Methemoglobin: An Unlikely Explanation for Cyanosis
Methemoglobinemia is an uncommon but possible reason for cyanosis. Methemoglobinemia is significant because the disease is fairly rare and consequently most physicians do not consider it as a cause when diagnosing a patient with cyanosis. Regrettably, patients often get misdiagnosed and sometimes treated for the wrong disorder as a result. A two fold dilemma occurs when the patient is treated for an incorrect disorder. The first part of the dilemma includes the patient experiencing all of the negative side effects of the wrong treatment, and gaining no benefit. The second part of the dilemma is that the patient’s actual medical condition is not being treated, and is getting worse with time. The higher the level of methemoglobin in the blood the higher the patient’s chances of dying are. Another thing for doctors to acknowledge is when methemoglobinemia is not considered a valid diagnosis; numerous unnecessary laboratory tests are performed. When unneeded laboratory tests are performed the medical laboratory technologist’s time is wasted when they could be running another patient’s samples. Also running unnecessary laboratory tests costs a great deal of money. During the analysis of cyanosis, physicians should consider methemoglobinemia as a valid diagnosis.
The Fugate family is better known as the Blue People of Troublesome Creek, Kentucky are unusual [12, 6]. As their name suggests, their skin is indeed a blue color. The Fugate family is quite large and keeps to themselves near the Appalachian Mountains in eastern Kentucky. Their story started with Martin Fugate, who may or may not have been blue. In the 1820’s, Martin married a pale and red haired woman named Eli...
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... away [5]. Something for laboratory managers and supervisors to consider is to have a CO-oximeter in the laboratory, since it can measure and distinguish between 4 different types of hemoglobin [13].
Methemoglobinemia for the most part is easily treated, as long as it is diagnosed properly on time. Early diagnosis is necessary because high levels of methemoglobin in the blood can be lethal. To prevent patients and hospitals from costly unnecessary laboratory tests, a CO-oximeter should be present in the medical laboratory. Couples that are consanguineous and are considering having children should get genetic counseling. People, especially the elderly, the young, and the immunosuppressed, should be aware of certain chemicals or medications that can cause the acquired form of the disease. Early detection of methemoglobinemia is the key to a favorable outcome.
Questioning looks, dirty gazes, and the snide babbles were all too accustomed to Ruth McBride, when she walked down the street with her tow of children. James McBribe, one of the dozen children from her two elopements, was often ashamed as well as scared. They had to prolong the worse racial monikers. His mother, who was white, maintained unattended, “Whenever she stepped out of the house with us she went into a somewhat mental zone where her attention span went no farther than the five kids trailing her,” McBride subsequently wrote “My mom had absolutely no interest in a world that seemed incredulously agitated by our presence. The remarks and stares that we heard as we walked about the world went right over our head.” Her indomitable spirit and her son’s recollections became the basis of “The Color of Water”. In the work there is a great presence of God and the fortitude he unconditionally sends, especially to Ruth. Although Ruth’s clout frequently surpassed her circadian problems, she would more regularly rely on God for her vigor.
Hemoglobin is composed of four subunits (beta/Alpha) containing a heme group which binds an iron and that iron binds to the oxygen. The blueness of the skin occurs when, rather than carrying oxygenated hemoglobin, our blood carries deoxygenated hemoglobin in increased amounts “>5 g/dL”. In this case, the baby is experiencing central cyanosis, which is abnormal and needs to be treated immediately. When the doctor attempted to give the baby oxygen via nasal cannula, it did not change the blood oxygen saturation because although the concentration of blood oxygen levels increased, there is too much deoxyhemoglobin to cause the blood oxygen saturation percent to increase back to its normal state. Cyanosis occurs either because of decrease of oxygen in the blood, or due to a congenital heart defect known
A 54 year old female was presented with complaints of lethargy, excessive thirst and diminished appetite. Given the fact that these symptoms are very broad and could be the underlying cause of various diseases, the physician decided to order a urinalysis by cystoscope; a comprehensive diagnostic chemistry panel; and a CBC with differential, to acquire a better understanding on his patient health status. The following abnormal results caught the physician’s attention:
In Charles Chestnutt’s “The Wife of His Youth,” Liza Jane is a woman who is determined to find her long lost husband, Sam Taylor. When he ran away from slavery and escaped up north, he left his wife behind. He changed his name to Mr. Ryder, to forget his past with slavery. Soon he became involved with a group called the Blue Veins, which were a group of people who believed in the preservation of light skinned blacks. In this group he was known as the dean. The Blue Vein society thought that dark skinned blacks were dirt and ignorant. Many years went by and Liza still felt that Sam was in love with her and that they would be back together.
The diminished rate of synthesis amongst the globin chains was first described from Cooley and Lee. However, the term “Thalassemia: was coined by Whipple and Bradford in 1936 (Bain, 2006). The term “Thalassemia” is derived from the Greek words “Thalassa” (sea) and “Heama” (blood) and refers to disorders associated with defective synthesis of the alpha or beta globin subunits of the hemoglobin molecule. Hemoglobin A (a2B2) is inherited. ...
Hemochromatosis is a disease which makes your body absorb all of the iron in food, instead of regulating iron intake. Hemochromatosis “attacks” the entire body, especially the places where most of the iron normally goes: the bloodstream and liver. Some symptoms of this disease are bone and joint discomfort, liver problems, irregular heartbeat, and an unusual bronzing of the skin. Armand Trousseau first described it in 1865 as Diabetes bronze, due to people with diabetes showing the bronze-skin symptom. It was thought to be quite rare at the time. About “⅓ or ¼ of people of Western European descent have th...
