1.

) What is the difference between oxyhemoglobin and reduced hemoglobin

(deoxyhemoglobin) in terms of structure?
Background Check
The major distinction between oxyhemoglobin and deoxyhemoglobin is that
oxyhemoglobin is hemoglobin that has been loosely coupled with oxygen, whereas
deoxyhemoglobin is hemoglobin that has released its bound oxygen. In addition,
oxyhemoglobin is brilliant red in color, whereas deoxyhemoglobin is purple. Inside the
blood vessels, there are two types of hemoglobin: oxyhemoglobin and
deoxyhemoglobin. Both have a connection to red blood cells. Hemoglobin's primary job
is to transport oxygen to the metabolizing tissue in the vertebrate body.
Oxyhemoglobin
The oxygen-bound form of hemoglobin is called oxyhemoglobin. The hemoglobin
component of red blood cells is exposed to oxygen and loosely attached to it during
lung respiration. The binding of oxygen to hemoglobin happens when the blood has a
high pH, low carbon dioxide, and a high temperature which is often seen inside the
lungs. The heme draws the iron (II) into the porphyrin ring when the first oxygen
molecule binds to the iron (II). This minor conformational alteration enables the
hemoglobin to attract three more oxygen molecules. In its completely saturated state,
oxyhemoglobin includes four bonded oxygen molecules. As a result, oxyhemoglobin is
classified as hemoglobin in the relaxed (R) state. Oxygenated blood is blood that
contains oxyhemoglobin. Under the force exerted by the heart, oxygenated blood
travels via arteries away from the heart. Blood that has been oxygenated is vibrant
scarlet in color. During the creation of ATP, oxygen is employed as the last electron
acceptor when oxyhemoglobin drops oxygen at the cells, a process known as oxidative
phosphorylation. When oxygen is removed from the blood, the pH of the blood drops.
Deoxyhemoglobin
Hemoglobin that has released oxygen is known as deoxyhemoglobin. Because of the
low pH, high carbon dioxide content, and low temperature, oxygen is released at the
metabolizing tissue. The tensed (T) state of hemoglobin is caused by the release of
oxygen molecules. The purplish-colored deoxyhemoglobin is delivered to the heart by
veins. Deoxygenated blood is blood that contains deoxyhemoglobin. It may bind with
oxygen in the lungs and generate oxyhemoglobin, which raises the pH of the blood. The
purplish-colored deoxyhemoglobin is delivered to the heart by veins. Deoxygenated
blood is blood that contains deoxyhemoglobin. It may bind with oxygen in the lungs and
generate oxyhemoglobin which raises the pH of the blood.
Structural Differences
The a and b chains are paired in hemoglobin,
with one a chain and one b chain closely
linked in a dimer. Alpha-1beta-1 is one dimer
while alpha-2beta-2 is the other. When
oxygen is bound, hemoglobin's structure
alters slightly. The tense condition of
deoxyhemoglobin which has no oxygen
attached to it is referred to as "T." When
oxygen binds to a molecule, the molecule
relaxes enabling the Fe to migrate closer to
the protoporphyrin plane. The condition is
referred to as "R" which stands for "relaxed." The molecules of deoxyhemoglobin are
packed very close together. The iron atom, in fact, does not exactly fit within the plane
established by the protoporphyrin and rests a bit below it. After oxygen is bound, the
molecular structure relaxes a bit and the iron moves closer into the protoporphyrin
plane.
Alteration of Structure
The T conformation of deoxyhemoglobin is maintained by C-terminal arginine carboxyl
group of alpha-1 with amino group of lysine in alpha-2 and C-terminal arginine group of
alpha-1 with carboxyl group of aspartic acid in alpha-2. These alpha-1 and alpha-2
bridges cannot be formed in oxyhemoglobin. During oxygen uptake, the T form switches
to the R form with disruption of the salt bridges. Hemoglobin subunits are moved
relative to one another. During oxygenation, the alpha1-beta2 interface shows
movement. The two subunits slip over each other. The binding of the iron to oxygen is
now stronger. Thus, the R form has a higher affinity for oxygen.

