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FINALS HEMA LEC > FORMS OF HGB > Flashcards

FORMS OF HGB Flashcards

1
Q

Normal Hemoglobin: Oxyhemoglobin (HbO2)
1. formed when rbcs pass through _____
2. circulates in the _____ circulation
3. ___ is loosely bound and unstable for easier release into the tissues
4. gives ____ color

A
  1. alveolar/ capillaries
  2. arterial circulation
  3. Oxygen
  4. scarlet red/ bright red color
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2
Q

Normal Hemoglobin: Deoxyhemoglobin (HHb)
1. formed when rbcs passes through ____
2. reduced form but increased ____
3. CO2 binds to free amino group of hb to form ________
4. ____ color

A
  1. Tissues
  2. CO2
  3. Carbaminohemoglobin
  4. Dark red color
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3
Q

Abnormal Hemoglobin: Carboxyhemoglobin (HbCO)
1. hemoglobin with ____
- affinity of CO to Hb is _____ greater than affinity of oxygen
2. EXOGENOUS chief sources (3)
3. CO is normally present in the body due to this ______ source: ____ is degraded into ___ & ____
- but CO is exhaled within ___ as long as we exhaled
- CO contributes ___% in the body
4. ____ color

A
  1. Carbon Monoxide
    - 200-210x
  2. automobile exhaust, industrial waste, tobacco smoking (10%)
  3. ENDOGENOUS; protoporphyrin IX; biliverdin & CO
    - 4hrs
    - <1%
  4. cherry red
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4
Q

CARBOXYHGB cont.
1. critical values: ______
- may cause irreversible tissue changes: _____ when increased
2. 50-70% HbCO: _____ or inability to breathe
- treatment: administration of _____ (increased dose of oxygen under high pressure)
- HBCO is ________
- this administration may also used to treat ______ wound
3. absorption wavelength: ____

A
  1. 5g of CO/ 100mL of blood
    - hypoxia
  2. asphyxia
    - hyperbaric oxygen
    - reversible
    - gangrenous wound
  3. 576nm
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5
Q

CARBOXYHGB cont.: Rapid Tests

NaOH (Sodium Hydroxide) Test
1. Composition
2. results:
- positive for oxyhgb
- negative for carboxyhgb

Dilution test (addition of water)
1. Composition
2. results:
- positive for oxyhgb
- negative for carboxyhgb

Tannic acid test: ___ precipitate
1. Composition
2. results:
- positive for oxyhgb
- neg

A

NaOH (Sodium Hydroxide) Test
1. 40% Sodium Hydroxide + EDTA-blood
2. results:
- black-brown
- red

Dilution test (addition of water)
1. 1mL blood + 50mL water
2. results:
- yellowish red
- cherry red-pink/ bluish-red

red precipitate
1. 1% tannic acid
2. results:
- black brown
- red

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6
Q

_____: oxidized hemoglobin

  1. aka
  2. ____ is oxidized into ___
  3. normally makes up ___ of hgb in the body daily
    - this small amount can be reduced back by red cells to normal hgb as red cells have ______
  4. increase in normal value will cause _____
    - patient will suffer from ____ coloration of skin due to depletion of ______
    - conveys ___ color in the blood
  5. approx ____ to ___ of total body hb is spontaneously converted to this daily
    - Hi is _____
A

Methemoglobin

  1. Hemiglobin
  2. Fe2+ Ferrous > Fe3+ Ferric
  3. 1.5%
    - reducing potentials
  4. Cyanosis
    - bluish; oxygen
    - chocolate brown
  5. 0.5-3%
    - reversible
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7
Q

Methemoglobin cont

  1. increased methgb in blood when amount of ferric surpasses capacity of red cell to reduce it back to ferrous
    - most common symptom
  2. methgb has no affinity to oxygen but with ___
    - when methgb combines with this it results to ______
  3. methgb can be diagnostic tool for ____
    - patient is given an ___: an oxidizing agent that converts hb into hi
  4. absorption wavelength
  5. screening tests:
    - blood retains its color
    - addition of ___: blood turns red (+ for methgbemia)
A
  1. Methemoglobinemia
    - Cyanosis
  2. cyanide
    - hemiglobincyanide
  3. cyanide poisoning
    - nitrogen dioxide
  4. 630-635
  5. screening tests:
    - Aeration
    - 1% methylene blue
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8
Q

REDUCING POTENTIALS OF RED CELL: using enzymes

  1. Production of reduced DPNH or NAD in the presence of _______
    - DPNH or NAD
  2. Production of reduced TPNH/NADP in the presence of _____
    - TPNH/NADP
  3. Main antioxidant property of red cell
    - reduced glutathione is antioxidant of red cell since it has _____ with ___
A
  1. methemoglobin reductase (diaphorase)
    - diphosphopyridine dinucleotide
  2. Glucose-6-Phosphate dehydrogenase
    - triphosphopyridine nucleotide
  3. Reduced glutathione
    - reducing property w/ NADPH
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9
Q

