Lecture 6 Chapter 7 Flashcards
What percent of urobilinogen get reabsorbed into blood
10-20%
What is albumin?
A carrier molecule
What happens when bilirubin is delivered to plasma and binds to albumin
Albumin carries hydrophobic molecule in blood until it gets to the liver
What happens once bilirubin reaches the liver
In the liver, the cells are hepatisized and separate bilirubin from albumin. Then they process bilirubin by adding 2 glucuronic acids
How does glucuronic acid help bilirubin
It makes it hydrophilic, now water soluble, and gives it charge. It is then added to bile
What happens once bilirubin reaches the bile?
Bile goes to the duodenum and bacteria starts breaking down bilirubin converting it to urobilinogen
What happens once bilirubin becomes urobilinogen
Travels down the intestinal tract. Some gets broken down to stercobilin, some gets reabsorbed into blood, and the rest travels to hepatic portal vein to liver
What happens after urobilinogen reaches the liver
Liver removes some urobilinogen and what’s left goes to the kidneys and gets filtered
What is stercobilin responsible for
Color of feces
What is urobilin responsible for
Pigment/color of urine
What does the prefix heme- mean
Iron
What does the suffix -globin mean
Protein
What is hemoglobin composed of
Iron
Protoporphyn IX
Protein
What is protoporphyrin
Heme that carries a central ferrous ion (Fe^2+)
What makes up a primary protein structure
A sequence of a chain of amino acids
What makes up a secondary protein structure and name those structures
Occurs when the sequence of amino acids are linked by hydrogen bonds
Alpha helix
Beta sheets
What makes up a tertiary protein structure
Occurs when certain attractions are present between alpha helices and beta sheets
What makes up a quaternary protein structure
It is a protein consisting of more than one amino acid chain
How can the biosynthesis of hemoglobin change
Can change based on the body’s needs
What are the 3 types of normal hemoglobin
Hgb A
Hgb A2
Hgb F
What makes up Hgb A
2 alpha
2 beta
What makes up Hgb A2
2 alpha
2 delta
What makes up Hgb F
2 alpha
2 gamma
(Only about 1-2% fetal)
When a child is born what is their primary Hgb
Fetal Hgb (Hgb F)
Name the 4 intrauterine Hgbs
Gower - 1
Gower - 2
Portland
Hgb F
What makes up Portland Hgb and when is it present
2 Xi
2 gamma
1st 8 weeks of intrauterine life
What makes up Gower 1 Hgb
2 Xi
2 epsilon
What makes up Gower 2 Hgb
2 alpha
2 epsilon
What makes up the abnormal Hgb H and why
4 beta
It will bind to itself if there is not enough alpha
What makes up the abnormal Hgb Bart’s and what is the result
4 gamma
If there is no alpha at all, the child will not survive
What is Hgb A1c and what percent of it is found in adult Hgb
Glycohemoglobin
Hgb with glucose attached/binded
4-6%
If glycohemoglobin is lower than normal, what does that tell you
Something is wrong with the longevity of RBCs where they are being destroyed too early (anemia)
What can Hgb A1c tell us?
Diabetes
Gives us an idea about the patient’s diet
With an increase in glucose in blood, it will be present in urine
How does CO2 travel from tissue to lungs
CO2 combines with water and becomes an ion to transport. Once it reaches the lungs it dissociates and reverts back to CO2
What percent of CO2 can dissolve
20-30%
What is the normal pH
7.35-7.45
What pH is wanted in your tissues
7.35
How does O2 get released from Hgb
Hgb has 4 parts to it
H+ squeezes O2 out of each 4
The first H+ requires a lot of energy
The second H+ requires less energy
The third H+ is very easy
Don’t even need a 4th H+
On an oxygen dissociation curve, how do you push the graph to facilitate Hgb to let go of O2
Change in pH, temp, and presence of 2-3 DPG
In an oxygen dissociation curve, what is the normal Po2 (mm Hg), or O2 concentration in the environment
27 mm Hg
In an oxygen dissociation curve what is the normal % O2 saturation
50%
In an oxygen dissociation curve what is the normal P value
P50
In an oxygen dissociation curve what will a shift to the left look like
P50 < 27 mm Hg
Higher oxygens affinity
In an oxygen dissociation curve what will a shift to the right look like
P50 > 27 mm Hg
Lower oxygen affinity
In an oxygen dissociation curve, what will cause a left shift (include Bohr effect)
Decreased body temp
Decreased 2-3 DPG
Decreased [H+]
Bohr effect:
Decreased H+ ions
Increased pH
Increased O2 affinity
In an oxygen dissociation curve, what will cause a right shift (include Bohr effect)
Increased body temp
Increased 2-3 DPG
Increased [H+]
Bohr effect:
Increased H+ ions
Decreased pH
Decreased O2 affinity
What are additional causes for a right or left shift
Altitude
Hypoxia (low O2 concentration)
Abnormal Hgb
What is myoglobin
Resivoir for O2
High affinity for O2
Helps O2 when exercising
What happens when CO2 levels increase in blood
Blood will become more acidic
Hemoglobins oxygen binding affinity is
Inversely related both to acidity and to the concentration of CO2
Describe the chloride shift
Chloride concentration is lower in
Systemic venous blood than in systemic arterial blood
In order to go through a membrane hemoglobin must be
Ferrous
Fe^2+
What is the purpose of ferric irons
Storage and transport
Hemoglobin is ______
Methemoglobin is ______
Ferrous (Fe^2+)
Ferric (Fe^3+)
Always carry iron in what state
Ferric
