1. Blood analysis
Lab # 4

2. Hemoglobin (Hb) Characteristics: 1-Hb is a associated protein
- Non-protein part → Heme (iron protoporphyrin)
- Protein part → Globin
2-Hb is a chromoprotein i.e it gives the blood its red color
Function:
O2 transport
Hb + O2 → Oxyhemoglobin

3. Determination of Hemoglobin (Hb) (Cyanmethemoglobin Technique)
Principle
Hb + Ferricyanide → met-Hb
Met-Hb + cyanide → cyanomethemoglobin
Procedure
Drabkin reagent blood read abs. at 546
5 min.

4. Cont. Calculation Normal levels: Hb conc. (gm/dl) = 36.77 x A
M: g/dl
F: g/dl

5. Interpretation of the results
↓Hb → Anemia
Causes of anemia:
1- ↓ Production of Hb
a- Iron deficiency
b- Vitamins deficiency e.g. vit B12, vit B6 & folic acid
c- Protein deficiency

6. Interpretation of the results
2- ↑ Hb destruction
a- Hemolytic anemia
b- Heavy metal poisoning e.g. lead
c- Infections e.g. malaria
↑ Hb → Polycythemia
Causes:
- High altitudes
- CO intoxication
- Pulmonary diseases e.g. emphysema

7. Bilirubin
Bilirubin is the end product of Hb destruction

8. Bilirubin bilirubin + glucouronic acid →water soluble bilirubin
Types of bilirubin
1- Conjugated = soluble =direct
bilirubin + glucouronic acid →water soluble bilirubin
2- Unconjugated = insoluble = indirect

9. Bilirubin: cont.

10. Bilirubin: cont. Total bilirubin= direct + indirect Normal values:
Total bilirubin: 0-1 mg/dl
Direct bilirubin: up to 0.25 mg/dl
Indirect bilirubin: up to 0.75 mg/dl

11. Clinical significance
Hyperbilirubinemia indicates Jaundice
Causes of jaundice
1- Pre-hepatic (↑ indirect bilirubin)
a- Hemolytic anemia
b- Incompatible blood transfusion
2- Hepatic (↑ indirect bilirubin)
a- ↓ glucouronyl transferase enz.
b- Viral hepatitis & liver cirrhosis
3- Post hepatic (↑ direct bilirubin)
common bile duct obstruction

12. Iron Iron physiology Iron forms: Ferrous → in Hb & oxyHb
Ferric → in cyanmetHb
Iron physiology

13. Iron containing compounds
1- Oxygen carrying chromoproteins:
e.g. Hb & myoglobin
2- Enzymes:
e.g. cytochromes, catalase, peroxidase

14. Iron Absorption Storage Duodenum & jejunum
Iron is stored in ferric form

15. Determination of iron Principle
1- Acidification; transferrin-Ferrric HCL transferrin + ferric ion
2- Reduction: ferric ion + thioglycolic acid ferrous ion
3- Coloring: ferrous ion + bathophenanthrolene pink color

16. Iron ↑ iron ↓ iron 1- ↑ RBCs destruction 2- ↑ iron absorption
Normal value
60 – 160 mg/dl
Clinical significance
↑ iron
↓ iron
1- ↑ RBCs destruction
2- ↑ iron absorption
3- Iron overload
4- Liver diseases
1- Decreased dietary iron intake
2- Blood loss
3- Increased demand e.g. pregnancy & children