Red blood cells contain hemoglobin and transport oxygen around the body. A normal red blood cell count is 4.0-5.9 million cells per liter of blood for men and 3.8-5.2 million cells per liter of blood for women. Low red blood cell count can be caused by iron deficiency anemia, vitamin deficiencies, internal bleeding, or kidney disease. High red blood cell count can be caused by smoking, congenital heart disease, dehydration, or low blood oxygen levels. Hemoglobin is a protein in red blood cells that carries oxygen, with each hemoglobin molecule able to carry 4 oxygen molecules. Oxygen binds to hemoglobin in the lungs and is released from oxyhemoglobin in tissues where

1. Worksheet – case study 2
Let’s recap!
I) Red blood cells
DEFINITION What are red blood cells?
Red blood cells are specific cells in the blood that contain hemoglobin.
• Function: transport hemoglobin around the body
Normal red blood cell count
• Men: 4.0 - 5.9 million in 1 liter of blood
• Women: 3.8 - 5.2 million in 1 liter of blood
Abnormal red blood cell count
Low red blood cell:
• Iron deficiency anaemia (tiredness, delayed growth, weak and fragile bones)
• Vitamin B6, B12 or folate deficiency (tiredness, delayed growth, weak and fragile
bones)
• Internal bleeding, kindnye disease, malnutrition
High red blood cells count:
• Smoking
• Congenital heart disease
• Dehydration
• Low blood oxygen
• Pulmonary fibrosis
II) Haemoglobin
DEFINITION What is hemoglobin?
Hemoglobin is a protein that carriers oxygen in the blood.
• 4 chains that contain each a haem group and an iron ion
• One hemoglobin can carry 4 molecule of oxygen
III) Oxygen transport
• At high oxygen concentration in the lungs: oxygen binds to haemoglobin in red
blood cells and forms oxyhaemoglobin.
• At low oxygen concentration in the organs: oxyhaemoglobin turns into
haemoglobin.

2. Patient presentation
Patient X is a 6 months old baby and presents at his GP with severe tiredness and
weakness. Upon examination the GP notices that his skin is pale and yellowish. When
listening to his heart he notices his heart fluttering with irregular heartbeats
(palpitations). Doctor also notices the patient presents delayed growth and
development.
The GP decides to take a blood sample to be tested for anaemia and abnormal
haemoglobin. A lab technician will also look at the blood under a microscope to see if
the red blood cells are oddly shaped.
Results: Full blood count
RBC: 3.6 million per L of blood
Platelet count: 357,198 per microliter (normal range: 150,000 to 450,000 per microliter)
White blood cells: 7,546 per µL of blood (normal range: 5,000-10,000 µL of blood)
After receiving the results, the doctor analyses them and tries to come up with a
diagnosis and a potential treatment.
With your teammates, discuss and answer these questions using the
padlet.