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EXERSISE
Please try to read these representative nine samples. Never try to make the "name of the disease", but to catch the characteristic feature of each tracing.
Find the order of the height of globulin fractions in each sample, and consider which globulin(s) are increased, or decreased. Then, make out the undelying clinical condition hidden behind the each figure.
The mean best score of primers, including some groups of medical students and physicians, were 2 poits or less. However;
I believe that this exercise is not so difficult.
When your score was 5 points or over, your ability must be excellent !
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Only when you got a sufficient consideration, please click the number shown under the sample figures.
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1.
The gamma globulin peak is higher tahan that of beta globulin. The
order of the height of the globulin peak can be described as 4 3 2 1.
Many chronic diseases withoout inflammation, e.g. sarcoidosis, collagen diseases, are included in this type.
(This patient: chronic hepatitis. The name of disease can't be made only by the figure. )
2.
The gamma globulin peak is higher tahan that of beta globulin. The order of the height of the globulin peak can be shown as 4 3 2 1.
There is a fast gamma M-component on the decreased usual gamma globulin fraction.
(This patient: D-myeloma. A diagnosis of monoclonal gammopathy should be made, but the class of the M-componentcan't be decided only by the figure.
3.
A very decreased and flat gamma globulin fraction is characteristic. The alpha-2 globulin peak is higher than that of beta globulin. This indicates the complication of any inflammatory process. The order of the height of the globulin peak can be described as 3 1 2 4.
(This patient: common variable hypogammaglobulinemia complicated by any inflammatory process. The name of disease can't be made only by the figure.
4.
A sharp alpha-2 globulin peak is characteristic. The gamma globulin fraction is probably decreased.
The order of the height of the globulin peak can be described as 3 1 2 4.
(This patient: nephrosis. The diagnosis of nephrosis must be made only by this figure. )
5.
The gamma globulin peak and the alpha-1 and 2 globulin peaks are
higher tahan that of beta globulin. The order of the height of the globulin
peak can be described as 3 2 4 1. The reversed position in the height of alpha-1
vs beta globulin indicates the presence of severe inflammatory
process.
Many chronic infectious and non-infectious inflammations are included in this type of figure.
(This patient: fuberculous pyothorax. The name of disease can't be made only by the figure. )
6.
The gamma globulin peak is higher tahan that of beta globulin. The low beta and flat alpha-2 globulin peaks are also seen. The "valley" made between beta and gamma globulin fraction is shallow. The characteristic figure of beta-gamma complex is called as "beta-gamma linking" or "beta-gamma bridging".
The order of the height of the globulin peak can be described as 3 4 2 1 or 2 4 3 1.
(This patient: liver cirrhosis. The diagnosis should be made only by the figure. )
7.
The alpha-2 globulin peak is higher than that of beta globulin. The
order of the height of the globulin peak can be shown as 4 1 2 3.
Many acute inflammations, especially acute infectious diseases belong to this type.
(This patient: acute pyelonephritis. The name of disease can't be made only by the figure. )
8.
The decreased alpha-2 globulin fraction is characteristic. The alpha-1
globulin fraction is probably increased. The order of the height of the globulin peak can be described as 1 4 2 3.
This pattern characteristic of intravascular hemolysis with inflammation is frequently found not only in many types of hematological disorders but also in many types and various stages of malignancies.
(This patient: acute myelogenous leukemia The name of disease can't be made only by the figure. )
9.
The gamma globulin fraction is markedly increased without alpha-2 globulin elevation.
The order of the height of the globulin peak can be described as 4 3 2 1.
The extraordinal increase in gamma globulin fraction is characteristically found in autoimmune diseases.
(This patient: systemic lupus erythematosus (SLE). The name of disease can't be made only by the figure. )
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