Hematology: Blood Composition and Functions

Hematology (RBCs)

• Jobs of Blood: transportation of nutrients, oxygen, RBCs, waste products, and hormones; regulation of acid-base balance, fluid balance, and heat regulation; and protection through antibodies, phagocytes, and clotting.
• Blood volume consists of plasma and cells, with plasma making up 55% and containing albumin, globulins, and fibrinogen as major solutes.

Hematopoiesis

• Formation of blood cells takes place in the bone marrow, with stem cells differentiating into granulocytes, erythrocytes, and thrombocytes.
• Stem cells can be uncommitted or committed, with colony-stimulating factors (CSFs) controlling the production of circulating blood cells.
• CSFs can be naturally occurring hormones or artificial, such as Neupogen (filgrastim) and Epogen (erythropoietin).

Erythropoiesis

• Formation of RBCs requires "FIB" (folate, iron, and B12), and is stimulated by hypoxia, low RBC count, and erythropoietin.
• Characteristics of RBCs: 4-6 million per microliter, no nucleus, and biconcave shape for flexibility and increased surface area.
• Immature RBCs are reticulocytes, which live for one day and increase in count with increased erythropoietin.

Elements for HbG Formation

• Iron is a mineral essential for heme synthesis, stored in the liver as ferritin, and transported by transferrin.
• Vitamin B12 (cobalamin) is stored in the liver and necessary for RBC DNA synthesis, while folate (B9) is important for RBC DNA synthesis and maturation.

RBC, O2, and CO2 Transport

• O2 binds with heme of HgB, with arterial blood having 95-100% saturation and venous blood having 70% saturation.
• Pulse oximeter shows HgB O2 saturation, and acidosis or alkalosis affects O2 binding.

Influences on Erythropoiesis

• Androgens, hypoxia, anemia, and erythropoietin stimulate RBC production.

Destruction of RBC

• RBCs are destroyed by macrophages after 120 days, with iron being recycled in the bone marrow and heme being converted to bilirubin.

Excessive RBCs

• Polycythemia is characterized by excessive RBC production, causing hyperviscosity and symptoms such as chest pain, SOB, and clot formation.
• Causes of polycythemia include hypoxia, smoking, pulmonary/cardiac diseases, erythropoietin overproduction, malignant tumors, and genetic disorders.
• Treatment involves phlebotomy to decrease hematocrit levels.

Hematology (RBCs)

• Jobs of Blood: transportation of nutrients, oxygen, RBCs, waste products, and hormones; regulation of acid-base balance, fluid balance, and heat regulation; and protection through antibodies, phagocytes, and clotting.
• Blood volume consists of plasma and cells, with plasma making up 55% and containing albumin, globulins, and fibrinogen as major solutes.

Hematopoiesis

• Formation of blood cells takes place in the bone marrow, with stem cells differentiating into granulocytes, erythrocytes, and thrombocytes.
• Stem cells can be uncommitted or committed, with colony-stimulating factors (CSFs) controlling the production of circulating blood cells.
• CSFs can be naturally occurring hormones or artificial, such as Neupogen (filgrastim) and Epogen (erythropoietin).

Erythropoiesis

• Formation of RBCs requires "FIB" (folate, iron, and B12), and is stimulated by hypoxia, low RBC count, and erythropoietin.
• Characteristics of RBCs: 4-6 million per microliter, no nucleus, and biconcave shape for flexibility and increased surface area.
• Immature RBCs are reticulocytes, which live for one day and increase in count with increased erythropoietin.

Elements for HbG Formation

• Iron is a mineral essential for heme synthesis, stored in the liver as ferritin, and transported by transferrin.
• Vitamin B12 (cobalamin) is stored in the liver and necessary for RBC DNA synthesis, while folate (B9) is important for RBC DNA synthesis and maturation.

RBC, O2, and CO2 Transport

• O2 binds with heme of HgB, with arterial blood having 95-100% saturation and venous blood having 70% saturation.
• Pulse oximeter shows HgB O2 saturation, and acidosis or alkalosis affects O2 binding.

Influences on Erythropoiesis

• Androgens, hypoxia, anemia, and erythropoietin stimulate RBC production.

Destruction of RBC

• RBCs are destroyed by macrophages after 120 days, with iron being recycled in the bone marrow and heme being converted to bilirubin.

Excessive RBCs

• Polycythemia is characterized by excessive RBC production, causing hyperviscosity and symptoms such as chest pain, SOB, and clot formation.
• Causes of polycythemia include hypoxia, smoking, pulmonary/cardiac diseases, erythropoietin overproduction, malignant tumors, and genetic disorders.
• Treatment involves phlebotomy to decrease hematocrit levels.