2.) Why does blood coagulate? Briefly describe the mechanism for blood clotting.
Hemostasis
Blood flows smoothly via the intact lining (endothelium) of blood vessel walls in normal
circumstances. When the wall of a blood vessel breaks, a chain of events kicks off the
process of hemostasis or stopping the bleeding. Many substances found in plasma as
well as those produced by platelets and damaged tissue cells are involved in this quick
and localized reaction. Vascular spasms, platelet plug formation, and coagulation, or
blood clotting are the three primary phases of hemostasis which occur in quick
succession. Fibrous tissue forms into the clot and plugs the opening in the blood vessel
preventing blood loss at the spot.
Vascular spasms will happen. Vasoconstriction, which induces blood vessel spasms, is
the body's first response to blood vessel damage. The spasms constrict the blood
vessel, reducing blood loss until clotting can take
place.
A platelet plug develops. When the underlying
collagen fibers of a ruptured vessel are revealed,
platelets become sticky and adhere to the injured
spot. Platelets that have been anchored emit
substances that increase vascular spasms and
attract additional platelets to the area. A platelet clog
occurs as more platelets accumulate.
Coagulation can happen. During this moment,
wounded tissues release tissue factor which
interacts with platelet factor 3, a phospholipid that
coats platelet surfaces. This composition combines
with other clotting factors and calcium ions to
generate an activator that leads to the synthesis of
thrombin, an enzyme. The soluble fibrinogen
proteins are subsequently joined by thrombin to form
long hair-like molecules of insoluble fibrin. Fibrin
creates a meshwork that captures RBCs and serves
as the clot's foundation. Within an hour, the clot
begins to retract sucking serum from the mass and
bringing the blood vessel's burst edges closer
together.
Blood normally clots in 3 to 6 minutes. The triggering
factors are usually inactivated quickly once the
clotting cascade has started to prevent extensive clotting. The endothelium regenerates
over time and the clot dissolves. Once these steps in the clotting cascade were
recognized, it was evident that covering a cut with sterile gauze or applying pressure to
a wound would hasten the clotting process. The gauze offers a rough surface for
platelets to attach to and the pressure breaks cells causing tissue factor to be released
more locally.

3.) Why must a 24-hour period sample of urine be used for examination if a detailed
composition is to be determined?
Background Check
A 24-hour urine collection is a standard lab test that determines the contents of your
urine. The test is done to determine how well your kidneys are working. A 24-hour urine
collection involves collecting your urine in a particular container for the whole day. Until
the urine is returned to the lab, the container must be kept cold. Water and dissolved
chemicals such as sodium and potassium make up urine. It also has urea in it. When
protein is broken down, this is produced. It also includes creatinine a byproduct of
muscle breakdown. These waste products are normally seen in small concentrations in
urine. If these values are outside of the normal range, it might indicate the presence of a
disease or condition. Or if there are other compounds present.
Non-protein Nitrogen
Urea, creatinine, and uric acid are among these. Urine is the primary route of excretion
for these compounds. The levels of these compounds in plasma are higher with kidney
failure. Creatinine test is the most specific and sensitive indicator of renal function of the
three. Other minor components of NPN are urobilinogen, indican, ammonia and amino
acids. Estimation of NPN along with electrolytes and assessment of acid-base balance
are used as a panel of tests to indicate abnormalities in kidney function.
Creatinine Clearance Test
Creatinine is a waste product that results from the breakdown of creatine phosphate.
This is a non-enzymatic spontaneous conversion that is reliant on the body's total
muscle mass. It is unaffected by diet, age, or physical activity. Because of their
decreased muscle mass, women and children excrete less creatinine than males.
Approximately 98 percent of the creatine pool is found in muscle. On a daily basis,
around 1.6 percent is converted to creatinine, which is quickly eliminated.
Creatinine is an appropriate material for clearance tests since its synthesis is constant
and the blood level does not change substantially. Because creatinine excretion is
consistent in a given individual, urine creatinine is occasionally used to determine
whether or not a 24-hour urine sample contains complete urine volume. This is critical
for collecting urine from young and mentally ill people. To avoid the inconvenience of
collecting urine, it is currently common practice to report urinary concentrations of
various compounds per gram of creatinine rather than per 24-hour urine. The value of
creatinine clearance lies in the early diagnosis of kidney dysfunction without obvious
indications or symptoms. Changes in plasma creatinine that may not appear to suggest
improper function can cause significant changes in clearance. The clearance value will
be reduced by 50% if plasma creatinine rises another mg. Other drugs' clearance levels
will not decline as much.
Long-term monitoring of patients with renal insufficiency on a protein-restricted diet is
made much easier with this test. It's possible that a clearance number of up to 75% of
the average normal value indicates appropriate renal function. The clearance of older
individuals is reduced.

