MIDTERMS Flashcards
➔ Ordered by physicians to diagnose and monitor the
course of
ANEMIA
HEMOGLOBIN Can be performed separately or as part of the
routine
COMPLETE BLOOD COUNT (CBC)
Hematologic analyzers to date include
hemoglobin determination as a _________ included in CBC
STANDARD TEST
FUNCTIONS OF HEMOGLOBIN
➔ Main component of __________
➔ Transports _____ and __________
● When fully saturated, each gram of
hemoglobin holds ___________.
➔ _______________
➔ Binding, inactivation, and transport of nitric oxide
(NO)
RED BLOOD CELLS
OXYGEN and CARBON DIOXIDE
1.34 mL of oxygen
Acid base balance
Hemoglobin molecule is composed of two different
pairs of polypeptide chains called _________ and four
___________, with one heme group embedded in
each of the four polypeptide chains
GLOBIN
HEME GROUPS
HEME STRUCTURE (2)
- Heme
- Globin
Heme consists of a ring of ____, ______, _______ called __________with a
divalent FERROUS IRON (Fe2+)
carbon,
hydrogen, and
nitrogen atoms
PROTOPORPHYRIN IX
When _________→ oxidized to ________) = CAN NO LONGER BIND TO
OXYGEN
ferrous iron
ferric state (Fe3+
Each heme is precisely located in a pocket or fold of
one of the _________
polypeptide chains
Hemoglobin is made up of ___________
4 PROSTHETIC HEME
GROUPS
If iron is lacking (decrease dietary intake or increase
loss from the blood) → Hemoglobin is not formed
sufficiently → thus leading to _________
ANEMIA
Ferrous (Fe2+) reversibly bound to oxygen
OXYHEMOGLOBIN
RELAXED FORM (with 2,3-BPG)
[2,3-Bisphosphoglyceric acid]
OXYHEMOGLOBIN
_____ is taken up at the iron atom until
each iron is bound with one oxygen
molecule → one hemoglobin molecule is
capable of binding with four oxygen
molecules
oxygen
Ferrous (Fe2+) NOT bound to oxygen
DEOXYHEMOGLOBIN
➔ TENSE FORM (with 2,3-BPG)
DEOXYHEMOGLOBIN
In the tissues, (oxygen tensions are LOW → down
to __________
20mmHg
Primarily made up of protein
● Made up of two chain combination of a, b, d, e, g, or z.
Globin
● A.k.a dysfunction hemoglobins
DYSHEMOGLOBIN
Unable to transport oxygen.
● Form and may accumulate to toxic levels, after
exposure to certain triggers.
DYSHEMOGLOBIN
DSHEMOGLOBIN
Severe impairment =
○ If not corrected =
can result to hypoxia
or cyanosis
will eventually lead to
death.
Most cases are acquired; only a small fraction is
hereditary
DYSHEMOGLOBIN
Normally 1-2%
● a.k.a Ferrihemoglobin or Hemiglobin
- METHEMOGLOBIN (Hi)
Formed by the reversible oxidation of Ferrous (Fe
2+
- METHEMOGLOBIN (Hi)
Color of blood (methemoglobinemia): chocolate
brown
- METHEMOGLOBIN (Hi)
Most cases of methemoglobinemia is acquired,
resulting from exposure to certain drugs and
chemicals such as ______, ______, _______, ________
nitrates, nitrites, quinolones, and
chlorates
CO (carbon monoxide) bound to heme
- CARBOXYHEMOGLOBIN (HbCO)
Has 210 times greater affinity to
hemoglobin than O22.
- CARBOXYHEMOGLOBIN (HbCO)
Silent killer; a tasteless, colorless, and
odorless gas - can make victimes quickly
hypoxic
- CARBOXYHEMOGLOBIN (HbCO)
● Binding is reversible
Carbon monoxide poisoning treatment is
use of __________ in order to
remove carbon monoxide in the blood
hyperbaric oxygen
Color of blood and skin in HbCO poisoning: cherry
red
- CARBOXYHEMOGLOBIN (HbCO)
Normally <1%
● Sulfur bound to heme (greenish pigment)
● Mixture of oxidized, partially denatured forms of
hemoglobin
- SULFHEMOGLOBIN (SHb)
Color of blood (sulfhemoglobinemia):
mauve-lavender
- SULFHEMOGLOBIN (SHb)
HEMOGLOBIN MEASUREMENT IN THE LABORATORY
(3)
- SPECIFIC GRAVITY METHOD (COPPER SULFATE
METHOD) - ACID HEMATIN METHOD (SAHLI-HELLIGE METHOD)
Report results in grams per 100 mL of blood (g/dL) - CYANMETHEMOGLOBIN METHOD
(HEMIGLOBINCYANIDE METHOD)
Blood is diluted with Drabkin’s reagent. Potassium
ferricyanide oxidizes hemoglobin to methemoglobin.
Potassium cyanide provides cyanide ions to form
cyanmethemoglobin.
- CYANMETHEMOGLOBIN METHOD
(HEMIGLOBINCYANIDE METHOD)
The solution is read at 540mm wavelength and is
compared with that of a standard HiCN solution
- CYANMETHEMOGLOBIN METHOD
(HEMIGLOBINCYANIDE METHOD)
Sample: EDTA whole blood
- CYANMETHEMOGLOBIN METHOD
(HEMIGLOBINCYANIDE METHOD)
Blood + 0.1 N HCI = Hemoglobin → Acid hematin
(dark brown colored compound)
- ACID HEMATIN METHOD (SAHLI-HELLIGE METHOD)
SG of blood > solution
= Sink
SG of blood < solution
Float
. ACID HEMATIN METHOD
(SAHLI-HELLIGE METHOD)