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Nigeria's free digital learning hub. Videos, lecture notes, practice questions and leaderboards aligned with CCMAS, NBTE, NCCE, WAEC, NECO, IJMB and JAMB curricula.
Medical Laboratory Science · 400 Level
This is the complete lecture note for MLS 402 Medical laboratory haematology 1, prepared for Medical Laboratory Science students at 400 Level. You can read it online below, open it in the full viewer, or download the PDF for offline study. It pairs with the course's video lectures, so you can read and watch together.
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Course code: MLS 402 Course title: Medical Laboratory Haematology I Course credit load: 2 Units Series 1: Iron, Folate, And Vitamin B2 Metabolism In Haematology • Part 1.1: Iron metabolism in haematology • Sub-Part 1.1.1: Absorption, transport, and storage of iron • Sub-Part 1.1.2: Role of iron in haemoglobin synthesis • Sub-Part 1.1.3: Laboratory investigation of iron deficiency and overload • Part 1.2: Folate metabolism and its haematological significance • Sub-Part 1.2.1: Dietary sources and absorption of folate • Sub-Part 1.2.2: Folate in DNA synthesis and red blood cell formation • Sub-Part 1.2.3: Laboratory investigation of folate deficiency • Part 1.3: Vitamin B2 metabolism and its role in haematology • Sub-Part 1.3.1: Functions of riboflavin in cellular metabolism • Sub-Part 1.3.2: Riboflavin deficiency and its haematological effects • Sub-Part 1.3.3: Laboratory approaches to assessing riboflavin status • Part 1.4: Integrated metabolic pathways and clinical relevance • Sub-Part 1.4.1: Interrelationship of iron, folate, and vitamin B2 in red blood cell production • Sub-Part 1.4.2: Clinical manifestations of combined deficiencies • Sub-Part 1.4.3: Case studies and laboratory applications
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Introduction Iron, folate, and vitamin B2 are essential nutrients that play critical roles in blood formation and overall haematological health. Deficiencies or imbalances in these nutrients can lead to serious conditions such as anaemia, impaired DNA synthesis, and reduced red blood cell production. For medical laboratory scientists, understanding the metabolism of these nutrients is fundamental to diagnosing and managing haematological disorders. This Series therefore provides the foundation for appreciating how nutrient metabolism directly influences laboratory practice in haematology. The aim of this Series is to equip you with knowledge of iron, folate, and vitamin B2 metabolism, and to enable you to apply this understanding to laboratory investigations and clinical contexts in haematology. We shall commence this Series by examining iron metabolism, including absorption, transport, storage, and its role in haemoglobin synthesis, as well as laboratory investigations of iron deficiency and overload. Next, we will continue with folate metabolism, focusing on dietary sources, its role in DNA synthesis and red blood cell formation, and laboratory approaches to folate deficiency. Following that, we will explore vitamin B2 metabolism, considering its functions in cellular metabolism, the effects of riboflavin deficiency, and laboratory methods of assessment. Finally, we will wrap up by integrating these metabolic pathways, highlighting their interrelationships, clinical manifestations of combined deficiencies, and practical laboratory applications. Series Learning Outcomes Upon completing this Series, you should be able to: • SLO 1.1 define the processes of iron absorption, transport, and storage in the human body, • SLO 1.2 explain the role of iron in haemoglobin synthesis and its relevance to haematology, • SLO 1.3 analyse laboratory methods used to investigate iron deficiency and iron overload, • SLO 1.4 describe the dietary sources and absorption pathways of folate, • SLO 1.5 explain the function of folate in DNA synthesis and red blood cell formation, • SLO 1.6 evaluate laboratory investigations used to detect folate deficiency, • SLO 1.7 describe the metabolic functions of vitamin B2 (riboflavin) in cellular processes, • SLO 1.8 explain the haematological effects of riboflavin deficiency, • SLO 1.9 apply laboratory approaches to assess riboflavin status, and • SLO 1.10 integrate knowledge of iron, folate, and vitamin B2 metabolism to interpret their combined impact on red blood cell production and clinical manifestations of deficiency.
