The questions are based on the photo below: 1. How do erythrocytes produce ATP? What is the role of ATP to red-cell morphology and function?2. How does compromised pyruvate kinase activity lead to anemia? A Case Study on Carbohydrate MetabolismObjectives1. Understand the role of pyruvate kinase in pyruvate metabolism.2. Be familiar with the Embden-Meyerhof pathway of RBC metabolism.3. Know how pyruvate kinase deficiency results in anemia.CASE STUDY # 2A 2-year-old black girl is being seen by the hematologist after her pediatrician found her to be severelyanemic with splenomegaly and jaundice. Her mother gives a possible history of a "blood problem" inher family but doesn't know for sure. Her hemoglobin electrophoresis was normal, and the completeblood count (CBC) revealed a normocytic anemia. The platelet and white blood cell counts are normal.On the peripheral smear, there are many bizarre erythrocytes, including spiculated cells. A diagnosisof pyruvate kinase deficiency is made.BIOCHEMICAL MECHANISM:Pyruvate kinase deficiency usually will manifest clinical symptoms on red blood cells (RBCS) with noapparent metabolic abnormalities in other cells. Insufficient adenosine triphosphate (ATP) is producedin the red cell and its membrane is affected, spiculated and removed by the spleen.CLINICAL CORRELATIONHemolytic anemia is not a common cause of anemia but should be considered in patients with elevatedserum bilirubin or urine bilirubin levels. Lysis of the erythrocyte can occur from various mechanismssuch as medications, antibodies against red blood cells, infection, coagulopathy, and mechanicalprocesses such as abnormal heart valves, and enzyme deficiencies of the red blood cell. Patients maynotice fatigue, dizziness from the anemia, and dark colored (classically "coke-colored" urine) from thebilirubinuria. Confirmation of hemolysis can be obtained by the peripheral blood smear revealingfragmented red blood cells, or increased serum bilirubin or decreased serum haptoglobin.Immunoglobulins can cause red blood cell lysis by attacking various proteins on the surface oferythrocytes; autoimmune processes (body attacking itself), or alloimmune (immunoglobulins fromoutside) such as from a blood transfusion or a fetus from the mother. The Coombs tests can assessfor immunoglobulin on the red blood cell or circulating in the serum. Typically, hemolysis of theerythrocyte is associated with increased levels of RBC precursors in the bone marrow and thusimmature forms of the erythrocytes in the bloodstream; therefore, an increased reticulocyteconcentration supports the increased destruction of red blood cells.Reference: Toy, E. C., Seifert r., W. E., Strobel, H. W., & Harms, K. P. (2008). Lange Case Files: Biochemistry (2nd ed.).McGraw-Hill Companies, Inc. https://doi.org/10.10360071486658

Question

The questions are based on the photo below: 1. How do erythrocytes produce ATP? What is the role of ATP to red-cell morphology and function?2. How does compromised pyruvate kinase activity lead to anemia? A Case Study on Carbohydrate MetabolismObjectives1. Understand the role of pyruvate kinase in pyruvate metabolism.2. Be familiar with the Embden-Meyerhof pathway of RBC metabolism.3. Know how pyruvate kinase deficiency results in anemia.CASE STUDY # 2A 2-year-old black girl is being seen by the hematologist after her pediatrician found her to be severelyanemic with splenomegaly and jaundice. Her mother gives a possible history of a &#34;blood problem&#34; inher family but doesn't know for sure. Her hemoglobin electrophoresis was normal, and the completeblood count (CBC) revealed a normocytic anemia. The platelet and white blood cell counts are normal.On the peripheral smear, there are many bizarre erythrocytes, including spiculated cells. A diagnosisof pyruvate kinase deficiency is made.BIOCHEMICAL MECHANISM:Pyruvate kinase deficiency usually will manifest clinical symptoms on red blood cells (RBCS) with noapparent metabolic abnormalities in other cells. Insufficient adenosine triphosphate (ATP) is producedin the red cell and its membrane is affected, spiculated and removed by the spleen.CLINICAL CORRELATIONHemolytic anemia is not a common cause of anemia but should be considered in patients with elevatedserum bilirubin or urine bilirubin levels. Lysis of the erythrocyte can occur from various mechanismssuch as medications, antibodies against red blood cells, infection, coagulopathy, and mechanicalprocesses such as abnormal heart valves, and enzyme deficiencies of the red blood cell. Patients maynotice fatigue, dizziness from the anemia, and dark colored (classically &#34;coke-colored&#34; urine) from thebilirubinuria. Confirmation of hemolysis can be obtained by the peripheral blood smear revealingfragmented red blood cells, or increased serum bilirubin or decreased serum haptoglobin.Immunoglobulins can cause red blood cell lysis by attacking various proteins on the surface oferythrocytes; autoimmune processes (body attacking itself), or alloimmune (immunoglobulins fromoutside) such as from a blood transfusion or a fetus from the mother. The Coombs tests can assessfor immunoglobulin on the red blood cell or circulating in the serum. Typically, hemolysis of theerythrocyte is associated with increased levels of RBC precursors in the bone marrow and thusimmature forms of the erythrocytes in the bloodstream; therefore, an increased reticulocyteconcentration supports the increased destruction of red blood cells.Reference: Toy, E. C., Seifert r., W. E., Strobel, H. W., & Harms, K. P. (2008). Lange Case Files: Biochemistry (2nd ed.).McGraw-Hill Companies, Inc. https://doi.org/10.10360071486658

Accepted Answer

Adenosine triphosphate (ATP) is an energy-carrying molecule particularly found in the cells of all…

How do erythrocytes produce ATP? What is the role of ATP to red-cell morphology and function? 2. How does compromised pyruvate kinase activity lead to anemia?