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Hematology CSMLS Latest 2024/2025 Updated Questions and Answers Guaranteed 100% Success.

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Shift to Left Hgb-O2 Dissociation - O2 not released to tissue adequately - Decreased CO2 - Increased pH - HbF (High affinity Hb) - Multiple transfusions (Decreased 2,3-DPG) Prenatal hematopoiesis - Begins in the yolk sac, then fetal liver, and then bone marrow at birth Hemoglobin - An iron-co...

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  • September 4, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Hematology CSMLS
  • Hematology CSMLS
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ACADEMICMATERIALS
Hematology CSMLS
Shift to Left Hgb-O2 Dissociation - O2 not released to tissue adequately



- Decreased CO2

- Increased pH

- HbF (High affinity Hb)

- Multiple transfusions (Decreased 2,3-DPG)




Prenatal hematopoiesis - Begins in the yolk sac, then fetal liver, and then bone marrow at birth



Hemoglobin - An iron-containing protein in red blood cells that reversibly binds oxygen.



- Must have iron and protoporphyrin



Transferrin - iron transport protein



Ferritin - Major Fe Storage form



Hemosiderin - H2O insoluble Fe storage form (long term)



Hemosiderosis - abnormal increase of iron in blood, excess iron stored in tissues and body organs



Early Heme Precursors - Delta-aminolevulinic acid



Porphobilinogen

,Late Heme Precursors - Uroporphyrinogen



- Coproporphyrinogen



- Protoporphyrin



- Heme




Shift to Right Hgb-O2 Dissociation - O2 released to tissue more easily



- Increased CO2

- Decreased pH

- Increased 2,3-DPG



HbF - Fetal hemoglobin



A2Y2. 2 alpha, 2 gamma chains



60-90% in Newborns



Hgb A2 - 2 alpha and 2 delta



<2% newborn

2% Adult



Hgb A - 2 Alpha and 2 Beta chains. Adult hemoglobin

,97% Adult

10-40% Newborn



Hemoglobin Measurement - principle: Conversion of hemoglobin to cyanmethemoglobin by
potassium cyanide and potassium ferricyanide



Sources of error:

- Lipemia/icterus

- High white count

- Resisting Hgbs: SS, CC



Diluent: Drabkin solution



-Hemoglobin RI

Males: 135-180 g/L

Females: 120-150 g/L



Methemoglobin - Fe2+ Oxidized to Fe3+, Brown, *Cannot* Bind *O2*



Carboxyhemoglobin - Increased in CO poisoning and smokers, cherry red



Hematocrit - Measures packed cell volume in percentage.



Calculated from MCV and RBC. MCV = HCT/RBC * 10



MicroHCT method: Fingerstick, EDTA or heparinized sample.



Sources of error:

-Failure to seal tube adequately, incorrect reading due to uneven clay plug.

, -Inappropriate Centrifuge time/ speed.

-Excess EDTA resulting in RBC shrinkage

-Cold agglutinins, high WBC count



Reference range:

Male: 0.40-0.54 L/L

Female: 0.35-0.49 L/L



MCH - = HGB/ RBC * 10



26-34 pg



MCHC - = Hgb / HCT * 100



320-360 g/L



Indicates hypochromic cells (anemia)

or Hyperchromic cells (Spherocytes), lipemia, Hb SS, CC



Manual WBC/Platelet Count - Diluent - 1.98 ml of 1% Ammonium Oxalate.

0.02 mL (20 uL pipet) patient sample.

- 1:100 Dilution (0.02 mL in 2.00 mL)

- Depth of chamber = 0.1 mm



Volume ( of 1 square) = Length * width * depth( 1mm * 1mm * 0.1mm = 0.1mm)

Total volume = Volume * # of squares counted, if you count 9 squares then 0.1mm * 9 = 0.9



# of cells counted * 1/(total volume) * dilution factor

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