> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/pulmonary/03-hemoglobin.md).

# 03 Hemoglobin

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/hemoglobin%20structures/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/edZ80KK.jpg)

* component of RBC, carries O2
* blue and red: globin chains
* green: heme, 4 in a hemoglobin

## Globin

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/Hemoglobin%20and%20globin%20types.%20Fetal%20Hb%20made%20when,%20special%20how.%20Hemoglobin%20diseases%20are)..

![](https://f001.backblazeb2.com/file/wikiFiles/NVZ4Eey.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/1K8QC9K.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/bmF2Exj.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/2T1uMVS.jpg)

* sickle cell: abnormal hemoglobin

![](https://f001.backblazeb2.com/file/wikiFiles/DckMu8y.jpg)

## Heme

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/heme%20is.%20Porphyrin%20is.%20O2%20binds%20where)..

![](https://f001.backblazeb2.com/file/wikiFiles/Dx48UZ0.jpg)

* porphyria: defects in enzymes making the porphyrin

![](https://f001.backblazeb2.com/file/wikiFiles/DckMu8y.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/2,%203%20BPG%20made%20how,%20function,%20when%20is%20it%20high/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/3zcS9F2.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/C1Czg1g.jpg)

* RBC with BPG Mutase makes 2, 3 BPG
* bad for red cells: sacrifices ATP (pyruvate normally used to make ATP)

## Hemoglobin Binding

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/taut%20vs%20relaxed%20hemoglobin%20forms.%20Tissue%20vs%20lung)..

![](https://f001.backblazeb2.com/file/wikiFiles/kArGeiE.jpg)

* favored in tissues to release O2. T for tissues
* relaxed form favored in lungs to pick up more O2

![](https://f001.backblazeb2.com/file/wikiFiles/ieZ9woi.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/hemoglobin%20vs%20myoglobin%20binding.%20Term%20for%20hemoglobin%20binding)..

![](https://f001.backblazeb2.com/file/wikiFiles/1aUbYSS.jpg)

* myoglobin: bind each O2 molecule equally, linear increase until plateau
* hemoglobin: S shaped curve. Hard to bind first one and then speeds up

![](https://f001.backblazeb2.com/file/wikiFiles/knzw54X.jpg)

* example of allosteric effect

### Allosteric Effects

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/allosteric%20effect%20is,%20examples%20with%20hemoglobin%20binding,%20shift%20of%20curve.%20HbF%20curve%20shift)..

![](https://f001.backblazeb2.com/file/wikiFiles/SvFq3OX.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/iVKtWbp.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/6BQEIlU.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/mrUhEV0.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/omwonDY.jpg)

## CO

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/CO%20binding%20result,%20curve/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/B2YUEQb.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/9NfYNEY.jpg)

* loses cooperativity

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/CO%20symptoms%20and%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/lOjpA6V.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/sM61Irl.jpg)

## MetHB

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/MetHb%20pathogenesis,%20binding%20result,%20curve/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/b33dnM8.jpg)

* rest of Fe2 binds O2 with higher affinity, left shift curve

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/MetHB%20causes%20and%20treatment.%20Classic%20case%20and%20symptoms)..

![](https://f001.backblazeb2.com/file/wikiFiles/imePscE.jpg)

* methylene blue reduces Fe3 to Fe2
* vitamin C reduces Fe3 to 2

![](https://f001.backblazeb2.com/file/wikiFiles/NOiRjtT.jpg)

* SOB from methemoblobinemia
* interferes with pulse ox
* normal amount of O2 in blood

## CN

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/cyanide%20binding%20pathogenesis%20and%20result,%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/mQMJpHG.jpg)

* functional hypoxia: enough O2 around but can't use them
* inhibits cytochrome oxidase a3

![](https://f001.backblazeb2.com/file/wikiFiles/rYaruwZ.jpg)