Production of reduced
diphosphopyridine dinucleotide (DPNH or NAD) in the presence of methemoglobin reductase (diaphorase)

  1. rxn in what pathway
  2. _____ is an oxidizing agent as it accepts e
  3. NAD is reduced to _____ that causes reduction of ferric into ferrous; so deficient of this will not make it reduce ferric to ferrous
    - this is called what system: ______ or _____
A
  1. EMBDEN-MEYERHOFF PATHWAY
  2. NAD: nicotinamide adenine dinucleotide
  3. NADH
    - NAD cytochrome B5 reductase system or NADH methemoglobin reductase system
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10
Q

Production of reduced triphosphopyridine nucleotide (TPNH/NADP) in the presence of Glucose-6-PO4 dehydrogenase

  1. Occurs in the _____
    - can produce ___ and ___
  2. ____ is an oxidant which needs to be reduced with NADPH first
  3. G6PD catalyzes the conversion of
    Glucose-6-PO4 into ______ which aids reduction of NADP into NADPH
A
  1. hexose monophosphate shunt
    - NADPH + GSH (Glutathione)
  2. NADP: nicotinamide adenine dinucleotide phosphate
  3. 6-phosphogluconate
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11
Q

Non-enzymatic maintenance of ferrous in hemoglobin:

  1. reducing agent; strengthens blood vessels
  2. accelerates the transfer of electrons
A
  1. Ascorbic acid
  2. Methylene blue
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12
Q

Conditions of methemoglobinemia

  1. form is not maintained hence there will be no source of electron donor which is importantly in reducing ferric to ferrous
    - commonly attributed to _____
  2. results of various amino acid substitutions in the globin chain that directly affects the heme group
    - 5 different structural abnormalities
  3. effects of chemical or therapeutic agents
    - therapy (2)
A
  1. Inherited enzyme deficiency
    - NADH-methemoglobin reductase deficiency/diaphorase deficiency
  2. Inherited methemoglobinemia
    - M-HydePark
    - M-Iwate
    - M-Milwaukee
    - M-Boston
    - M-Saskatoon
  3. Acquired/ Toxic methemoglobinemia
    - ascorbic acid
    - methylthioninium chloride
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13
Q

____: formed when organic sulfides combine with Hb

  1. observed in patients taking ____ (3)
  2. ____ once formed for ____ days
    - prevents it to be measured by ____
    - can combine with CO forming ____ (Sulfide + Hb + CO)
  3. can precipitate inside the cell causing ____ (precipitated unstable hgb): these are cells with prime to hemolysis
  4. not normally in blood so its critical value is ____ as it causes damage to tissues
  5. absorption wavelength
  6. color which is not enough to color the circulation
A

Sulfhemoglobin

  1. oxidant drugs (phenacetin and acetanilid, sulfonamides)
  2. Irreversible; 120 days
    - DRABKINS REAGENT
    - CARBOXYSULFHEMOGLOBIN
  3. HEINZ BODIES
  4. 0.5g / 100mL
  5. 600-620
  6. greenish
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14
Q

OTHER FORMS OF HGB

_____: most stable among hb pigments

  1. Formed when _____ is added to the ferrous of a normal Hb
  2. Absorption wavelength
A

Cyanhemoglobin

  1. ferricyanide
  2. 540 nm
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15
Q

OTHER FORMS OF HGB

_____: Described as “fast hemoglobin” because they migrate fast in electrophoresis

  1. addition or attachment of
    glucose molecule to the hemoglobin molecule
  2. types (3)
    - major fraction
  3. takes place non-enzymatically; formation is dependent on ____
  4. increase blood glucose = patient is ______ (diabetes mellitus)
  5. ___ elevated 2–3 folds in patients with DM; not diagnostic tool but rather used for monitoring patients who already have DM
A

Glycosylated Hemoglobin

  1. Glycosylation
  2. HbA1a; HbA1b; HbA1c
    - HbA1c
  3. plasma glucose level
  4. hyperglycemic
  5. HbA1c
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16
Q

Glycosylated Hemoglobin cont

  1. used as an index of ____ in diabetes during the preceding 2-4 months
    - reflects the _____ in the past 2-4 months
  2. for the diagnosis of hyperglycemia
  3. Collect patient blood in EDTA; no ____ , no _____ need
A
  1. metabolic control
    - patient glycemic control
  2. FBS (fasting blood sugar)
  3. no centrifuge, no fasting need

FINALS HEMA LEC (6 decks)

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