HEMOGLOBIN Flashcards by Anne Cruz

HEMOGLOBIN

Iron bearing protein contained within the _________

It is synthesized by _________ from the________ up to_________

1 gram of hemoglobin can carry_______

Erythrocytes

Young erythroblast ; polychromatophilic normoblast stage ; reticulocytes stage

1.34 mL of oxygen

How well did you know this?

Not at all

Perfectly

Functions of hemoglobin:

Transport oxygen from the_____ to the_______ and carbon dioxide from the__________

Base balance regulation

Lungs
Tissue
tissue

Acid

How well did you know this?

Not at all

Perfectly

Composition of heme (2)

Protophorphyrin IX

Ferrous iron

How well did you know this?

Not at all

Perfectly

Protophorphyrin consists of a ring of: (3)

Carbon

Hydrogen

Nitrogen

How well did you know this?

Not at all

Perfectly

Structure of hemoglobin:

a1B2 & a2 B1 bonds:

a1 B1 bonds:

a2 B2 bonds:

Between the dimers

Front

Behind

How well did you know this?

Not at all

Perfectly

Globin structure:

_______ compromising each hemoglobin molecule consist of_______ of unlike polypeptide chains____to______

Each hemoglobin_______ separated by_______

Four globin chains
Two identical pairs
141 to 146 amino acids each

8 helices ; 7 non helices segments

How well did you know this?

Not at all

Perfectly

Number of amino acids:

Alpha & Zeta:

Beta, Gamma, Delta ,epsilon:

Theta:

141 amino acids

146 amino acids

Unknown

How well did you know this?

Not at all

Perfectly

Complete hemoglobin molecule

Primary:

Secondary:

Tertiary:

Quaternary:

Amino acid sequence

Helices and non-helices

Pretzel like configuration

Complete molecule

How well did you know this?

Not at all

Perfectly

Outline of heme synthesis:

Succinyl- CoA + Glycine —-> ALA synthase = ________

______ enters cytoplasm by ________then becomes______then_______then_____——->_________ then becomes______ enters mitochondria again by ________ then becomes______ then______ then_______ to form _______

Amino levulinic acid

Amino levulinic acid ; ALA-dehydratase ; porphobilinogen ; hydroxymethylbilane ; uroporphorinogen III ; uroporphirinogen III decarboxylase ; coproporphyrinogen III ; coproporphyrinogen III oxidase ; Protoporphyrinogen III ; protoporphyrin IX ; ferrochelatase ; HEME

How well did you know this?

Not at all

Perfectly

Ontogeny of globin synthesis:

3 weeks of gestation
-region:
-type of globin gene:
-type of hemoglobin:

5 weeks of gestation
-region:
-type of globin gene:
-type of hemoglobin:

6 - 30 weeks of gestation
-region:
-type of globin gene:
-type of hemoglobin:

30 weeks of gestation
-region:
-type of globin gene:
-type of hemoglobin:

At birth
-region:
-type of globin gene:
-type of hemoglobin:

Yolk sac
Zeta and epsilon
Hemoglobin gower 1

Yolk sac
Gamma and Alpha
Hemoglobin Portland and hemoglobin gower 2

Liver and spleen
Alpha, Gamma, Beta
Hemoglobin F

Liver
Delta
Hemoglobin A2

Bone marrow
None
Hemoglobin A

How well did you know this?

Not at all

Perfectly

Function of hemoglobin is readily bind oxygen molecules in lung, which requires high oxygen affinity to transport oxygen into efficiently unload oxygen to the tissues which requires low oxygen affinity

Oxygen transport

How well did you know this?

Not at all

Perfectly

Second crucial function of hemoglobin is the transport of carbon dioxide

Carbon dioxide

How well did you know this?

Not at all

Perfectly

Third function of hemoglobin involves the binding and activation and transport of nitric oxide

Secreted by vascular endothelial cells and causes relaxation of vascular walls, smooth muscle and muscle vasodilation

Nitric oxide

How well did you know this?

Not at all

Perfectly

Ability of hemoglobin to bind or release oxygen. Oxygen tension at hgb is 50% saturated

Oxygen affinity

How well did you know this?

Not at all

Perfectly

Relationship between O2 tension amd hemoglobin saturation with oxygen

Oxygen Dissociation Curve

How well did you know this?

Not at all

Perfectly

Relationship of O2 affinity with hgb to pH

Bohr effect

How well did you know this?

