Which of the following would be unexpected in homozygous Hb S?

a. High reticulocyte count
b. Hemoglobin A (Hb A)
c. Elevated hemoglobin F (Hb F)
d. Hemoglobin that is less soluble


ANS: B
Both b-globin genes are abnormal in homozygous Hb S. Therefore Hb A is not present unless the patient has received a red cell transfusion. Hb S is less soluble than normal Hb A, the reticulocyte count is elevated, and patients usually have a high Hb F.

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