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Topic: How to identify which patient is in more serious danger?  (Read 3822 times)

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Offline ashleigh

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How to identify which patient is in more serious danger?
« on: September 06, 2010, 06:41:26 AM »
Here is the senario and question i am having trouble finding any information specific to this case.

Though carbon monoxide (CO) is hindered in its binding by the distal histidine, hemoglobin’s affinity for CO is nonetheless about 200 times that for hemoglobin compared to that for O2.  Like oxygen, carbon monoxide shows positive cooperativity in binding to the heme sites of hemoglobin. A molecule of carbon monoxide and a molecule of oxygen can bind to the hemoglobin tetramer at the same time, though at different heme-binding sites. Use this information to analyze the following clinical situation.

Two people are in a hospital emergency room.  John’s blood hemoglobin concentration is one-half the normal value (only one-half the normal number of hemoglobin molecules are present).  David has been poisoned with carbon monoxide by car exhaust, such that the number of oxygen binding sites available to bind oxygen is only one-half the normal value (because, on average, every hemoglobin molecule has two carbon monoxides bound to two of its four hemes).  Assuming that John and David are otherwise similar, which patient is in more serious danger?

Offline Guitarmaniac86

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Re: How to identify which patient is in more serious danger?
« Reply #1 on: September 06, 2010, 07:32:17 AM »
You know that David has been poisoned by the car exhaust fumes. How does CO bind to the haemoglobin? Could the way CO binds to the Haemoglobin be an issue?
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