Not at all

Perfectly

Increase pH:

Decrease pH:

Increase hgb affinity for O2

Decrease affinity for O2

How well did you know this?

Not at all

Perfectly

Shift to the left (DECREASE) (3)

TEMPERATURE

ORGANIC PHOSPHATES (2,3 DPG)

p (CO2)

How well did you know this?

Not at all

Perfectly

Shift to the left (INCREASE) (2)

p (CO)

How well did you know this?

Not at all

Perfectly

Shift to the right (DECREASE)

p (CO2)

How well did you know this?

Not at all

Perfectly

Shift to the right (INCREASE) (3)

TEMPERATURE

ORG PHOSPHATE (2,3 DPG)

p (CO2)

How well did you know this?

Not at all

Perfectly

________ ( decreases oxygen affinity, more O2 release)

(4)

________( increases oxygen affinity, less O2 release)

(3)

Right shift

High 2,3 DPG
Decrease body pH
High carbon dioxide
Hemoglobin S

Left shift

Low 2,3 DPG
Decrease body temp
Hemoglobin F

How well did you know this?

Not at all

Perfectly

Hemoglobin combination with oxygen

Give pinkness to skin and mucous membrane.

Seen in arterial circulation

Oxyhemoglobin

How well did you know this?

Not at all

Perfectly

Hemoglobin with iron but no O2 seen in venous circulation

Unassociated with oxygen

Deoxyhemoglobin

How well did you know this?

Not at all

Perfectly

5 normal hemoglobin

Embryonic hemoglobin Fetal hemoglobin Hemoglobin A or A1 Hemoglobin A2 Hemoglobin A3

3 types of embryonic hemoglobin: Hemoglobin gower 1: Hemoglobin gower 2: Hemoglobin portland:

2 zeta & 2 epsilon 2 alpha & 2 epsilon 2 zeta & 2 gamma

Major hemoglobin of fetus amd newborns. 2 ___ 2 ____ Produced _____after______

Fetal hemoglobin 2 alpha & 2 gamma 4 months ; conception

Normap adult hemoglobin _____ of hemoglobin in normal adults produced after________ 2_____ & 2______

Hemoglobin A or A1 95 to 97% ; 1 year 2 alpha 2 beta

Constitutes less than 3% of total hemoglobin 2____ & 2_____

Hemoglobin A2 2 alpha & 2 delta

Degradation product of Hemoglobin A2 2_____& 2______

Hemoglobin A3 2 alpha 2 delta

4 abnormal hemoglobin

Hemoglobin S Hemoglobin C Hemoglobin E Hemoglobin H

Primary hemoglobin in people with sickle cell disease Those with hemoglobin S have 2______ and 2________ Causes red blood cell to deform when exposed to dec oxygen. Glutamic acid is replaced by ______ in the 6th position of beta chain:

Hemoglobin S 2 abnormal beta ; 2 normal alpha Valine

2-3% of people of west african descent are heterozygotes for hemoglobin C, have ______copy of beta Hemoglobin C disease, seen in homozygotes have ______copies of beta Instead of glutamic acid _____ is in B6 Causes a minor amount of _______ and mild to moderate _________

Hemoglobin C 1 2 Lysine Hemolytic anemia Enlargement of the spleen

Most common beta chain hemoglobin variants in the world People who are homozygous for hgb E , have ____copies of beta Mild_________, _________ and_______ Single copy of hgb E gene does not cause symptoms unless combined with another mutation such as _______

Hemoglobin E 2 copies Hemolytic anemia, microcytic red blood cells, mild enlargement of spleen Beta thalassemia trait

Occurs in some cases of alpha thalassemia It is composed of _____globin chains and produced in response to a __________

Hemoglobin H Four beta Severe shortage of alpha chains

3 chemically modified hemoglobins

methemoglobin Sulfhemoglobin Carboxyhemoglobin

Form hgb in its ferric state _______ color and does not revert red on exposure to oxygen Peak range________at____ under________ Causes: (2)

Methemoglobin Brownish to bluish 620-640 nm at pH 7.1 Spectral absorption test Presence of oxidants Genetic deficiency (dec activity of methgb)

Formed by irreversible oxidation of hgb of certain drugs and chemicals Examples: (3) Formed by the addition of ________ to hgb has a ________ If sulfhemoglobin reaches critical level in blood it imparts ______

Sulfhemoglobin Sulfonamides Phenacetin Acetanilide Hydrogen sulfide ; greenish pigment Mauve lavender

