Hemoglobin.2

Question 1

CLINICAL SIGNIFICANCE

Increased Hgb
1. hgb increases in blood cells due to abnormal increase of blood production
2. burns and diarrhea has has massive loose bowel, which contains more water and also plasma water; what is the response of the body
- loose of plasma water will result to cell conc and will lead to _______

Decreased Hgb
1. group of condition, and all are characterized in decreased hemoglobin; hgb test is its screening test
2. defective bone marrow
- excessive production of ______ and the normal cell production of RBCs will decrease

Answer 1

Increased Hgb
1. Polycythemia Vera
2. Dehydration
- Hemoconcentration

Decreased Hgb
1. Anemia
2. Leukemia
- leukemic cells

Question 2

More on Clin Sig

1. slightly _____ after 50 years of age due to decrease on ____ fxn; hypoxia
2. hemoglobin is ____ if lying down
   - interstitial fluid will shift inside the circulation resulting now in ______
3. ____ in morning & ____ in evening
   - due to _______
4. increased in ____ smokers due to higher value of abnormal hgb ______
   - __% of hgb of smokers is this hgb
5. ____ among males
6. ____ in high altitudes due to _____

Answer 2

1. decreases; bm fxn
2. lower
   - hemodilution
3. Higher in the morning and lower in the evening
   - Circadian effect,
4. chronic smokers; carboxyhemoglobin
   - 10%
5. Increased
6. Increased; hypoxia

Question 3

QUANTITATION OF FETAL HEMOGLOBIN (HbF)

adults have
A1 =
A2 =
F =

Answer 3

adults have
A1 = 97%
A2 = <3.5%
F = <1.2%

Question 4

QUANTITATION OF FETAL HEMOGLOBIN (HbF): Alkali denaturation

1. two methods
2. purpose of this method is to determine the ______
3. positive control: drop of blood from _______
4. procedure:
   - hemolyse the blood so its product is ______
   - RBC hemolysate + drabkins will alkalinize with _____ (denatures HbA 1&2)
   - denatured hba is precipitated by ______
   - reporting
5. CLIN SIG: elevated hgb (about 40-60%)

Answer 4

1. BETKE & SINGER METHOD
2. PERCENTAGE OF HGBF
3. fetal umbilical blood
4. procedure:
   - RBC hemolysate
   - SODIUM HYDROXIDE
   - AMMONIUM SULFATE
   - __% HbF
5. Hereditary Persistence
   of Fetal Hemoglobin

Question 5

REFERENCE VALUE:

1. Mod by BETKE:
2. National Committee for Clinical Laboratory
   Standards (NCCLS): HbF quantitation
3. Radial immunoassay (most preferred)
4. Column Chromatography
5. most acceptable method as it measure regardless of expected conc but not a routine test in clinical laboratory

Answer 5

1. 0.2% - 1.0%
2. 2-40%
3. <2%
4. > 40%
5. High Performance Liquid Chromatography

Question 6

QUANTITATION OF FETAL HEMOGLOBIN (HbF): Acid Elution Method

1. Modification of _______
2. purpose of this method is to assess the ______
3. Useful in diagnosis of
4. procedure:
   - ____ add this acid at pH ____ (so hba is removed)
   - stain with _____
   - counter stain with ______ (standard test for quantitating fetomaternal hemorrhage)
5. maternal red cells appear as _____
6. fetal red cells appear as ___
7. In adults: almost all red cells appear _____ cells
8. clinical significance:
   - even distribution of hbf among red cells/ homogenous
   - heterogenous distribution of the HbF among cells.

Answer 6

1. Kleihauer-Betke by Shepard
2. distribution of HbF in all red cell is the same
3. Hemolytic Disease of Fetus & the New born
4. procedure:
   - citric acid at 3.3
   - Ehrlich acid Hematoxylin
   - Erytrosin
5. ghost cells
6. rose pink cells
7. ghost cells
8. clinical significance:
   - Hereditary Persistence of Fetal Hemoglobin
   - Thalassemia & Hemoglobinopathy

Question 7

Summary:

w/ alkaline distribution: ____
w/ acid elution:

Answer 7

increased hbf
iba iba distribution ng HbF

Question 8

HEMOGLOBIN ELECTROPHORESIS

____: method of separating substances or molecules on the basis of their net charge (BASIC/ALKALINE)

1. pH
2. proteins are bipolar, it means they have both cathode and anode electron “_____”
3. if the protein is placed in a medium (_____), it will have altered electrical charge (net negative charge)
4. HgbC travels with (3)
5. HgbS travels with (2)
6. slowest to fastest

Answer 8

CELLULOSE ACETATE ELECTROPHORESIS

1. 8.4-8.6
2. AMPOTHERIC
3. cellulose acetate
4. A2, E, O
5. D,G, L
6. C > S > F > A

Question 9

HEMOGLOBIN ELECTROPHORESIS

____: method of separating substances or molecules on the basis of their net charge (ACIDIC)

1. pH
2. interaction of ___ and ___
3. their charge is ____ unlike with cellulose acetate that are all negative
4. Cathode > Anode
5. Anode > Cathode

Answer 9

CITRATE AGAR ELECTROPHORESIS

1. 6.0-6.2
2. agar and citrate buffer ions
3. Altered
4. Cathode: F > A; Anode: S > C
5. Anode: C > S; Cathode: A > F

Question 10

CHARACTERISTIC OF HbF

1. ____ on electrophoresis than HbA
2. Has high affinity with
3. Has a decreased affinity with _____ or ______ which is molecule that affects affinity of hgb to oxygen
4. T/F: quantification of hbf is not a routine procedure

Answer 10

1. Slower
2. Oxygen
3. 2,3 DPG/ Diphosphoglycerate
4. TRUE

Question 11

hgb reference values:
1. Male:
2. Female:
3. At birth:

Answer 11

1. Male: 140-175 g/dL
2. Female: 123-153 g/dL
3. At birth: 150-200 g/dL

Question 12

hgb reference values:
1. Male:
2. Female:
3. At birth:

Answer 12

1. Male: 140-175 g/dL
2. Female: 123-153 g/dL
3. At birth: 150-200 g/dL