4.) What is meant by glucosuria? Albuminuria?

Glycusuria
Glycosuria occurs when blood sugar (glucose) is excreted in the urine. Normally, every
liquid that goes through the kidneys absorbs blood sugar and returns it to the blood
vessels. The kidneys may not be able to remove enough blood sugar from urine before
it leaves the body if there is a certain case of glycosuria. This happens frequently when
blood glucose level is unusually high. Even if the blood sugar levels are normal or low,
glycosuria can occur. Renal glycosuria is the medical term for this condition.
Causes
Glycosuria is usually induced by a blood glucose disorder such as diabetes. Glycosuria
is most commonly caused by type 2 diabetes. Insulin in the body does not act correctly
in one of two ways. In other circumstances, insulin is unable to efficiently transfer blood
sugar into the body's cells. Blood sugar may instead be excreted in urine as a result of
this. In certain circumstances, the body may not produce enough insulin to keep blood
sugar levels in check. Any extra blood sugar is excreted in the urine.
Glycosuria can also occur in pregnant and develop gestational diabetes. When
hormones from baby's placenta hinder the body's insulin from correctly managing the
blood sugar, this develop into diabetes. This can result in dangerously high blood sugar
levels. Gestational diabetes can be avoided. Renal glycosuria is a kind of glycosuria
that is substantially less common. When the renal tubules in the kidneys, the sections of
the kidneys that function as filters in urinary system that don't filter blood sugar out of
the urine adequately, this happens. A mutation in a single gene is frequently the cause
of this condition. Renal glycosuria, unlike glycosuria produced by type 2 diabetes, isn't
always caused by general health or lifestyle choices.
Diagnosis
Glycosuria can be diagnosed in a variety of methods, but the most frequent method is
urinalysis. The doctor will ask the patient to urine on a test strip that will be submitted to
a lab for analysis. The urine glucose levels will be checked by a lab professional to see
if there is a glycosuria. If the amount of glucose in the urine is more than 180 milligrams
per deciliter (mg/dL) in a single day, glycosuria may be the reason. Blood tests to
assess the blood sugar may also be ordered by the doctor. Depending on whether the
patient eaten lately or whether patient has diabetes, normal blood sugar levels range
from 70 to 140 mg/dL.
If the blood sugar levels are high and haven't been diagnosed with diabetes yet, the
doctor would most likely order an A1C test. This blood test will reveal the blood sugar
levels throughout the last several months.
Treatment
Glycosuria isn't a reason for alarm in and of itself. If a person don't have an underlying
ailment that causes to pass large amounts of glucose in the urine, there's no need for
therapy. If glycosuria is caused by a condition like diabetes, doctor will work with the
patient to design a treatment plan. Possible treatment and management options include:
Getting at least 30 minutes of physical activity every day, Developing a diet plan, Taking
medications to help body use insulin more effectively, Keeping track of the blood sugar
levels so that it can be better to understand how the body reacts to certain foods,
activities, or therapies
Albuminuria
Albumin is a kind of protein that may be present in the bloodstream. Protein is required
by the body. It is an essential vitamin that aids in the development of muscle, tissue
regeneration, and infection resistance. However, it should be in the blood rather than in
urine. Albuminuria or proteinuria refers to the presence of albumin in the urine.
Diagnosis
A simple urine test is available. This is a regular examination. A patient will be asked to
urinate into a specimen cup, which is a clean cup. The test requires only a tiny sample
of the urine, approximately two teaspoons. A dipstick, a tiny plastic strip that is inserted
in the urine is used to examine some of the urine immediately away. The rest is
examined under a microscope before being submitted to a laboratory for an ACR
(albumin-to-creatinine ratio) test. An ACR determines whether albumin is present in the
urine. Albumin levels in the urine should be fewer than 30 mg/g. Even if GFR is at 60,
anything above 30 mg/g might indicate kidney disease.
Why is it bad?
Kidneys filter the blood which is one of their primary functions. The kidneys store crucial
substances in blood such as protein that the body need. They also get rid of waste
materials and excess water that the body doesn't require. If the kidneys are in good
shape, it should have very little protein in urine, if any at all. Protein can leak out of
kidneys into the urine if kidneys are damaged.
Although albuminuria may be an early symptom of kidney disease, the doctor may
examine again to be sure it isn't caused by something else, such as not drinking enough
water. The albumin test will be redone if the doctor feels if someone has kidney
problems. It's a symptom of kidney disease if a person have three positive findings in
three months or more. GFR is a measurement of how well the kidneys are functioning.
A healthcare professional will develop a treatment plan if kidney disease is diagnosed.
A diagnosed individual may also be sent to a nephrologist, a specialist in kidney
disease. Therapy may involve the following: Medications, Changes in your diet, Lifestyle
changes such as losing extra weight, exercising, and stopping smoking, Speak to your
healthcare provider.