Sulfhemoglobin usually reported: Patient under prolonged treatment with _______ or _______ Patient with ________ In cases of bacteremia caused by ________ In condition known as ________

Sulfonamides or aromatic compounds Severe constipation Clostridium perfringens Enterogenous cyanosis

Binding of carbon monoxide to heme iron Hgb can combine with carbon monoxide with affinity ______times greater than that oxygen Carbon monoxide is termed as_____

200 Silent killer, for its colorless gas, odor and patient become easily hypoxic

5 hemoglobin determination

Visual method Gasometric method Spectronic method Automated Other methods

6 visual methods

Sahli method Dares method Hadens method Wintrobe Haldene Tallquists

2 spectronic method

Oxyhemoglobin Cyanmethemoglobin

3 other methods

Alkaline Specific gravity Comparator

4 hemoglobin methods

Copper sulfate specific gravity Gasometric method/ Oxygen capacity method Chemical method/ Iron content method Colorimetric method

Qualitative screening test based on specific gravity Density of drop of blood is directly proportional to amount of hemoglobin Principle of this test is when drop of donor’s blood dropped into copper sulfate solution becomes encased in a sac of copper proteinate which prevents any change in the specific gravity for about ______

Copper sulfate specific gravity 15 seconds

Hemoglobin will combine and liberate a fixed quantity of oxygen Blood is hemolyzed with _____ and ____ is collected and measured in a ________

Gasometric method or Oxygen Capacity Method Saponin and gas Van slyke apparatus

2 methods of colorimetric method

Visual Photoelectric

Visual: (3) Photoelectric:(2)

Direct matching Acid hematin Alkaline hematin Oxyhemoglobin method Cyanmethemoglobin / Hemoglobincyanide method

Measures plasma hemoglobin

Oxyhemoglobin method

Standard and reference method use to measure hemoglobin

Cyanmethemoglobin / Hemoglobincyanide method

Not converted to cyanmethemoglobin and cannot be measured

Sulfhemoglobin

Hemoglobin is oxidized to methemoglobin by_________ ________ converts methemoglobin to cyanmethemoglobin Absorbance is measured at ____

Potassium ferricyanide Potassium cyanide 540 nm

CYANMETHEMOGLOBIN METHOD Reagent used in hemoglobin determination _______ _______color with a pH of _____ Specimen: Reference range: Male: Female: Factors that affect hgb results: (3)

Modified drabkin’s reagent Pale and yellow ; pH 7.2 Whole blood (EDTA) 13.5-18g/dL 12-15g/dL Age Sex Altitude of locality

Composition of modified drabkin’s reagent: (4)

Sodium bicarbonate 1 gram Potassium cyanide 52 mg Potassium ferricyanide 198 mg Distilled water 1000 mL

Increased hemoglobin level Found in: (3)

Hyperchromia Polycythemia Dehydration Changing from high to low altitudes

Decreased hemoglobin level Found in:(1)

Oligochromia Anemias

SOURCES OF ERROR AND CORRECTION: Drabkin’s reagent is sensitive to light: High WBC and platelet count: Lipemic sample: Hgb S and hgb C: Abnorma globulins found in multiple myeloma or waldenstrom:

Store in brown bottle or dark place Centrifuge the solution and measure the supernatant Add 0.01 mL of patient’s plasma to 5 mL of drabkin’a reagent and used the solition as reagent blank Dilution with distilled water (1:2) Add 0.1 g of potassium carbonate to drabkin’s reagent

Hemoglobin determination test is used to (4)

Screen for disease associated with anemia Determine severity of anemia Follow the response to treatment for anemia Evaluate polycythemia vera

Decreased hgb levels (8)

Anemia (all kinds of anemia) Liver disease Hypothyroidism Hemorrhage Hodgkins disease Leukemia Lymphoma SLE

Increased hgb levels: (6)

Polycythemia vera Congestive heart failure Chronic obstructive pulmonary disease Transfusion Hemorrhage Burns

INTERFERING FATORS: (5) Peolple living at high altitudes have _______ Excessive fluid intake cause a _______ Normally, the hgb is higher in ____ Drugs Hgb is normally decrease during ______

Increased hgb values Decreased hgb Infants Pregnancy

CLINICAL ALERT The panic hgb is less than______a condition that leads to_______and ______ A value more than______ leads to _____ of the _____ as a result of hemoconcentration

5.0g/dL Heart failure & death 20g/dL Clogging of the capillaries

HEMOGLOBIN Flashcards

(63 cards)