So let's take a look at hemoglobin.
Now you see that we often
shorten that to be Hgb.
Now, its job is to carry oxygen
throughout the body.
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.
Remember the red blood cell is just
that sack that carries the hemoglobin.
Now, it's a quaternary structure.
That means it has
4 globular proteins. There's 4 units that
can carry oxygen in an adult patient;
2 alpha and 2 beta.
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.
So each group has a heme molecule,
and it has an iron center
that loves to bind with oxygen.
So each red blood cell has a hemoglobin.
It can carry 4 oxygen components with it.
So let's talk about what happens
when you have extra cells.
You've got polycythemia vera, that's
a bone marrow is going crazy.
You could be in a high altitude.
Remember that's an adaptation to altitude.
Now we talked about that previously.
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.
Okay, hopefully, you remembered
that in a high altitude, there's
less oxygen available.
So if you're there long enough,
the body will adapt by putting
out extra red blood cells.
Extra red blood cells means
a higher hemoglobin.
Same thing with congenital heart disease.
We've looked at each one of these previously.
Anything that causes an
elevated red blood cell
will also cause the hemoglobin
to be elevated.
Same thing with anemia.
Anything that causes a lower red blood
cell will cause a lower hemoglobin.
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.
So, chronic renal failure,
because they don't have erythropoietin,
which stimulates red blood cells.
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.
So, looking at this, like you don't
have multiple slides to remember.
We're just walking you through the
concept that anything that causes
elevated red blood cells will cause
Anything that causes decreased red blood
cells will cause decreased hemoglobin.