Mean Corpuscular Hemoglobin

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What is the normal range for the MCH (just one answer applies)?

a
26-32 picograms/dL
b
26-32 picograms
c
26-32 nanograms
d
26-32%

The MCH is directly proportional to (more than one answer may apply):

a
MCV
b
Hct
c
MCHC
d
Hb
e
RDW

The RBC on the left is normal. Describe the cell on the right (more than one answer may apply):

a
Low MCH
Can’t tell because we have no idea how large the cell is!
b
High MCV
Can’t tell!
c
Low MCHC
d
Hypochromic

You are an astronaut on the space station studying the effect of space travel on red blood cell parameters. You draw blood from your fellow astronauts at various time points during your travel and store the samples at 4oC. When you return to earth, you wish to measure the MCV. However, water has shifted into the cells during storage, causing which of the following artefactual changes (more than one answer may apply):

a
Elevated Hct
b
Decreased MCHC
c
Decreased MCH
No, the MCH is STABLE and thus a surrogate marker for the MCV!
d
Decreased MCV
e
Increased MCV

Diagnostic algorithms for anemia employ which of the following:

a
MCH
b
MCHC

Imagine that planet earth is one giant red blood cell! It has a normal proportion of Hb – about 1/3 central pallor 🙂

What can you say about this gigantic cell?

a
MCH is low
b
MCH is high
Astronomically high
c
MCHC is low
MCHC is normal!
d
MCHC is high
MCHC is normal!

True or false: The MCH is a more sensitive than the MCV or MCHC in diagnosing iron deficiency.

a
True
By definition, this has to be case because MCH = MCV x MCHC, and both MCH and MCHC tend to decrease in iron deficiency. So the MCV and MCHC have a multiplying effect on the MCH.
b
False

But is that enough justification to keep the MCH on your radar screen?

Honestly, the incremental information provided by the MCH hardly justifies the confusion and mental anguish it causes!

Focus on the MCHC!

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