High risk during surgery:

 # Which of the following may constitute high-risk during surgery? 

a. β-Thalasemia minor 

b. Hb S homozygous 

c. Hb D Punjab

d. Hb E trait

 

The correct answer is B. Hb S homozygous.

Hb D Punjab and Hb D Los Angeles are having same biochemical structure (Glutamic acid is replaced by Lysine at 121 position in β chain). Heterozygous state is essentially asymptomatic. Homozygous Hb D is very rare. Sickle cell disease is relatively less associated with by Hb S/D Punjab/Los Angeles . Mutation in β chain by virtue of which glutamic acid is replaced by lysine at 26th position in β chain causes Hb E. In Hb E carrier state, 30–45% of the Hb is Hb E, and such carriers are asymptomatic but shows microcytosis. Homozygons E disease is associated with marked microcytosis and hypochromia, but the anemia is usually mild. Clinically resembles β-thalassemia minor. Hb E with Hb D heterozygous state is variable in severity.

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The duffy blood group system is functionally associated with:

# The duffy blood group system is functionally associated with:

a. Invasion by P. falciparum

b. Red cell urea transporter

c. Maintenance of membrane integrity

d. Invasion by P. vivax

The correct answer is: D. Invasion by P. vivax.

Duffy antigen is a receptor for Plasmodium vivax.

• The receptor for P. falciparum on RBCs are glycophorins

• Red cell urea transporter is the Kidd antigen and its absence can be associated with impaired urea transport and urine concentrating defect.

• Integral membrane proteins are band 3, glycophorins, Rh, Kell,  Kidd, Duffy and Lutheran glycoproteins. Though Duffy is an integral membrane protein but it is not the major protein involved in the overall integrity of RBC membrane.

• The peripheral membrane proteins are spectrin, ankyrin, actin, protein 4.1, 4.2 and 4.9, p 55 and the adducins.

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Howell–Jolly bodies contain

 # Howell–Jolly bodies contain: 

a. Iron 

b. DNA 

c. RNA 

d. Protein

The correct answer is B. DNA.

A Howell–Jolly body is a cytopathological finding of basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. During maturation in the bone marrow, late erythroblasts normally expel their nuclei; but, in some cases, a small portion of DNA remains.

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Pappenheimer bodies contain:

 # Pappenheimer bodies contain: 

a. Iron 

b. DNA 

c. RNA 

d. Ribosomal proteins

The correct answer is a. Iron.

Pappenheimer bodies are abnormal basophilic granules of iron found inside red blood cells on routine blood stain. They are a type of inclusion body composed of ferritin aggregates, or mitochondria or phagosomes containing aggregated ferritin.

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