Hematology and Immune System Lecture Notes PDF

Hematology and Immune System Dr. Nisreen Daffa Alla M.B.B.S, PhD (Human Physiology), MSc health Profession Education 1  REFERENCES Human Physiology, Lauralee Sherwood, seventh edition. Text book Physiology by Guyton &Hall,11th edition....

Hematology and Immune System Dr. Nisreen Daffa Alla M.B.B.S, PhD (Human Physiology), MSc health Profession Education 1  REFERENCES Human Physiology, Lauralee Sherwood, seventh edition. Text book Physiology by Guyton &Hall,11th edition. Text book of Physiology by Linda S. Contanzo, third edition. Physiology by Berne and Levy, sixth edition. 2  Lecture 1 Plasma Proteins 3  OBJECTIVES OF THIS LECTURE The student should be able to: Describe the composition of blood. Enumerate different plasma proteins. Explain the functions of plasma proteins. Correlate the changes in plasma proteins with the clinical conditions. 4  BLOOD Represents about 8% of total body weight. Average volume: – 5 liters in women. – 5.5 liters in men. Composed of two parts: 1. Plasma (liquid portion of blood). 2. Cellular elements. 5  Types of Cellular Elements – Erythrocytes (Red blood cells( Important in O2 transport, CO2 transport, buffer hydrogen ion. – Leukocytes(White blood cells( Immunity – Thrombocytes (Platelets): Important in hemostasis What is hemostasis? 6  Erythrocytes (Red blood cells( Most numerous cell type in blood Hematocrit or packed cell volume (PCV) is the percentage of erythrocytes in the total blood volume Average PCV in men 45% in women 42% Plasma volume Average normal volume: – 58% in women. – 55% in men. 7 CENTRIFUGATION OF BLOOD IN CAPILLARY TUBE 8  PLASMA Constituents Example Water Makes up 90% of plasma. Na+, K+, Cl-, HCO3 – Electrolytes Proteins Albumin, Globulin, Fibrinogen Carbohydrates Glucose Lipids Cholesterol, fatty acids Minerals Ca2+, PO43- Enzymes Alkaline Phosphatase, Amylase Metabolites Bilirubin, Urea, Uric acid, Creatinine 9  Plasma Electrolytes Na+, K+, Cl-, HCO3 – Functions: Membrane potentials Osmotic distribution of fluid between ECF and ICF Buffer pH changes 10  PLASMA PROTEINS Plasma proteins: – Compose 6% to 8% of plasma’s total weight – 3 groups of plasma proteins Albumins – Most abundant plasma proteins Globulins – 3 subclasses » Alpha (α) » Beta (β) » Gamma (γ) Fibrinogen 11  PLASMA PROTEINS Plasma protein Average concentration Albumin 4.8 g/100ml Globulins 2.3 g/100ml Fibrinogen 0.3 g/100ml Total 7.4 g/100ml 12  PLASMA PROTEINS Plasma protein Function Lipoprotein Nutrients Alkaline Phosphatase, Amylase Enzymes Angiotensin Hormone γ - Globulin Antibodies Fibrinogen Clotting factor Albumin, Ceruloplasmin, Transferrin Carriers Gasoline, Gc protein Scavengers 13  ALBUMIN Synthesized in liver. 10-12 g each day and half life is 20 days. Functions 1. Exerts about 80-90% of the plasma colloid osmotic pressure. 2. carriers 3. Buffer pH changes It forms about 60% of total plasma protein. Decrease in albumin (hypoalbuminaemia) result in fluid leaves the circulation causing edema (edema is accumulation of fluid in the interstitial fluid). Causes of hypoalbuminaemia are: malnutrition, liver disease, 14 kidney disease.  GLOBULINS Subdivided into α 1, α 2, β and γ Alpha and beta globulins are synthesized in liver. γ- gamma globulins are synthesized in reticuloendothelial system by plasma cells. Functions : Alpha globulins: Transport water insoluble substances such as lipoproteins, lipids, hormones: cortisol binding globulin, thyroid binding globulin. Beta globulins: Transport lipids, cholesterol, iron and copper. Gamma globulins: function as antibodies (immunoglobulins) 15  FIBRINOGEN Synthesis : Liver Functions: formation of blood clot 16 Deficiency of fibrinogen will result in excessive bleeding 17  Functions of Blood 1. Transport: – Respiratory gases (O2 & CO2) – Nutrients – Metabolites – Hormones – Drugs – Enzymes 2. Defense against infections. 3. Participate in homeostasis by regulating: – Body temperature. 18 – Acid-Base balance.  ANY QUESTION? ANY INFORMATION TO BE REPEATED? 19  Revision QUESTIONS Mention components of blood Which one is the most numerous blood cells List 3 plasma proteins and their functions Mention the site of synthesis and function of: 1. Albumin 2. Alpha and beta globulin 3. Gamma globulin 20  Case Study Critical Thinking 55 yrs. old male being evaluated in clinic for new onset ascites and lower extremity edema. Drank alcohol moderately heavy. His eyes were yellow. Abdomen distended with fluid wave, mild tenderness to palpation – No hepatosplenomegaly. edema to mid-calf / Pedal pulses barely palpable 21 Lower limbs edema 22 Ascites 23  Investigations BUN – 8 mg/dl -Serum creatinine - 1.0 mg/dl AST - 68 IU/ml -WBC - 4200 Serum albumin - 2.5 gm/dl ALT -46 IU/ml Platelets - 94,000 Serum sodium - 133 mEq/ml - potassium – 3.8 mEq/ml Alkaline phosphatase – 130 IU/ml Serum Total bilirubin - 3 mg/dl 24  Questions The patient was diagnosed with liver failure What is the cause of edema in this patient? Explain the development of edema in this patient? 25  Case of congenital a fibrinogenemia will presents with…………………………… 26 27