two or more
peptide bonds to give a violet colored product, measured at 450 nm.
2_ total proteins in urine and CSF measured by either nephylometric or
turbidimetric method or dye binding methods ( pyrogallol methods).
3_ serum individual proteins other than total proteins and albumin are measured
by immunoturbidimetry or immunonephylometry.
15

16. Biuret test
16

17. Calculation :
NB ➡ as serum proteins contain albumin and globulin
only, globulins are calculated after measuring both total
protein and albumin as follow:
Globulin = total proteins _ albumin
A/G ratio = divide albumin by globulin
Calculation of Globulin and A/G ratio
17

18. Normal range
Normal range of serum
albumin ➡ 3.5 _ 5.5 gm/dl
Normal range of total
protein ➡ 6_8 gm/dl
Normal range of globulin
➡ 2 _ 3.5 gm/dl
Normal range of A/G ratio
➡ 1.5 _ 2
18

19. Alpha1 globulin➡
0.2 to 0.4 g/dL
Alpha2 globulin ➡
0.5 to 0.9 g/dL
Beta globulin
➡0.6 to 1.1 g/dL
Gamma globulin
➡ 0.7 to 1.7 g/dL
Globulin
19

20. Causes of hypoproteinaemia
Causes of hypoproteinaemia :
‫إما‬ ‫سببين‬ ‫لها‬
:
A_ Hemodilutions
‫وغيره‬ ‫المحاليل‬ ‫في‬ ‫زي‬
I. V fluid also increase or expand the volume of plasma such
as congestive heart disease,steroid,...
B_ Hypoalbuminaemia :
20

21. CAUSES OF
HYPOALBUMINEMIA
Impaired synthesis :
• 1_acquired ➡ LCF ➡ liver can't
synthesise albumin
• 2_ genetics as ➡ analbuminaemia (
very rare disease. may reach 0.05
gm /dl.)
• NB : Human serum albumin is
encoded by the ALB gene.
21

22. CAUSES OF
HYPOALBUMINEMI
A
Increased loss :
3 _ in kidney as ➡ RF and nephrotic S ➡ protein
loosing in urine
Also DM, HT, and another causes of protenuria.
4_in intestine ➡ as protein loosing entropathy. ➡ loose
protein in stool.
5_ skin ➡ burn
22

23. CAUSES OF
HYPOALBUMINE
MIA
Others :
6_ Acute and chronic infections (most
common cause)
7_ Malnutrition and malabsorbtion
23

24. NB➡
If total protein is abnormal, your
healthcare practitioner may
recommend follow-up tests, such
as protein electrophoresis, albumin
and quantitative immunoglobulins.
24

25. Causes of
hyperproteinaemia
Causes of hyperproteinaemia :
‫إما‬ ‫سببين‬ ‫لها‬
:
A_ haemoconcentration as the result of dehydration
‫اتبخرت‬ ‫العينة‬ ‫ركنة‬ ‫نتيجة‬ ‫ممكن‬
‫مثل‬ ‫أشياء‬ ‫ممكن‬
Dirutics,severe vomiting, severe diarrhea,...
‫ال‬ ‫نتيجة‬ ‫كله‬ ‫المهم‬
Dehydration
B_ hyper gammaglobulinaemia :
25

26. B_ hyper
gammaglobulinaemia
B_ hyper
gammaglobulinaemia :
‫الجلوبيولب‬ ‫ارتفاع‬ ‫سببها‬
‫ودي‬ ‫ن‬
‫إما‬
:
Monoclonal
gammopathy or poly
clonal gammopathy
26

27. 27

28. 28

29. 29

30. Polyclonal
hypergammaglobulinaemia
¨ Chronic liver disease
¨ Chronic infections
¨ Inflammatory disease of bowel
¨ Autoimmune disorder
¨ Granulomas
•
‫ونلخصها‬
‫بال‬
• Chronic infection and inflammation
30

31. Causes of Monoclonal
hypergammaglobulinaemia
‫الجل‬ ‫علي‬ ‫بتعمل‬ ‫دي‬
sharp localized band as :
multiple myeloma
MGUS
waldenstrom macrogloulinaemia
Amylodosis
B cell malignancy as CLL,lymphoma,...
‫بال‬ ‫ونلخصها‬
B cell cancer
31

32. A/G ratio
A/G ratio = divide albumin by globulin
Normal range of A/G ratio ➡ 1.5 _ 2
Low A/G ratio may be caused by:
• Overproduction of globulins, such as seen in
multiple myeloma or autoimmune diseases
• Underproduction of albumin, such as may
occur with cirrhosis or loss of albumin from
the circulation, as in nephrotic syndrome.
32

33. A/G ratio
High A/G ratio may be caused by:
Underproduction of immunoglobulins
as happens in some genetic deficiencies
Leukemias
A/G ratio is normal in hemodilution and
hemoconcentration
33

34. REFERENCES :
• _ https://labtestsonline.org
• _ https://www.medscape.com
• _ https://www.wikipedia.org
• _ https ps://www.labcorp.com
• _ https://www.uptodate.com
• _ https://www.ncbi.nlm.nih.gov Home - PubMed – NCBI
• _TIETZ TEXTBOOK OF CLINICAL CHEMISTRY AND MOLECULAR DIAGNOSTICS, SIXTH EDITION 2018.
• _Essential of clinical pathology book; 1st edition; Shirish M Kawthalkar; 2010.
• _Essential of biochemistry book ;1st edition; 2012.
• _ ABC of clinical hematology ; 4th edition ; Drew Provan; 2018.
• _ Harper's illustrated biochemistry 30th edition 2015.
• _ Lippincott's illustrated review of biochemistry sixth edition 2014.
• _ Lecturea Notes Clinical Biochemistry, 9th Edition Walker, Simon, 2103.
• _Some audios and videos from Well-known, trusted professors who study from accredited books.
34

35. ‫اليوتيوب‬ ‫علي‬ ‫البحث‬ ‫أو‬ ،‫اليوتيوب‬ ‫علي‬ ‫قناتي‬ ‫دي‬
‫د‬ ‫باسم‬
.
‫سفيان‬ ‫بهجت‬ ‫محمد‬
،
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‫حتى‬ ‫بالقناة‬ ‫ا‬
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DMBMS2018
،
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ِ ‫للناس‬ ‫أنفعهم‬ ‫الناس‬ ‫خير‬
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