general malaise
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A?
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| robin082006
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B?
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| docwannbe
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i think its (b)
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| mjl1717
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my pure guess is answer-b ( its the only one that has to do directly with O2 affinity or Caissons disease)
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| guangyu
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I think it is something wrong about Fe, so i go for c
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| truedeam59
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I go for C. Chocolate blood is may be due to increased iron
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| doc179
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I dont think increased proportion of iron means the iron is in ferric state...may be its B? 
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| Slacker
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C. The child has drank nitrate contain water which has caused metHb. Thus in the Hb the iron Fe2 has became Fe3. Hence oxygen can't bind to the Hb. The reason for chocolate colored blood is that there is No oxygen bound to the Hb!!!!!!!!!
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| nadiabarati
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ok but why increased proportion of Fe???!!
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| leen
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to nadia ....its a request ......pl post the right ans to ur qs ...all wait for it ....
even if u dont have the explanation for it or u get the q from some other forum ,then pl post wat the ppl there say could be the right ans....
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| Slacker
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Nitrite and sulfur are oxidizing agent. They oxidize the heme group to Fe3. For treatment u can' use methylene blue which activates metHb reductase(which converts Fe3 to Fe2) or u can use ascorbic acid, which directly reduces Fe3 to Fe2. Thats the only thing i know bout it it because thats all dr. Goljan said bout it.
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| nadiabarati
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leen I don't know the answer. But slacker seems logical regarding methemoglobin. But I'm still wondering why conversion of Fe2+ to Fe3+ or oxidation means increased proportion of Fe?!!!!
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| robin082006
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Nitrate intoxication---> hypoxemia---> increased BPG
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| doc179
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to me B looks right as conversion of ferrous to ferric does not mean the proportion of iron is increased , its just the valency which is increased and not the proportion I guess.
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| usmlebaby
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agree with B
erythrocyte 2,3BPG cause unloading of o2 at tissue level and reduce o2 saturation at lungs.
Nitrate cant cause methemoglobinemia but only cause by nitrite so nitrite is mostly use in the treatment of
cyanide poisoning.
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| rj
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IT IS C.LOOK AT FIRST CELL INJURY FROM GOLJAN' S NOTES.
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| rj
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IT IS C.LOOK AT FIRST CELL INJURY FROM GOLJAN' S NOTES.
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| vallia
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Nitrate is reduced to nitrite in the stomach of infants and nitrite is able to oxidise Hb to metHb which is unable to transport oxygen around the body. When MetHb reach 10% of normal Hb concentration, appear the cianosis, "baby blue syndrome". The chocolate colored blood is a result of the dark-colored MetHb.
Now , hemoglobin structure contain a heme and a prostetic group. Heme is a complex of protoporfirin and ferrous iron Fe2+. The iron is held in the center of the heme and can form 6 bonds , 4 with the nitrogen from the prostetic group and 2 more bonds, one for the histidine residue from globin and the other one is for oxygen..Hb has a tetrameric molecule so can bind maximum 4 moleculles of O2.. and now we arrive at the problem. The ability of Hb to bind O2 depens on 4 factors (the allosteric effectors,)pO2, PCo2, pH, and 2,3BPG.
What does 2,3 BPG
HBO2 +2,3 BPG <-----> Hb-2,3 BPG + O2
so 2,3 BPG bind to deoxyHb lowering o2 affinity for Hb and permitting greater release of O2 to tissues.
i'll go with B
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| docsrinu
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explanations by slacker & vallia appear to be right. unable to decide the answer. can someone help.
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