HGB, HCT & ESR Flashcards

1
Q

HGB normal range in CHILDREN

A

12-15 g/dL or 120 to 150 g/L

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2
Q

HGB normal range in ADULT MALE

A

14-18 g/dL or 140-180 g/L

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3
Q

HGB normal range in ADULT FEMALE

A

12-15 g/dL or 120-150 g/L

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4
Q

AKA Respiratory pigment

A

Hemoglobin

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5
Q

Hgb concentration within RBCs

A

Approximately 34 g/dL

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6
Q

Identified the respiratory protein hemoglobin in 1862

A

Felix Skyler

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7
Q

1 gram of hgb can carry _____ mL of O2

A

1.34 mL

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8
Q

1 gram of hemoglobin can carry a constant ____ mg Iron

A

3.47 mg

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9
Q

Ring or hole in center where ferrous iron is inserted

A

Protoporphoryin IX

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10
Q

4 CONSTITUENTS OF HGB

A

Globin
4 molecules of nitrogenous protoporphyrin IX
4 iron atoms in ferrous state
1 2,3-BPG molecule

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11
Q

These 2 constituents of hgb combine to form the 4 heme molecules

A

Iron in ferrous form and protoporphyrin IX

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12
Q

It is sometime a resident in the center of the hemoglobin unit

A

2,3-BPG

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13
Q

Number of amino acids in Alpha and Zeta globin chains

A

141

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14
Q

Number of amino acids in Beta, Delta, Gamma A, Gamma G, Epsilon globin chains

A

146

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15
Q

Position 136 : alanine

A

Gamma A

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16
Q

Position 136 : glycine

A

Gamma G

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17
Q

HGB PROTEIN STRUCTURE : Describes the amino acid sequence of the polypeptide chains

A

PRIMARY

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18
Q

HGB PROTEIN STRUCTURE : describes the chain arrangements in helices and non helices

A

Secondary

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19
Q

HGB PROTEIN STRUCTURE : describes the arrangement of the helices into a pretzel like configuration or formation

A

Tertiary

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20
Q

HGB PROTEIN STRUCTURE : describes the complete hemoglobin molecule is spherical , has four heme group attached to 4 polypeptide chains, may carry up to 4 molecules of oxygen

A

Quaternary (tetramer)

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21
Q

Reference method for hemoglobin determination

A

Cyanmethemoglobin (HiCN) method

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22
Q

Reagent used in cyanmethemoglobin method

A

Drabkin’s reagent

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23
Q

Major components of Drabkin’s reagent

A

Potassium ferricyanide (K3Fe(CN)6)
Potassium cyanide (KCN)

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24
Q

Cyanmethemoglobin is measured at what wavelength

A

540 nm

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25
Q

All types of hemoglobin may be measured through 540 nm except

A

Sulfhemoglobin

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26
Q

Full conversion of hemoglobin to cyanmethemoglobin

A

10 mins at room temp

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27
Q

High wbc count
High plt ct
Life is
Cells with Hb S and C
Abnormal globulins

These are sources of error that causes falsely _____ hgb

A

Elevated

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28
Q

Centrifuge reagent sample solution then the Supernatant is mesured ; this is a correction for what source of error in Hgb determination

A

High WBC count and Plt count

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29
Q

Add 0.1 ml of the ptx plasma to 5 mL of the Cyanmethemoglobin reagent using this solution as the reagent blank ; this is a correction for what source of error in Hgb determination

A

Lips is

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30
Q

Make a 1;2 dilution with distilled water and multiplying the results from the standard curved by 2 ; this is a correction for what source of error in Hgb determination

A

Cells containing HB S and C

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31
Q

ADD 0.1 gram of potassium carbonate to the Cyanmethemoglobin reagent ; this is a correction for what source of error in Hgb determination

A

Abnormal globulin

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32
Q

Cyanmethemoglobin is sensitive to

A

Light

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33
Q

An example of a commercially available handheld system to measure the hgb concentration

A

Hemocue

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34
Q

Movement of charged particles in an electric field

A

Electrophoresis

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35
Q

Considered as the primary screening procedure to detect variant hemoglobins

A

Cellulose acetate

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36
Q

Cellulose acetate buffer pH

A

8.4-8.6

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37
Q

Hgb are negatively charged molecule therefore it travels towards the _____

A

Anode

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38
Q

Fastest and normal hemoglobin in electrophoresis

A

Hemoglobin A1 / A

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39
Q

Fast hemoglobins

A

Bart Hb
Hb H
Hb 1

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40
Q

Slowest hemoglobin

A

Hb C
Hb A2
Hb E
Hb C Harlem
HB Oarab

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41
Q

Slowest hemoglobin

A

Hb C
Hb A2
Hb E
Hb C Harlem
HB Oarab

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42
Q

Complementary procedure to cellulose acetate Hb electrophoresis

A

Citrate Agar

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43
Q

Used to confirm variant hemoglobins and further differentiates Hb S form D and G and Hb C from Hb E, O Arab, C Harlem