5.) Discuss the symptoms and treatment of blood/urine related diseases.

a.Anemia b.Leukopenia c.Thrombocytopenia d.Enuresis e.Nephrolith

Anemia
Anemia is a disorder in which body's tissues don't get enough oxygen because there is
no enough healthy red blood cells. Feeling fatigued and weak is a symptoms of anemia.
Anemia comes in a variety of types, each with its unique etiology. Anemia can be minor
to severe, and it can be transitory or long-term. If a person has anemia, see a doctor. It
might be an indication of something more serious. Anemia can be treated in a variety of
ways, from taking vitamins to undergoing medical treatments. Some kinds of anemia
may be prevented by eating a healthy, diversified diet.
Symptoms
Depending on the causes of your anemia, you might have no symptoms. Signs and
symptoms, if they do occur, might include: Fatigue, Weakness, Pale or yellowish skin,
Irregular heartbeats, Shortness of breath, Dizziness or lightheadedness, Chest pain,
Cold hands and feet, Headaches. Anemia might be so subtle at first that it goes
unnoticed. However, when anemia progresses, symptoms intensify.
Treatment
First, the doctor will determine if the anemia is due to a poor diet or a more significant
health concern. The anemia as well as the cause of the anemia can then be addressed.
Treatment for iron deficiency anemia includes: Iron supplements are administered
orally, Iron-rich diets and meals that aid in iron absorption like foods with Vitamin C, An
intravenous infusion of iron is provided, Red blood cell transfusions.
If internal bleeding is the source of the anemia, the doctor may need to perform surgery
to stop it. Anemia has been treated with surgical correction in persons with
paraesophageal hiatal hernias, both with and without ulcers. Other kinds of anemia may
necessitate different treatments. Genetic diseases such as beta thalassemia and sickle
cell anemia, for example, may necessitate a bone marrow transplant.

Leukopenia
Leukopenia is a condition in which a person's circulation has fewer white blood cells
than it should. A complete blood count or CBC test is used to identify leukopenia.
Between 3,500 to 11,000 white blood cells per microliter are considered healthy.
Leukopenia causes a person's white blood cell count to drop below 3,500 per microliter.
The immune system relies on white blood cells which are produced in the bone marrow.
When the body has too few of them, it is less equipped to fight infections and illnesses.
Symptoms
A low white blood cell count is not associated with any specific symptoms. People with
leukopenia, on the other hand, are more susceptible to infections. The following are
some of the symptoms of infection: Fever, sweating, chills.
Treatment
Depending on what's causing your leukopenia, you'll have different therapy choices.
The following are some of the treatments: Treatment that produces low white blood cell
counts should be stopped. Medication, chemotherapy, or radiation may be used.
Growth factor therapy is a bone marrow-derived treatment that stimulates the
generation of white blood cells. Low-bacterial diet, a diet that limits your exposure to
bacteria present in foods like raw, unwashed produce and undercooked meat.
Medications treatment that aids in the production of blood cells or combats the illness
that is producing low white blood cell levels.

