Beta 2 microglobulin it is a small nonglycosylated

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BETA 2 MICROGLOBULIN --- it is a small, nonglycosylated peptide found on the surface of most nucleated cells; the plasma membrane sheds it as a relatively intact molecule into the surrounding extracellular fluid; b/c this process is fairly constant in adults levels of beta 2 microglobulin remain stable in normal patients; Elevated levels in serum indicate increased cellular turnover as seen in myeloproliferative and lymphoproliferative disorders , inflammation , and renal failure ; as a small endogenous peptide it is easily filtered by the glomerulus – about 99.9% is then reabsorbed by the proximal tubules and catabolized; measurement of serum beta 2 microglobulin is clinically used to assess renal tubular function in renal transplant patients w/ elevated levels indicating organ rejection ; beta 2 microglobulin has been found in some studies to be a more efficient marker of renal transplant rejection than serum creatinine values b/c it does not depend on lean muscle mass or daily variation in excretion MYOGLOBIN --- a low molecular wt. protein associated w/ acute skeletal and cardiac muscle injury ; myoglobin functions to bind and transport oxygen from the plasma membrane to the mitochondria in muscle cells; in rhabdomyolysis myoglobin release from skeletal muscle is sufficient to overload the proximal tu bules and cause acute renal failure ; early diagnosis and aggressive trx of elevated myoglobin may prevent or lessen the severity of renal failure – myoglobin clearance has been proposed as an effective early indicator of myoglobin-induced acute renal failure; a high clearance or low
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RENAL FUNCTION OBJECTIVES clearance and low serum concentration indicates high risk ; serum and urine myoglobin can be measured easily and rapidly by immunoassays ; urine myoglobin can also be measured by dipstick methods after removing hg but this method has a lack of sensitivity and specifity CYSTATIN C --- a low molecular wt. protein produced by nucleated cells; it is freely filtered by the glomerulus, reabsorbed, and catabolized by the proximal tubule; produced at a constant rate, levels remain stable if kidney function is normal; plasma concentrations appear to be unaffected by gender, race, age, and muscle mass; studies have shown measurement of cystatin C to be al least as useful as serum creatinine and creatinine clearance in detecting early changes in kidney function ; a rise in cystatin C is often detectible before there is a measureable decreased in GFR or increase in creatinine ; cystatin C can be measured by immunoassay methods 3. Explain the following diseases and their causes: acute glomerulonephritis, chronic glomerulonephritis, nephrotic syndrome, kidney stones ACUTE GLOMERULONEPHRITIS --- pathologic lesions in acute glomerulonephritis primarily involve the glomerulus ; histologic examination shows large, inflamed glomeruli w/ a decreased capillary lumen; abnormal lab findings include rapid onset of hematuria and proteinuria (usually albumin, and generally <3g/day); the rapid development of a decreased GFR
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