HGB, HCT & ESR Flashcards
1
Q
HGB normal range in CHILDREN
A
12-15 g/dL or 120 to 150 g/L
2
Q
HGB normal range in ADULT MALE
A
14-18 g/dL or 140-180 g/L
3
Q
HGB normal range in ADULT FEMALE
A
12-15 g/dL or 120-150 g/L
4
Q
AKA Respiratory pigment
A
Hemoglobin
5
Q
Maximum Hgb concentration within RBCs
A
Approximately 37 g/dL
6
Q
Identified the respiratory protein hemoglobin in 1862
A
Felix Skyler
7
Q
1 gram of hgb can carry _____ mL of O2
A
1.34 mL
8
Q
1 gram of hemoglobin can carry a constant ____ mg Iron
A
3.47 mg
9
Q
Ring or hole in center where ferrous iron is inserted
A
Protoporphoryin IX
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
11
Q
These 2 constituents of hgb combine to form the 4 heme molecules
A
Iron in ferrous form and protoporphyrin IX
12
Q
It is sometime a resident in the center of the hemoglobin unit
A
2,3-BPG
13
Q
Number of amino acids in Alpha and Zeta globin chains
A
141
14
Q
Number of amino acids in Beta, Delta, Gamma A, Gamma G, Epsilon globin chains
A
146
15
Q
Position 136 : alanine
A
Gamma A
16
Q
Position 136 : glycine
A
Gamma G
17
Q
HGB PROTEIN STRUCTURE : Describes the amino acid sequence of the polypeptide chains
A
PRIMARY
18
Q
HGB PROTEIN STRUCTURE : describes the chain arrangements in helices and non helices
A
Secondary
19
Q
HGB PROTEIN STRUCTURE : describes the arrangement of the helices into a pretzel like configuration or formation
A
Tertiary
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)
21
Q
Reference method for hemoglobin determination
A
Cyanmethemoglobin (HiCN) method
22
Q
Reagent used in cyanmethemoglobin method
A
Drabkin’s reagent
23
Q
Major components of Drabkin’s reagent
A
Potassium ferricyanide (K3Fe(CN)6)
Potassium cyanide (KCN)
24
Q
Cyanmethemoglobin is measured at what wavelength
A
540 nm
25
All types of hemoglobin may be measured through 540 nm except
Sulfhemoglobin
26
Full conversion of hemoglobin to cyanmethemoglobin
10 mins at room temp
27
High wbc count
High plt ct
Lipemia
Cells with Hb S and C
Abnormal globulins
These are sources of error that causes falsely _____ hgb
Elevated
28
Centrifuge reagent sample solution then the Supernatant is mesured ; this is a correction for what source of error in Hgb determination
High WBC count and Plt count
29
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
Lipemia
30
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
Cells containing HB S and C
31
ADD 0.1 gram of potassium carbonate to the Cyanmethemoglobin reagent ; this is a correction for what source of error in Hgb determination
Abnormal globulin
32
Cyanmethemoglobin is sensitive to
Light
33
An example of a commercially available handheld system to measure the hgb concentration
Hemocue
34
Movement of charged particles in an electric field
Electrophoresis
35
Considered as the primary screening procedure to detect variant hemoglobins
Cellulose acetate
36
Cellulose acetate buffer pH
8.4-8.6
37
Hgb are negatively charged molecule therefore it travels towards the _____
Anode
38
Fastest and normal hemoglobin in electrophoresis
Hemoglobin A1 / A
39
Fast hemoglobins
Bart Hb
Hb H
Hb 1
40
Slowest hemoglobin
Hb C
Hb A2
Hb E
Hb C Harlem
HB Oarab
41
Slowest hemoglobin
Hb C
Hb A2
Hb E
Hb C Harlem
HB Oarab
42
Complementary procedure to cellulose acetate Hb electrophoresis
Citrate Agar
43
Used to confirm variant hemoglobins and further differentiates Hb S form D and G and Hb C from Hb E, O Arab, C Harlem
CITRATE AGAR
44
pH of citrate agar
6.0 to 6.2
45
Ferroprotoporphyrin IX is also known as
Heme
46
Site of heme synthesis
Mitochondria
47
occurs in all metabolically active cells containing mitochondria
Heme biosynthesis
48
Heme synthesis is prominent in ____ and ____
Bone marrow and liver
49
Major heme forming tissue , generating 85% of the daily heme requirement
Erythroid marrow
50
Aka heme synthetase
Ferrochelatase
51
Enzyme needed to insert the ferrous iron to the protoporphyrin IX ring
Ferrochelatase
52
Site of globin synthesis
Ribosome in the normoblast cytoplasm
53
Chromosome that dictates the production of Alpha and Zeta globin chains
Chromosome 16
54
Chromosome that dictates the production of Beta, Epsilon, Delta, and Gamma globin chains
Chromosome 11
55
Embryonic hemoglobin
Portland
Gower I
Gower II
56
Molecular structure of Portland Hb
2 zeta, 2 gamma
57
Molecular structure of Gower I Hb
2 zeta, 2 epsilon
58
Molecular structure of Gower II
2 alpha, 2 epsilon
59
Molecular structure of Hb F
2 alpha, 2 gamma
60
Molecular structure of A1
2 alpha, 2 beta
61
Molecular structure of Hb A2
2 alpha, 2 delta
62
Proportion of Hb A1 in newborns
20%
63
Adult forms of Hb
Hb F
Hb A1
Hb A2
64
Proportion of Hb A1in adults
97%
65
Predominant form of adult Hb
Hb A1
66
Conformation of Hb in the oxygenated state is
R state or relaxed
67
Conformation of Hb in the deoxygenated state is
T state or “tense”
68
