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MCQ – 85784

Question

Regarding hemoglobinopathies, identify the correct statements:

a. Hemoglobin S (HbS) is caused by substitution of valine for glutamic acid at the 6th position of the β-globin chain.
b. Hemoglobin H (HbH) disease results from deletion of three α-globin genes.
c. Hemoglobin Bart’s (Hb Bart’s) results from deletion of all four α-globin genes.
d. Hemoglobin C (HbC) is caused by substitution of lysine for glutamic acid at the 6th position of the β-globin chain.

A. a and b are true; c and d are false
B.

b and c are true; a and d are false

C.

b and d are true; a and c are false

D.

a, b, c, and d are true

Show Answer

Correct Answer » D

Explanation

a. HbS — True 

  • HbS is caused by a point mutation in the β-globin gene.
  • The mutation occurs at the 6th position of the β-globin chain.
  • Glutamic acid is replaced by valine.

Mutation:

β6 Glu → Val

Original statement error:

  • It states lysine for glutamine, which is incorrect.
  • The correct substitution is valine for glutamic acid.

b. HbH disease — True

  • Normally, there are four α-globin genes.
  • Deletion of three α-globin genes causes HbH disease.
  • Excess β-globin chains form tetramers.

HbH:

β₄

Clinical features:

  • Microcytic anemia
  • Hemolytic anemia
  • Splenomegaly

c. Hb Bart’s — True 

  • Hb Bart’s occurs due to deletion of all four α-globin genes.
  • During fetal life, excess γ-globin chains form tetramers.

Hb Bart’s:

γ₄

Clinical consequence:

  • Severe anemia
  • Hydrops fetalis
  • Usually fatal without treatment

Original statement error:

  • It states deletion of four β-globin genes.
  • The correct abnormality is deletion of all four α-globin genes.

d. HbC — True

  • HbC is caused by a point mutation in the β-globin gene.
  • The mutation occurs at the 6th position.
  • Glutamic acid is replaced by lysine.

Mutation:

β6 Glu → Lys

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