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 1.1 Iron Metabolism In Haematology 1.1.1 Absorption, transport, and storage of iron Iron is a vital mineral required for the production of haemoglobin, the protein in red blood cells that carries oxygen throughout the body. Iron absorption occurs mainly in the duodenum and upper jejunum, where dietary iron is taken up in two forms: haem iron from animal sources and non-haem iron from plant sources. Haem iron is absorbed more efficiently, while non-haem iron absorption depends on dietary factors such as vitamin C, which enhances uptake, and phytates, which inhibit it. Once absorbed, iron is transported in the blood bound to transferrin, a protein that delivers iron to tissues including the bone marrow. Excess iron is stored in the liver, spleen, and bone marrow as ferritin or haemosiderin, which act as reserves for future use. Fill in the blank: The protein that transports iron in the blood to tissues is called __________. Figure 1.1: Pathways of iron absorption, transport, and storage 1.1.2 Role of iron in haemoglobin synthesis Iron plays a central role in the synthesis of haemoglobin, which is essential for oxygen transport. Each haemoglobin molecule contains four haem groups, each with an iron atom at its centre. This iron atom binds oxygen reversibly, allowing red blood cells to pick up oxygen in the lungs and release it in tissues. Without adequate iron, haemoglobin production is impaired, leading to reduced oxygen delivery and symptoms such as fatigue and pallor. Fill in the blank: Each haem group in haemoglobin contains an atom of __________ at its centre.
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Plate 1.1: Structure of haemoglobin with iron atoms 1.1.3 Laboratory investigation of iron deficiency and overload Laboratory tests are crucial for assessing iron status. Serum ferritin reflects iron stores, while serum iron and total iron-binding capacity (TIBC) provide information about circulating iron and transferrin saturation. Low ferritin and high TIBC are typical indicators of iron deficiency anaemia. Conversely, high ferritin and transferrin saturation may suggest iron overload conditions such as haemochromatosis. Other tests include serum transferrin receptor levels, which rise in iron deficiency, and bone marrow iron staining, which provides a direct assessment of iron stores. These investigations guide diagnosis and management of iron-related disorders. Fill in the blank: A laboratory test that reflects iron stores in the body is __________. Marker Iron Deficiency Iron Overload (e.g., Hemochromatosis) Serum ferritin Low (reflects depleted iron stores) High (reflects excess iron storage) Serum iron Low High Total iron-binding capacity (TIBC) High (liver increases transferrin to capture scarce iron) Low/Normal (transferrin production decreases when iron is abundant) Transferrin saturation Low (<15%) High (>45–50%)
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Table 1.1: Laboratory markers of iron status Pilot questions 1.1 1. Name the two main forms of dietary iron. 2. Which protein transports iron in the blood? 3. State one factor that enhances non-haem iron absorption. 4. What is the role of iron in haemoglobin synthesis? 5. Which laboratory test reflects iron stores in the body? 1.2 Folate Metabolism And Its Haematological Significance 1.2.1 Dietary sources and absorption of folate Folate is a water-soluble B-vitamin that plays a vital role in cell growth and division. It is found in foods such as leafy green vegetables, legumes, citrus fruits, and fortified cereals. Once ingested, folate is absorbed mainly in the small intestine, where it is converted into its active form, tetrahydrofolate (THF). THF acts as a coenzyme in several metabolic pathways, particularly those involving the synthesis of nucleic acids. Fill in the blank: The active form of folate that functions as a coenzyme in metabolic pathways is __________. Figure 1.2: Folate sources and absorption pathway
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 1.2.2 Folate in DNA synthesis and red blood cell formation Folate is essential for DNA synthesis, as it provides methyl groups required for nucleotide production. Without adequate folate, DNA replication is impaired, leading to defective cell division. This is particularly critical in the bone marrow, where red blood cells are produced. Folate deficiency results in megaloblastic anaemia, a condition characterised by large, immature red blood cells that cannot function properly. Fill in the blank: Folate deficiency in the bone marrow leads to __________ anaemia. Plate 1.2: Comparison of normal and megaloblastic red blood cells 1.2.3 Laboratory investigation of folate deficiency Laboratory tests for folate status include serum folate and red blood cell folate measurements. Serum folate reflects recent dietary intake, while red blood cell folate provides a longer-term indication of folate stores. Low levels in either test suggest deficiency. Additional investigations may include homocysteine levels, which rise when folate is insufficient, and bone marrow examination, which may reveal megaloblastic changes. Fill in the blank: A laboratory test that reflects long-term folate stores is __________. Marker Typical finding in folate deficiency Serum folate Low (reflects immediate folate status in blood) Red blood cell folate Low (better indicator of long-term folate stores)
LA-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Marker Typical finding in folate deficiency Homocysteine Elevated (due to impaired methylation pathways without folate) Table 1.2: Laboratory markers of folate deficiency Pilot questions 1.2 1. Name two dietary sources of folate. 2. What is the active form of folate in the body? 3. Which type of anaemia results from folate deficiency? 4. State one laboratory test used to assess folate status. 5. Which
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