Beta thalassemia is placed under the group of inherited blood disorders that can be transferred from both the genes of parents into their children. Mutations in HBB gene (Haemoglobin subunit beta) provides the instructions to beta-globin which is a subunit haemoglobin consisting of 4 protein subunits. A lack of Beta-globin can lead to a reduction of Haemoglobin and by not having an enough Haemoglobin, blood cells won’t produce normally and cause a shortage of mature blood cells which can eventually lead Anemia
There are many causes of anemia in the body. Some factors include genetics and deficiencies in the diet. Ms. A claims that for the past 10 – 12 years menorrhagia and dysmenorrheal have been a problem for her. Menorrhagia is abnormal and heavy menstrual bleeding during menstruation (Mayoclinic, 2013). Menorrhagia can deplete iron levels in the blood and increase the risk of an individual to have iron deficiency anemia. This is the cause of Ms. A’s anemia. Moreover, Ms. A says that she constantly takes aspirin especially in the summer to prevent stiffness in the joints. Aspirin affects and hinders the production of red blood cells (Mayoclinic, 2013). From the description of anemia given above, the lack of red blood cells, leads to low levels of iron and therefore low levels of hemoglobin which in turn affects the transportation of oxygen and thereby causing shortness of breath. Ms. A’s initial complains of shortness of breath and fatigue is the reason why she went to see the physician.
A patient with sickle cell has inherited the condition from both parents, and it all starts in the hemoglobin. Hemoglobin is “an iron-containing protein in red blood cells that reversibly binds to oxygen” (Reece, Urry, Cain, Wasserman, Minorsky, & Jackson, 2011). Obviously, hemoglobin is an important substance for oxygen to be transported in red blood cells. However, a patient with sickle cell has irregular hemoglobin cause by inherited genes. This “oxygen delivery” system cannot function properly because a gene
Methamphetamine is said to have first made its appearance in the United States as early as World War II (Anglin, Burke, Perrochet, Stamper, & Dawud-Noursi, 2000). It was given to soldiers and pilots to increase their endurance as well as their attentiveness. Roughly two decades later, a liquid form of methamphetamine became available for the treatment of heroin addiction. It wasn’t until the 1990’s where it really began to be a problem. In trailer parks across Oregon, methamphetamine abuse was at an all-time high (Byker, 2011). By 2003, meth had begun spreading throughout the United States as the number of reports of meth labs increased from as far east as Florida.
I was on my Monday evening shift and I was assigned for eight patients where seven of them were older and this teen named Mr.Govanni was with sickle cell anemia. When I took the handover from the dayshift nurse, I particularly noticed this patient from my assignment list because of his age and condition and at the same time the nurse who handed over the duty specifically told me that the teen boy was non-cooperative and also I saw it from the chart that the patient was getting the normal saline at 75cc/hr, CBC result morning( 6 am) showed HB-82g/dl, WBC 10.6. According to doctor’s order repeat CBC at 1600hr and if the HB is less than 80 transfuse two units of PRBC and lasix 40 mg in between the transfusion.
Hypertrichosis, which is also known as Ambras Syndrome or Werewolf Syndrome, is excess growth of hair on parts of the body. Hypertrichosis can either be generalized meaning it covers the whole body or localized meaning it is only on a certain area. There are three different hair types that may be involved. They include Lanugo (long and silky), Vellus (replace Lanugo after birth except on the scalp and eyebrows), and terminal (course, thick, and pigmented). Generalized can include all three types while acquired usually involves vellus that turn into terminal. Along with being generalized or localized, Hypertrichosis is also separated into congenital or acquired classifications. Congenital means that this disorder was present at birth and may have been caused by mutations in the genes. While acquired means that it became present over time. The cause for congenital is typically genetics while the cause for acquired is influence by medical conditions such as metabolic disorders, cancer or even oral and topical drug treatments. Congenital Hypertrichosis Lanuginosa is thought to be caused by mutations on the eighth chromosome or spontaneous gene mutations. The main sign of Hypertrichosis is excess hair growth, especially in places that hair does not typically grow in. Symptoms of Hypertrichosis may be present because of underlying conditions or chemical imbalances and the side effects of some medications. When a patient is being diagnosed with Hypertrichosis, a Doctor will determine if this was congenital or acquired. Congenital has no cure but acquired are typically triggered by factors that can be reversed or lessened so the Doctor could try to find these triggers. Hypertrichosis can cause cosmet...
Hemoglobin S is an autosomal recessive mutation which means that a person must have two copies of the mutation in order for the disease to occur in the body (Maakaron). If a person carries one copy of the sickle cell trait, they will not have sickle cell anemia and will most likely not experience any negative effects. The children of someone carrying a sickle cell trait can inherit the gene and develop the disease if the other parent passes down another sickle cell trait. There is a twenty five percent chance of inheriting sickle cell anemia if both parents have just one sickle cell trait (Sickle Cell Anaemia).
Diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. Glucose comes from two different sources, your liver and food. It's also your brain's main source of fuel. Glucose is made and stored in the liver. When your blood sugar gets low then your liver will use the stored glucose to keep your blood sugar level normal. If you have diabetes it means you have too much glucose in your blood. This is where insulin comes in. Diabetes is a growing epidemic in America's many nutritional diseases. There are a few factors that can cause or increase a person's chance of getting diabetes. Poor nutritional choices are a big factor in the cause of diabetes. The sad part is the increase is happening to the young children and teenagers in America. I will talk about what diabetes is, the increase in diabetes and why it’s so high, the complications that follow the diagnosis, and how it can be treated or reduced with diet and exercise.
the proper way to count a fluid on a hemacytometer. Recently our lab purchased two new