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Hematology test 2


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P50 value for hemoglobin
pressure at which 50% of hemoglobin is oxygenated.

P50 for hgb=26 torrs
POâ‚‚for alveolar capillaries
almost 100 torrs
pressure effects on oxygen release from hemoglobin
increase in pressure=higher affinity (more bound)
decrease in pressure=lower affinity (more released)
Bohr Effect
increased pH=increased hgb-oxygen affinity
decreased pH=decreased hgb-oxygen affinity
shift to the right
decreased hgb-oxygen affinity
pH ↓
temp ↑
shift to the left
increased hbg-oxygen affinity
pH ↑
temp ↓
smokers, smog
reversible over time, slow and unpredictable. occurs when CO (hgb has higher affinity for this) binds instead of oxygen
formed during increase in sulfur in blood
caused by taking sulfa drugs or chronic constipation
irreversible--RBCs must be removed from circulation
formed when ferrous iron (++) bound to heme is oxidized to (+++). Normal in 1% of circulating blood
reversible with strong reducing agents.
Hemoglobin S
substitution of valine for glutamate in the 6th position of the beta chain of hemoglobin. Causes sticky patches which lead to deformation of RBC
Intravascular Hemolysis
occurs when severely damaged cells lyse in circulation.
components are found in circulation.
hemoglobin bound to haptoglobin and transported to liver
hemoglobinemia, hemoglobinuria, hemosidinuria
Extravascular Hemolysis
normal processes of removal of old or damaged cells from circulation by spleen or liver.
components are saved and reutilized.
increased serum bilirubin, carboxyhemoglobin, methemoglobin
Disassembly of protoporphyrin
Alpha carbon exhaled as CO
protoporphyrin ring converted to biliverdin (green) which is then converted to bilirubin (yellow) and carried by albumin to liver then excreted
results of increased intravascular hemolysis
increased indirect bilirubin
depleted haptoglobin and hemopexin
increased LDH
increased retic count
measurable methemalbumin
hyperplastic bone marrow
role of erythropoeitin in intravascular and extravascular hemolysis
controls production/destruction balance
4.7-6.1 x 10 6th/μl Male

4.2-5.4 x 10 6tg /μl Female
4.8 – 10.8 x 10 3rd/μl
14-18 grams/dL Male

12 – 16 grams/dL Female
42-52% Male

37-47% Female
The average size (volume) of an RBC

Normal values: 80-100 fl. (a femtoliter [fl] = 10-15 liter)
the average hemoglobin content of a RBC.

Normal values: 26-34 pg. (a picogram [pg] = 10-12 gram)
the percentage of a RBC's volume which contains hemoglobin.

Normal values: Usually between 31-37%.

(not normal part of CBC)
0.5 – 1.5%
150,000 – 450,000/μl

1.4-6.5 x 10 3rd/μl
20 – 50%

1.2-3.4 x 10 3rd/μl
1.7 – 9.3%

0.11-0.59 x 10 3rd/μl
0 – 4 %

0-0.5 x 10 3rd/μl
0 – 2 %

0 – 0.2 x 10 3rd/μl
increased number of WBCs
decreased number of WBCs
decreased number of all blood cells
RBC's of normal size (Normal MCV)
Abnormally small RBC's (corresponds to an MCV < 80)
Abnormally large RBC's (corresponds to a MCV > 100)
RBC's that appear to contain normal amounts of hemoglobin on microscopic examination of blood smear
RBC's that have decreased amounts of hemoglobin and appear pale, and washed out on smear. (corresponds to a low MCH and low MCHC)
Variation in RBC size.
The higher the RDW, the greater the amount of anisocytosis
Variation in RBC shape
reticulocyte count
The proportion (%) of RBC's in a specimen of blood that are immature reticulocytes

Normal Range = 0.5% - 1.5%
Rule of Three
In calculating the RBC indices the RBC count is usually 1/3rd of the Hemoglobin, and the Hemoglobin is usually 1/3rd of the Hematocrit. This gives a MCHC of 33.3 in a normal CBC.
calculating MCV
MCV= Hct X 10/RBC
calculating MCH
MCH = Hemoglobin X 10/RBC Count
calculating MCHC
MCHC = Hemoglobin X 10/Hematocrit
Calculating absolute values for cells
total WBC count x % of cell
EX: WBC Count of 8.2 x 10 3rd/μl
73 Neutrophils of 100 cells
so .73 * 8200=5.98 x 10 3rd/μl
Howell Jolly bodies
spherical granules of 1 to 2 mm--DNA
single granules, occasionally two are present, rarely more
distinctly dark purple with Wrights Stain
Megaloblastic anemia, severe hemolytic anemias, thalassemias and splenectomy
Granules or aggregates of ferritin
small clusters near the periphery of normoblasts and less often, reticulocytes
Stained with Prussian Blue (Iron Stain)
Pappenheimer Bodies
Irregular deposits of iron mature erythrocytes
Wright’s Stain--faint violet or magenta specks
Prussian blue stain-confirm iron
Heinz Bodies
Spheres of denatured or precipitated hemoglobin
phase contrast microscopy or stained with crystal violet or brilliant cresyl blue
G-6-PD and pyruvate kinase deficiencies, oxidizing drugs, splenectomy
Basophilic Stippling
Consists of fine, diffuse to course, irregular granules of aggregated ribosomes and polyribosomes
Wright's Stain-dark blue to black
Prominent in fetal and neonatal blood and exposure to lead and other toxic metals

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