Iron and Hb

HbA

2 alpha 2 beta

HbA2

2 alpha 2 delta

HbF

2 alpha 2 gamma

Which types of Hb can be found in adults and fetus

HbA, HbA2, HbF

Which types of Hb can only be found in the embryo

Gower 1 and 2, Portland 1 and 2

Gower 1

2 zeta 2 epsilon

Gower 2

2 alpha 2 epsilon

Portland 1

2 zeta 2 gamma

Portland 2

2 zeta 2 beta

Which chromosome is the alpha globin gene cluster located

Chromosome 16

Which chromosome is the beta globin gene cluster located

Chromosome 11

Which globins are on the alpha globin gene cluster

Zeta, alpha

Which globins are on the beta globin gene cluster

Epsilon, gamma, delta, beta

Where are epsilon and zeta made

Yolk sac

Where is alpha and beta primarily made in adult

Bone marrow

HbF level at birth

75-80%

HbF level in adult

<1%

HbA level in adult

97%

HbA2 level in adult

2.5%

Higher HbA2 indicates what?

Thalassemia

Why do fetus have higher HbF

HbF has higher O2 affinity than HbA or HbA2

HbH

4 beta

What is the byproduct of HbH

Heinz body

Hb Bart

4 gamma

What is commonly associated with Hb Bart

Hydrops fetalis

What is the glycosylated form HbA

HbA1C

OxyHb

Hb with O2

DeoxyHb

O2 without Hb

Carbaminohemoglobin

HbCO2

methHb

Hb found to Fe3+ instead of Fe2+

What can cause methHb

Lidocaine, benzocaine, prilocaine, free radical

What is used to reduce HbFe3+ into HbFe2+

Methylene blue and NADPH

Carboxyhemoglobin

COHb

What factors affect affinity

pH, 2,3DPG, temperature

Left shift means what

Less O2 is delivered, higher affinity for binding

Right shift means what

More O2 delivered, lower bonding affinity

Increase pH, decreased 2,3DPG, PCO2 and temp means the graph will shift to left or right

Left

Decreased pH, increased 2,3DPG, PCO2 and temperature means the graph with shift to the left or right

Right

Acute alkalosis causes what shift

Left shift

Acute acidosis causes what shift

Right shift

Ferrous iron

Fe2+

Ferric iron

Fe3+

What helps reduce non heme iron

DCYTB, Vitamin C, DMT1

What form is iron is used for storage

Ferritin

What is expressed on cell surface when iron is needed

TFR

Where is iron mainly stored

Macrophage and liver

Where do macrophages get iron

RBC destruction

What is hemosiderin

Disease caused by long storage of ferritin

What is the function of hepsidin

Iron regulation

What inhibits hepsidin

Low iron

What does serum iron measure

Circulating iron

What is normal serum iron level (M, F)

M = 10.5-28 umol/L, F = 6.6-26 umol/L

What does serum ferritin measure

Iron storage

What is the normal serum ferritin level

M = 30-400 ng/mL, F = 15-150 ng/mL

What does transferrin measure

Iron binding protein in blood

What is the normal transferrin rnage

25.2-45.4 umol/L

What does TIBC measure

Available iron binding sites on transferrin

What is normal TIBC

40.8-76.6

What is transferrin saturation

Ratio of serum iron to TIBC

What is the normal transferrin saturation

20-55%