A young black man was brought to the emergency room (ER) owing to severe pain throughout his body…

A young black man was brought to the emergency room (ER) owing to severe pain throughout his body. He had been exercising vigorously when the pain started. He has had such episodes about twice a year for the past 10 years. An analysis of the blood shows a reduced blood cell count (anemia), and oddlooking red blood cells that were no longer concave and looked like an elongated sausage. An underlying cause in the change of shape of these cells is which one of the following? (A) Increased ionic interactions between hemoglobin molecules in the oxygenated state. (B) Increased ionic interactions between hemoglobin molecules in the deoxygenated state. (c) Increased hydrophobic interactions between hemoglobin molecules in the oxygenated state. (d) Increased hydrophobic interactions between hemoglobin molecules in the deoxygenated state. (E) Increased phosphorylation of hemoglobin molecules in the oxygenated state. (f) Increased phosphorylation of hemoglobin molecules in the deoxygenated state.

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