Hematology (RBCs)

• Blood consists of plasma and cells, with plasma making up 55% and cells making up 45%
• Plasma is a clear yellow fluid containing albumin, globulins, and fibrinogen
• Blood volume is approximately 5.3L in women and 7.6L in men

Hematopoiesis

• Formation of blood cells in the bone marrow
• Stem cells develop into three precursors of blood cell types: granulocytes, erythrocytes, and thrombocytes
• Colony Stimulating Factor (CSF) helps with cell production and can be given artificially to increase production
• Uncommitted stem cells can develop into any kind of cell, while committed stem cells are a Colony Forming Unit to a certain line

Erythropoiesis

• Formation of RBCs requires FIB (folate, iron, and B12)
• RBCs are made in the bone marrow and begin after birth
• Characteristics of RBCs include:
  • 4-6 million RBCs per microliter of blood
  • No nucleus
  • Biconcave shape
  • Immature RBCs are reticulocytes that live for 1 day
• HbG levels: men 14-18, women 12-16; transfusions should be given to people with HgB less than 7

Elements for HbG Formation

• Iron:
  • Mineral needed for heme synthesis
  • Most iron is in HbG, but some is stored in the liver as ferritin
  • Iron is reused to produce new RBCs
  • Transported by transferrin
  • Iron is better absorbed with vitamin C
• Vitamin B12 (Cobalamin):
  • Stored in the liver until needed
  • Important for RBC DNA synthesis
  • Lack of B12 inhibits DNA synthesis and causes megaloblastic anemia
• Folic Acid (Folate - B9):
  • Important for RBC DNA synthesis
  • Prevents DNA changes that may cause cancer
  • Important for RBC maturation
  • Low B9:
    • Causes anemia
    • Manifestations include anorexia, SOB, weakness, irritability, nausea, and glossitis

RBC, O2, and CO2 Transport

• O2 binds with heme of HgB
• Arterial blood has 95-100% saturation, while venous blood has 70% saturation
• Pulse oximeter shows HgB O2 saturation
• Acidosis: low pH level, increases H+ ions, and decreases oxygen pick-up from the lungs
• Alkalosis: increases oxygen pick-up from the lungs

Influences on Erythropoiesis

• Androgens
• Hypoxia or anemia: tissues not getting enough oxygen, erythropoietin is released, and bone marrow increases RBC production
• Erythropoietin:
  • Secreted by the kidney to stimulate bone marrow RBC production
  • Artificial: Epogen, hold or reduce based on HbG levels (hold over 10)

Destruction of RBC

• RBCs are destroyed after 120 days by macrophages
• Iron from heme is recycled in the bone marrow
• Heme is turned to bilirubin and conjugated in the liver and excreted in the bile
• Jaundice in babies: liver is immature, phototherapy is used

Excessive RBCs

• Polycythemia:
  • Causes: hypoxia, smoking, pulmonary/cardiac diseases, erythropoietin overproduction, malignant tumors, genetic disorder, and newborn babies
  • Secondary polycythemia: overload in adults, causes include OSA and COPD
  • Manifestations of hyperviscosity:
    • Increase in viscosity: harder to pump through smaller vessels
    • Chest pain, SOB, clot formation, leg pain (with or without swelling), and increased platelet count
  • Treatment: phlebotomy (goal is to decrease hematocrit levels)

Hematology (RBCs)

• Blood consists of plasma and cells, with plasma making up 55% and cells making up 45%
• Plasma is a clear yellow fluid containing albumin, globulins, and fibrinogen
• Blood volume is approximately 5.3L in women and 7.6L in men

Hematopoiesis

• Formation of blood cells in the bone marrow
• Stem cells develop into three precursors of blood cell types: granulocytes, erythrocytes, and thrombocytes
• Colony Stimulating Factor (CSF) helps with cell production and can be given artificially to increase production
• Uncommitted stem cells can develop into any kind of cell, while committed stem cells are a Colony Forming Unit to a certain line

Erythropoiesis

• Formation of RBCs requires FIB (folate, iron, and B12)
• RBCs are made in the bone marrow and begin after birth
• Characteristics of RBCs include:
  • 4-6 million RBCs per microliter of blood
  • No nucleus
  • Biconcave shape
  • Immature RBCs are reticulocytes that live for 1 day
• HbG levels: men 14-18, women 12-16; transfusions should be given to people with HgB less than 7

Elements for HbG Formation

• Iron:
  • Mineral needed for heme synthesis
  • Most iron is in HbG, but some is stored in the liver as ferritin
  • Iron is reused to produce new RBCs
  • Transported by transferrin
  • Iron is better absorbed with vitamin C
• Vitamin B12 (Cobalamin):
  • Stored in the liver until needed
  • Important for RBC DNA synthesis
  • Lack of B12 inhibits DNA synthesis and causes megaloblastic anemia
• Folic Acid (Folate - B9):
  • Important for RBC DNA synthesis
  • Prevents DNA changes that may cause cancer
  • Important for RBC maturation
  • Low B9:
    • Causes anemia
    • Manifestations include anorexia, SOB, weakness, irritability, nausea, and glossitis

