00:01
So let's take a look at hemoglobin.
00:03
Now you see that we often
shorten that to be Hgb.
00:07
Now, its job is to carry oxygen
throughout the body.
00:09
Doesn't it feel great that that's
really familiar to you?
It's 95% of the dry weight
of a red blood cell,
so this is the meat of the red blood cell.
00:18
Remember the red blood cell is just
that sack that carries the hemoglobin.
00:22
Hemoglobin has a quaternary structure.
00:25
4 globular proteins. There's 4 units that
can carry oxygen in an adult patient;
2 alpha and 2 beta.
00:30
Now you don't need to ever memorize
it's 2 alpha, 2 beta,
but just know that there are 4 globular
proteins in an adult hemoglobin.
00:38
So each group has a heme molecule,
and it has an iron center
that loves to bind with oxygen.
00:45
So each red blood cell has a hemoglobin.
00:48
It can carry 4 oxygen components with it.
00:52
So let's talk about what happens
when you have extra cells.
00:56
You've got polycythemia vera, that's
a bone marrow is going crazy.
01:00
You could be in a high altitude.
01:02
Remember that's an adaptation to altitude.
01:05
Now we talked about that previously.
01:07
See if you can stop the video for just
a minute and jot some quick notes
as to why high altitude would give
you a higher hemoglobin.
01:19
Okay, hopefully, you remembered
that in a high altitude, there's
less oxygen available.
01:25
So if you're there long enough,
the body will adapt by putting
out extra red blood cells.
01:30
Extra red blood cells means
a higher hemoglobin.
01:34
Same thing with congenital heart disease.
01:36
We've looked at each one of these previously.
01:39
Anything that causes an
elevated red blood cell
will also cause the hemoglobin
to be elevated.
01:46
Same thing with anemia.
01:48
Anything that causes a lower red blood
cell will cause a lower hemoglobin.
01:53
So if you ever see a patient that
has a low hemoglobin,
you want look for some of these problems
that we've discussed in the other slides.
02:01
So, chronic renal failure,
because they don't have erythropoietin,
which stimulates red blood cells.
02:07
Pernicious or aplastic anemia, damage
to your bone marrow,
leukemia/lymphoma, where you have
acute or chronic blood loss,
or you've got some nutritional deficiencies.
02:17
So, looking at this, like you don't
have multiple slides to remember.
02:22
We're just walking you through the
concept that anything that causes
elevated red blood cells will cause
elevated hemoglobin.
02:30
Anything that causes decreased red blood
cells will cause decreased hemoglobin.