A

CITRATE AGAR

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44
Q

pH of citrate agar

A

6.0 to 6.2

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45
Q

Ferroprotoporphyrin IX is also known as

A

Heme

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46
Q

Site of heme synthesis

A

Mitochondria

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47
Q

occurs in all metabolically active cells containing mitochondria

A

Heme biosynthesis

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48
Q

Heme synthesis is prominent in ____ and ____

A

Bone marrow and liver

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49
Q

Major heme forming tissue , generating 85% of the daily heme requirement

A

Erythroid marrow

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50
Q

Aka heme synthetase

A

Ferrochelatase

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51
Q

Enzyme needed to insert the ferrous iron to the protoporphyrin IX ring

A

Ferrochelatase

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52
Q

Site of globin synthesis

A

Ribosome in the normoblast cytoplasm

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53
Q

Chromosome that dictates the production of Alpha and Zeta globin chains

A

Chromosome 16

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54
Q

Chromosome that dictates the production of Beta, Epsilon, Delta, and Gamma globin chains

A

Chromosome 11

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55
Q

Embryonic hemoglobin

A

Portland
Gower I
Gower II

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56
Q

Molecular structure of Portland Hb

A

2 zeta, 2 gamma

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57
Q

Molecular structure of Gower I Hb

A

2 zeta, 2 epsilon

58
Q

Molecular structure of Gower II

A

2 alpha, 2 epsilon

59
Q

Molecular structure of Hb F

A

2 alpha, 2 gamma

60
Q

Molecular structure of A1

A

2 alpha, 2 beta

61
Q

Molecular structure of Hb A2

A

2 alpha, 2 delta

62
Q

Proportion of Hb A1 in newborns

A

20%

63
Q

Adult forms of Hb

A

Hb F
Hb A1
Hb A2

64
Q

Proportion of Hb A1in adults

A

97%

65
Q

Predominant form of adult Hb

A

Hb A1

66
Q

Confirmation of Hb in the oxygenated state is

A

R state or relaxed

67
Q

Confirmation of Hb in the deoxygenated state is

A

T state or “tense”

68
Q

Hemoglobin bound to carbon monoxide

A

Carboxyhemoglobin

69
Q

Has 240 times greater affinity to Hb than O2

A

Carboxyhemoglobin

70
Q

Color of blood and skin in HbCo poisoning

A

Cherry red

71
Q

Aka ferrihemoglobin , hemoglobin

A

Methemoglobin

72
Q

Hb with ferric ion ; not bound to O2

A

METHEMOGLOBIN

73
Q

Color of blood in methemoglobin

A

Chocolate brown

74
Q

Mixture of oxidized partially denatured forms of Hb

A

Sulfhemoglobin

75
Q

Color of blood in Sulfhemoglobin

A

Mauve - lavender color

76
Q

Cause of Sulfhemoglobin formation

A

Increased constipation
Enterogenous cyanosi
Bacteremia (C. Perfringens)

77
Q

Sulfhemoglobin forms when hydrogen sulfide is added to Hb

A

In vitro

78
Q

Sulfhemoglobin forms in the occasional patient as a result of Hb oxidation by certain drugs and chemical

A

In vivo

79
Q

Hematocrit normal range : ADULT MALE

A

40 to 50% or 0.40 to 0.54 L/L

80
Q

Hematocrit normal range : ADULT FEMALES

A

35 to 49% or 0.35 to 0.49%

81
Q

Hematocrit normal range : NEWBORN

A

53 to 65% or 0.53 to 0.65 L/L

82
Q

Pertains to the instrument used to determine packed cell volume

A

Hematocrit

83
Q

Micro hematocrit tube length

A

Approx 75 mm long

84
Q

Microhematocrit tube inner bore size

A

1.2 mm

85
Q

Volume of microhematocrit tube

A

0.05 mL of blood

86
Q

Plug for microhematocrit tube

A

4-6 mm

87
Q

Microhematocrit that has an antigcoagulant - heparin

A

Red band

88
Q

Microhematocrit tube with no anticoagulant

A

Blue band

89
Q

Microhematocrit tubes must be centrifuged for

A

5 mins t 10,000 RPM

90
Q

Trapped plasma causes hematocrit to be ______ than the value derived from the automated instruments