Thrombocytopenia
Thrombocytopenia is a condition in which the blood platelet count is abnormally low.
Platelets are colorless blood cells that aid in the clotting process. Platelets cluster
together and form plugs in blood vessels to halt bleeding. A bone marrow disorder such
as leukemia or an immune system problem can cause thrombocytopenia. It might also
be an adverse effect of some drugs. Both children and adults are affected.
Thrombocytopenia can be minor with minimal symptoms or indicators. Rarely, the
amount of platelets might be so low that internal bleeding becomes serious. There are
several treatment methods available.
Symptoms
Thrombocytopenia signs and symptoms may include: Easy or excessive bruising,
Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple
spots (petechiae), usually on the lower legs, Prolonged bleeding from cuts, Bleeding
from your gums or nose, Blood in urine or stools, Unusually heavy menstrual flows,
Fatigue, Enlarged spleen.
Treatment
Thrombocytopenia can persist anywhere from a few days to several years. Mild
thrombocytopenia may not necessitate therapy. Treatment for thrombocytopenia varies
depending on the origin and severity of the condition. If the thrombocytopenia is caused
by an underlying ailment or a medicine, treating the underlying illness or drug may be
enough to cure it. Other treatments might involve: Blood or platelet transfusions,
Medications, Surgery, Plasma exchange.
Enuresis
Involuntary urine during sleeping also known as nighttime incontinence or nocturnal
enuresis occurs after the age at which being dry at night may be fairly expected. In
many families, wet sheets and pajamas as well as a humiliated youngster are a
common sight. But don't lose hope. Bedwetting isn't an indicator of failed toilet training.
It's usually just a regular aspect of a child's growth. In general, bedwetting before the
age of seven isn't a cause for concern. Your child may still be establishing nightly
bladder control at this age. If bedwetting persists, approach it with care and
understanding. Lifestyle changes, bladder training, moisture alarms and sometimes
medication may help reduce bed-wetting.
Symptoms
Most children are toilet trained by the age of five but there is no set age for achieving
total bladder control. Bedwetting is still a problem for some children between the ages of
5 and 7. Even at the age of seven, a tiny percentage of youngsters still pee the bed.
Treatment
Moisture alarm. This compact battery-operated gadgets attach to a moisture-sensitive
pad on the child's pajamas or bedding and are available without a prescription at most
pharmacies. The warning sounds when the pad detects moisture. The wetness alarm
should ring just as the kid starts to urinate giving parents enough time to help the child
to wake up, halt the urine flow, and get to the bathroom. If the child sleeps a lot,
someone else may need to listen for the alarm and wake them up.
Nephrolithiasis
Kidney stones are hard mineral and salt deposits that occur inside the kidneys. Kidney
stones can be caused by a variety of factors including diet, excess body weight, certain
medical conditions, and certain supplements and drugs. From your kidneys to your
bladder, kidney stones can harm any component of your urinary tract. When urine gets
concentrated, minerals crystallize and bind together, resulting in stones. Kidney stones
can be quite painful to pass but if caught early enough, they typically do not cause
permanent harm. To clear a kidney stone, one may only need to take pain medication
and drink plenty of water depending on the circumstances. Surgery may be required in
some cases such as when stones become trapped in the urinary system are connected
with a urinary infection or create problems.
Symptoms
A kidney stone normally does not produce symptoms until it travels about inside your
kidney or travels into your ureters, which are the tubes that link your kidneys and
bladder. If it becomes trapped in the ureters, it can obstruct urine flow and cause the
kidney to enlarge and the ureter to spasm, both of which can be quite painful.
 Severe, sharp pain in the side and back, below the ribs
 Pain that radiates to the lower abdomen and groin
  Pain that comes in waves and fluctuates in intensity
 Pain or burning sensation while urinating
Other signs and symptoms may include:
 Pink, red or brown urine
 Cloudy or foul-smelling urine
 A persistent need to urinate, urinating more often than usual or urinating in small
amounts
 Nausea and vomiting
 Fever and chills if an infection is present

Treatment
The majority of minor kidney stones do not necessitate invasive treatment. One might
be able to get by with a little stone: Drinking water, Pain relievers, Medical therapy.
Larger kidney stones as well as those that cause bleeding, kidney damage, or recurrent
urinary tract infections may necessitate more aggressive therapy. The following
procedures may be used: Using sound waves to break up stones, Surgery to remove
very large stones in the kidney, Using a scope to remove stones, Parathyroid gland
surgerys

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