Hemoglobin bound to carbon monoxide
Carboxyhemoglobin
69
Has 240 times greater affinity to Hb than O2
Carboxyhemoglobin
70
Color of blood and skin in HbCo poisoning
Cherry red
71
Aka ferrihemoglobin , hemoglobin
Methemoglobin
72
Hb with ferric ion ; not bound to O2
METHEMOGLOBIN
73
Color of blood in methemoglobin
Chocolate brown
74
Mixture of oxidized partially denatured forms of Hb
Sulfhemoglobin
75
Color of blood in Sulfhemoglobin
Mauve - lavender color
76
Cause of Sulfhemoglobin formation
Increased constipation
Enterogenous cyanosi
Bacteremia (C. Perfringens)
77
Sulfhemoglobin forms when hydrogen sulfide is added to Hb
In vitro
78
Sulfhemoglobin forms in the occasional patient as a result of Hb oxidation by certain drugs and chemical
In vivo
79
Hematocrit normal range : ADULT MALE
40 to 50% or 0.40 to 0.54 L/L
80
Hematocrit normal range : ADULT FEMALES
35 to 49% or 0.35 to 0.49%
81
Hematocrit normal range : NEWBORN
53 to 65% or 0.53 to 0.65 L/L
82
Pertains to the instrument used to determine packed cell volume
Hematocrit
83
Micro hematocrit tube length
Approx 75 mm long
84
Microhematocrit tube inner bore size
1.2 mm
85
Volume of microhematocrit tube
0.05 mL of blood
86
Plug for microhematocrit tube
4-6 mm
87
Microhematocrit that has an antigcoagulant - heparin
Red band
88
Microhematocrit tube with no anticoagulant
Blue band
89
Microhematocrit tubes must be centrifuged for
5 mins t 10,000 RPM
90
Trapped plasma causes hematocrit to be ______ than the value derived from the automated instruments
1% t o3% (0.01 to 0.03) higher
91
More trapped plasma in the following conditions :
Sickle cell anemia
Hypochromic anemia
Spherocytosis
Macrocytosis
Thalassemia
92
Causes of falsely increased HCT
Dehydration
Hemoconcentration
Insufficient centrifugation
Buffy coat inclusion in reading
93
Causes of falsely decreased HCT
Hemolysis
Improper sealing
High anticoagulant concentration
Introduction of excess interstitial fluid
94
Used for checking validity of test result ; works only on normocytic, normochromic specimens
Rule of three
95
MCV normal range
80-100 fL
96
MCV formula
HCT / rbc ct x 10
97
MCH normal range
26-32 picograms
98
MCH formula
Hb / rbc ct x 10
99
Mean cell hemoglobin concentration Normal range
31 to 37 g/dL or %
100
Defined as Increased hematocrit level above normal
Polycythemia
101
Kind of polycythemia with elevated total red cell mass
Absolute polycythemia
102
Kind of polycythemia with normal total red cell mass , but hematocrit is increased because plasma volume is decreased
Relative polycythemia
103
It is a panmyelosis (a case in which excessive proliferation occurs in RBCs, megakaryocytes and granulocytes
PV
104
Mutation in patient with PV
JAK2 V617F
105
Treatment for polycythemia Vera
Therapeutic phlebotomy
106
Rate of fall of RBCs settling to the bottom of the tube
ESR
107
Monitors the course of inflammation (e.g. rheumatoid arthritis )
ESR
108
Indicated in establishing the diagnosis and in monitoring polymyalgia rheumatica and temporal arthritis
ESR
109
ESR has a low specificity and sensitivity (T or F)
TRUE
110
Anticoagulant of westergren
3.8% sodium citrate
111
Most commonly used method for ESR determination
Modified westergren
112
Recommended by the ICSH and CLSI
Modified westergren
113
ICSH stands for
International Council for Standardization in Hematology
114
CLSI stands for
Clinical and Laboratory Standards Institute
115
3.8% sodium citrate serves as ____ in modified westergren
Diluents
116
Modified Westergren Diluents
0.85% NaCl or 3.8% sodium citrate
117
Modified Westergren Diluents
0.85% NaCl or 3.8% sodium citrate
118
Modified westergren anticoagulant
EDTAA
119
WINTROBE anticoagulant
Double oxalate or EDTA
120
Left sided (red) —> 0 (top) and 10 cm (bottom)
For ESR
121
Right side (white) —> 10 cm (top) and 0 (bottom)
For Macrohematocrit
122
ESR Normal range in ADULT MALES (MOD WESTERGREN)
0-10 mm/hour
123
ESR Normal range in ADULT FEMALES (MOD WESTERGREN)
0-15 mm/hour
124
ESR Normal range in ADULT MALES (WINTROBE)
0 to 9 mm/hour
125
ESR Normal range in ADULT FEMALES (WINTROBE)
0-20 mm/hour
126
Tilted ESR tube effect on ESR
Increased
127
Vibration effect on ESR
INCREASED
128
High temp effect on ESR
INCREASED
129
Clotted sample effect on ESR
DECREASED
130
BUBBLES EFFECT ON ESR
Decreseaed
131
Refrigerated sample not returned to room temp effect on ESR
INCREASED
132
Hyperfibriginemia effect on ESR
INCREASED
133
Anemia effect on ESR
INCREASED
134
Multiple myeloma effect on ESR
Increased
135
Macrocytosis effect on ESR
INCREASED
136
Diabetis mellitus effect on ESR
INCREASED
137
Marked leukocytosis effect on ESR
Low
138
Marked Anisocytosis effect on ESR
Low
139
Poikilocytosis, spherocytosis, and thalassemia effect on ESR
LOW
140
Increases phospholipid (lecithin) effect on ESR
LOW
141
Congestive heart failure effect on ESR
LOW
142
Low temp effect on ESR
LOW
