Clinical biochemistry: protein electrophoresis: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Biochemistry · Clinical biochemistry: protein electrophoresis

Sample item

A child with nephrotic syndrome has serum protein electrophoresis performed. Which pattern is expected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Low albumin with a prominent alpha-2 band

Albumin and small proteins are lost in urine, while alpha-2 macroglobulin is too large to pass and its synthesis rises, so the alpha-2 band looks prominent. Gamma globulins are often reduced. A monoclonal spike suggests myeloma.

Option by option

  • A. Low albumin with a monoclonal gamma spike

    A monoclonal gamma spike suggests plasma cell neoplasia.

  • B. Low albumin with a prominent alpha-2 band (correct)

    Correct. Low albumin with prominent alpha-2 fits nephrotic syndrome.

  • C. Absent alpha-1 band with normal albumin

    An absent alpha-1 band suggests alpha-1 antitrypsin deficiency.

  • D. Normal albumin with a polyclonal gamma rise

    A polyclonal gamma rise is seen in chronic liver disease or inflammation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is B, Low albumin with a prominent alpha-2 band. Albumin and small proteins are lost in urine, while alpha-2 macroglobulin is too large to pass and its synthesis rises, so the alpha-2 band looks prominent.

Why is "Low albumin with a monoclonal gamma spike" not the answer?

A monoclonal gamma spike suggests plasma cell neoplasia.

Why is "Absent alpha-1 band with normal albumin" not the answer?

An absent alpha-1 band suggests alpha-1 antitrypsin deficiency.

Why is "Normal albumin with a polyclonal gamma rise" not the answer?

A polyclonal gamma rise is seen in chronic liver disease or inflammation.

What concept does this question test?

It tests Clinical biochemistry: protein electrophoresis in Biochemistry. Gamma globulins are often reduced. A monoclonal spike suggests myeloma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clinical biochemistry: protein electrophoresis?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.