A

1% t o3% (0.01 to 0.03) higher

91
Q

More trapped plasma in the following conditions :

A

Sickle cell anemia
Hypochromic anemia
Spherocytosis
Macrocytosis
Thalassemia

92
Q

Causes of falsely increased HCT

A

Dehydration
Hemoconcentration
Insufficient centrifugation
Buffy coat inclusion in reading

93
Q

Causes of falsely decreased HCT

A

Hemolysis
Improper sealing
High anticoagulant concentration
Introduction of excess interstitial fluid

94
Q

Used for checking validity of test result ; works only on normocytic, normochromic specimens

A

Rule of three

95
Q

MCV normal range

A

80-100 fL

96
Q

MCV formula

A

HCT / rbc ct x 10

97
Q

MCH normal range

A

26-32 picograms

98
Q

MCH formula

A

Hb / rbc ct x 10

99
Q

Mean cell hemoglobin concentration Normal range

A

31 to 37 g/dL or %

100
Q

Defined as Increased hematocrit level above normal

A

Polycythemia

101
Q

Kind of polycythemia with elevated total red cell mass

A

Absolute polycythemia

102
Q

Kind of polycythemia with normal total red cell mass , but hematocrit is increased because plasma volume is decreased

A

Relative polycythemia

103
Q

It is a panmyelosis (a case in which excessive proliferation occurs in RBCs, megakaryocytes and granulocytes

A

PV

104
Q

Mutation in patient with PV

A

JAK2 V617F

105
Q

Treatment for polycythemia Vera

A

Therapeutic phlebotomy

106
Q

Rate of fall of RBCs settling to the bottom of the tube

A

ESR

107
Q

Monitors the course of inflammation (e.g. rheumatoid arthritis )

A

ESR

108
Q

Indicated in establishing the diagnosis and in monitoring polymyalgia rheumatica and temporal arthritis

A

ESR

109
Q

ESR has a low specificity and sensitivity (T or F)

A

TRUE

110
Q

Anticoagulant of westergren

A

3.8% sodium citrate

111
Q

Most commonly used method for ESR determination

A

Modified westergren

112
Q

Recommended by the ICSH and CLSI

A

Modified westergren

113
Q

ICSH stands for

A

International Council for Standardization in Hematology

114
Q

CLSI stands for

A

Clinical and Laboratory Standards Institute

115
Q

3.8% sodium citrate serves as ____ in modified westergren

A

Diluents

116
Q

Modified Westergren Diluents

A

0.85% NaCl or 3.8% sodium citrate

117
Q

Modified Westergren Diluents

A

0.85% NaCl or 3.8% sodium citrate

118
Q

Modified westergren anticoagulant

A

EDTAA

119
Q

WINTROBE anticoagulant

A

Double oxalate or EDTA

120
Q

Left sided (red) —> 0 (top) and 10 cm (bottom)

A

For ESR

121
Q

Right side (white) —> 10 cm (top) and 0 (bottom)

A

For Macrohematocrit

122
Q

ESR Normal range in ADULT MALES (MOD WESTERGREN)

A

0-10 mm/hour

123
Q

ESR Normal range in ADULT FEMALES (MOD WESTERGREN)

A

0-15 mm/hour

124
Q

ESR Normal range in ADULT MALES (WINTROBE)

A

0 to 9 mm/hour

125
Q

ESR Normal range in ADULT FEMALES (WINTROBE)

A

0-20 mm/hour

126
Q

Tilted ESR tube effect on ESR

A

Increased

127
Q

Vibration effect on ESR

A

INCREASED

128
Q

High temp effect on ESR

A

INCREASED

129
Q

Clotted sample effect on ESR

A

DECREASED

130
Q

BUBBLES EFFECT ON ESR

A

Decreseaed

131
Q

Refrigerated sample not returned to room temp effect on ESR

A

INCREASED

132
Q

Hyperfibriginemia effect on ESR

A

INCREASED

133
Q

Anemia effect on ESR

A

INCREASED

134
Q

Multiple myeloma effect on ESR

A

Increased

135
Q

Macrocytosis effect on ESR

A

INCREASED

136
Q

Diabetis mellitus effect on ESR

A

INCREASED

137
Q

Marked leukocytosis effect on ESR

A

Low

138
Q

Marked Anisocytosis effect on ESR

A

Low

139
Q

Poikilocytosis, spherocytosis, and thalassemia effect on ESR

A

LOW

140
Q

Increases phospholipid (lecithin) effect on ESR

A

LOW

141
Q

Congestive heart failure effect on ESR

A

LOW

142
Q

Low temp effect on ESR

A

LOW