RBC, O2, and CO2 Transport

• O2 binds with heme of HgB
• Arterial blood has 95-100% saturation, while venous blood has 70% saturation
• Pulse oximeter shows HgB O2 saturation
• Acidosis: low pH level, increases H+ ions, and decreases oxygen pick-up from the lungs
• Alkalosis: increases oxygen pick-up from the lungs

Influences on Erythropoiesis

• Androgens
• Hypoxia or anemia: tissues not getting enough oxygen, erythropoietin is released, and bone marrow increases RBC production
• Erythropoietin:
  • Secreted by the kidney to stimulate bone marrow RBC production
  • Artificial: Epogen, hold or reduce based on HbG levels (hold over 10)

Destruction of RBC

• RBCs are destroyed after 120 days by macrophages
• Iron from heme is recycled in the bone marrow
• Heme is turned to bilirubin and conjugated in the liver and excreted in the bile
• Jaundice in babies: liver is immature, phototherapy is used

Excessive RBCs

• Polycythemia:
  • Causes: hypoxia, smoking, pulmonary/cardiac diseases, erythropoietin overproduction, malignant tumors, genetic disorder, and newborn babies
  • Secondary polycythemia: overload in adults, causes include OSA and COPD
  • Manifestations of hyperviscosity:
    • Increase in viscosity: harder to pump through smaller vessels
    • Chest pain, SOB, clot formation, leg pain (with or without swelling), and increased platelet count
  • Treatment: phlebotomy (goal is to decrease hematocrit levels)

Hematology (RBCs)

• Blood consists of plasma and cells, with plasma making up 55% and cells making up 45%
• Plasma is a clear yellow fluid containing albumin, globulins, and fibrinogen
• Blood volume is approximately 5.3L in women and 7.6L in men

Hematopoiesis

• Formation of blood cells in the bone marrow
• Stem cells develop into three precursors of blood cell types: granulocytes, erythrocytes, and thrombocytes
• Colony Stimulating Factor (CSF) helps with cell production and can be given artificially to increase production
• Uncommitted stem cells can develop into any kind of cell, while committed stem cells are a Colony Forming Unit to a certain line

Erythropoiesis

• Formation of RBCs requires FIB (folate, iron, and B12)
• RBCs are made in the bone marrow and begin after birth
• Characteristics of RBCs include:
  • 4-6 million RBCs per microliter of blood
  • No nucleus
  • Biconcave shape
  • Immature RBCs are reticulocytes that live for 1 day
• HbG levels: men 14-18, women 12-16; transfusions should be given to people with HgB less than 7

Elements for HbG Formation

• Iron:
  • Mineral needed for heme synthesis
  • Most iron is in HbG, but some is stored in the liver as ferritin
  • Iron is reused to produce new RBCs
  • Transported by transferrin
  • Iron is better absorbed with vitamin C
• Vitamin B12 (Cobalamin):
  • Stored in the liver until needed
  • Important for RBC DNA synthesis
  • Lack of B12 inhibits DNA synthesis and causes megaloblastic anemia
• Folic Acid (Folate - B9):
  • Important for RBC DNA synthesis
  • Prevents DNA changes that may cause cancer
  • Important for RBC maturation
  • Low B9:
    • Causes anemia
    • Manifestations include anorexia, SOB, weakness, irritability, nausea, and glossitis

RBC, O2, and CO2 Transport

• O2 binds with heme of HgB
• Arterial blood has 95-100% saturation, while venous blood has 70% saturation
• Pulse oximeter shows HgB O2 saturation
• Acidosis: low pH level, increases H+ ions, and decreases oxygen pick-up from the lungs
• Alkalosis: increases oxygen pick-up from the lungs

Influences on Erythropoiesis

• Androgens
• Hypoxia or anemia: tissues not getting enough oxygen, erythropoietin is released, and bone marrow increases RBC production
• Erythropoietin:
  • Secreted by the kidney to stimulate bone marrow RBC production
  • Artificial: Epogen, hold or reduce based on HbG levels (hold over 10)

Destruction of RBC

• RBCs are destroyed after 120 days by macrophages
• Iron from heme is recycled in the bone marrow
• Heme is turned to bilirubin and conjugated in the liver and excreted in the bile
• Jaundice in babies: liver is immature, phototherapy is used

Excessive RBCs

• Polycythemia:
  • Causes: hypoxia, smoking, pulmonary/cardiac diseases, erythropoietin overproduction, malignant tumors, genetic disorder, and newborn babies
  • Secondary polycythemia: overload in adults, causes include OSA and COPD
  • Manifestations of hyperviscosity:
    • Increase in viscosity: harder to pump through smaller vessels
    • Chest pain, SOB, clot formation, leg pain (with or without swelling), and increased platelet count
  • Treatment: phlebotomy (goal is to decrease hematocrit levels)

This quiz covers the components and functions of blood, including the roles of red blood cells, plasma, and blood cells in transportation, regulation, and protection. Learn about the different types of blood cells and their importance in maintaining overall health.