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Med School: Semester 2 > Heme1c > Flashcards

Flashcards in Heme1c Deck (14):
1

What are the 3 forms of embryonic hb?

a. Gower 1: zeta2 epsilon2
b. Portland: zeta2 gamma2
c. Gower 2: alpha2 epsilon3

2

What are the chain components in fetal hb?

alpha2 gamma2

3

What are the components, names and percentages in adult hb?

alpha2 delta2, A2, 1.5-3.5%

alpha2 beta2, A, >95%

4

When does the beta gamma switch happen?

3-4 months gestation is when it begins.

5

At birth, what percent of Hb is fetal?

~80-90%

6

What causes a left shift in the O2 dissociation curve?

up: pH

down: temp, pCO2, 2,3-DPG

hb type: fetal

7

What causes a right shift in the O2 dissociation curve?

down: pH

up: temp, pCO2, 2,3-DPG

hb type: adult

8

Tell me about inheritance and clinical manifestations of G6P deficiency.

X-linked, also many drugs cause it.

Asymptomatic, neonatal hyperbilirubinemia, chronic hemolysis, intermittent hemolysis (stressors,- fava beans).

Late complications: diabetes, renal failure

9

What do you see on a smear for G6P deficiency?

Heinz bodies and "bites" take out of the RBC.

10

How do you Dx G6P deficiency?

CBC retic count
Smear: Heinz bodies, bite cells
LFTs: increased bilirubin
Haptoglobin
Enzyme assay
Genetic testing

11

What is the difference between Howell-Jolly and Heinz bodies?

Howell-Jolly: Nuclear remanants, found in damaged spleen (trauma, radiation, etc.) and megaloplastic anemia.

Heinz: gummed up globlin chains in thalassemias.

12

What factors does PT test for?

I, II,V, VII, and X

13

What factors does PTT test for?

Slides: II, V, VIII, IX, X, and XI

First Aid: All except VII and XIII

14

A deficiency in what leads to Hemophilia A? B? What do they do to the PTT?

A: VIII
B: IX
PTT: both increase the PTT