Any of the following could be an explanation for the invalid hemoglobin for Mary Jones (Questions 13 through
a. The blood sample is hemolyzed.
b. Lipemia is present in the plasma.
c. The patient has hemoglobin S (Hb S).
d. The patient's white count is 150.0 ยด 109/L.
ANS: A
If red cells have been hemolyzed in the blood sample, then it will have no effect on a manual hemoglobin because red cells are lysed to determine the hemoglobin. However, the red count will be falsely low. Lipemia, Hb S in which cells are more resistant to lysis, and a high white count all add turbidity to the hemoglobin dilution. This increases the optical density (decreases percent transmittance) and falsely elevates the hemoglobin calculation.
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