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30 Cards in this Set
- Front
- Back
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leukemia
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white blood
malignant cells from bone marrow. usually in blood stream cream colored with high blast counts |
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lymphomas
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extramedullary (outside bone marrow)
involves lymph nodes |
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acute vs chronic leukemia
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acute - immature cells (rapidly fatal)
chronic - cells are mature.indolent clinical course |
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taut configuration of Hb
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low oxygen, low binding. taut config due to inter and intra salt bonds within the molecule.
sequential breaking of the salt bonds --> relaxed form of Hb |
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numbers to remember positive cooperativity
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30 60
60 90 40 75 |
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under normal conditions, P50 for Hb (pH 7.4, temp = 37 C)
P50 for Mb |
Hb P50 = 27mmHg
Mb P50 = 2.75 mmHg |
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why does CO2 produced by tissues lead to decreased pH
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carbonnic anhydrase converts CO2 and water into carbonic acid.
carbonic acid --> bicarbonate and H+ decrease pH |
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increased temperature does what to O2 unloading
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increase temp
increase O2 unloading |
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2,3 BPG
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byproduct of anaerobic glycolytic pathway.
usually 5mmol/L binds to deoxyHb and stabilitzing it in the T configuration. decreased affinity for O2 |
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2,3 BPG is high in what conditions
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-states of increased oxygen utilization and glycolysis
-chronic hyhpoxia chronic anemia these conditions requires a need for increased delivery fo oxygen to tissues. |
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chromosome 16
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alpha like genes.
genome contains 4 copies of alpha-globin genes (2 paternal, 2 maternal) |
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beta like genes are on ehiwhc chromosome
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chromosome 11. one copy of the gene set is inherited from each parent
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3 Hb present between 4-14 weeks gestation
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Hb Gower I
Hb Gower II Hb Portland |
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3 Hb present between 4-14 weeks gestation
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Hb Gower I
Hb Gower II Hb Portland all have higher affinity for O2 than HbA |
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at 8 weeks gestation, which fetal Hb predominates
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Hb F. Hb F binds 2,3, BPG poorly. stabilizing the Hb in the R state. shift the oxygen dissoc curve left
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HbF in adults
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<1% of total Hb. unevenly distributed in red cells.
fetal hHb remains elevated in premature babies and infatns of mothers with diabetes. elevated in people with hemolytic anemias. |
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how to measure Hb variants like low-affinity and high-affinity Hb
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diagnose by measuring P50
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Hemoglobin chesapeake is what type of Hb variant
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high affinity Hb variant.
erythrocytosis with abnormal band on hemoglobin electrophoresis |
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hemoglobin zurich
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single point mutation that does not affect oxygen binding but does increase binding to carbon monoxide
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heoglobin Koln
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most commonly recognized unsatble Hgb in the west.
mild anemia reticulocytosis spenomegaly |
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to bind oxygen, what form does Hb need to be in (iron form)
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Ferrous (+2)
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if iron is in the ferric form, what form of hemoglobin persists
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ferric
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methemoglobinemia
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can occur bc of too much methemoglobin or because of decreased methemoglobin reduction.
acquired or genetic we usually have 1% methemoglobin |
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how is Hb maintained in the ferrous form within the erythrocyte
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NADPH methemoglboin reductase pathway
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acquired methemoglobinemia
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exposure to drugs and chemicals
benzocaine well water contaminated with nitrates |
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hereditary methemoglobinemia
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homozygous deficiency of cytochrome b5 reductase
mutation in hemoglobin resulting in production of hemoglobin M |
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diagnosis of methemoglobinemia
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person looks cyanotic but arterial partial pressure is normal.
blood dark red chocolate blue with exposure to oxygen. if it turns bright red then its due to increased deoxygenated Hb and not bc of methemoglobin |
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what does CO do to oxygen binding affinity
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CO binds Hb and increases affinity of O2 so decreases O2 delivery
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pulse ox
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red band 660 nm where deoxygb absorbs light maximally
940 nm IR where oxyb absorbs most |
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inaccuracies of pulse ox
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nail polish
carboxyhb and methemoglobiin both absorb at 660nm like deoxy |
