Blood Disorders 2021 PDF

Applied Pathophysiology I HEMATOLOGICAL DISORDERS HIM 2113 LO4  Blood Disorders Describe briefly the pathophysiology Identify the etiology Identify signs and symptoms C Define the most commonly performed investigations L State...

Applied Pathophysiology I HEMATOLOGICAL DISORDERS HIM 2113 LO4  Blood Disorders Describe briefly the pathophysiology Identify the etiology Identify signs and symptoms C Define the most commonly performed investigations L State the most common forms of management Apply knowledge in analyzing given case studies O Identify other relevant examples to illustrate disease categories 4 2  Agenda Components of Blood Blood Formation Anemia Iron deficiency Anemia Sickle Cell Anemia Bleeding Disorders Lymphoma Summary 3 4  Blood A specialized tissue containing Fluid (plasma) Cells Erythrocytes Leukocytes Thrombocytes 5  Blood components Erythrocytes Carry oxygen to the tissues and remove CO2 from them Leukocytes Act in the inflammatory response Act in the immune response Thrombocytes Control blood clotting Plasma Carries antibodies and nutrients to the tissues Carries wastes away 6 7  FUNCTION BY CELL FORMED ELEMENTS FUNCTIONS RED BLOOD CELLS Transport of O2 & CO2 GRANULOCYTES Neutrophils Phagocytosis Eosinophils Attack Ag/Ab complex Supress inflammatory response Basophils Histamine- stimulates inflammatory response AGRANULOCYTES Monocytes Phagocytosis Lymphocytes B Mature to Plasma cells Produce Ab T Direct cellular attack on Ag PLATELETS Clotting Coagulation 8  Blood formation Called hematopoiesis Primarily takes place in the bone marrow Average human has 5 -6 liters of circulating blood! FEMALE 4- 5 L MALE 5- 6 L This comes to 7.5% of our total body weight. 9  Major Diseases Anemia The reduction of hemoglobin in the blood to below normal levels Leukemia Malignant neoplasms (cancer) of white blood cells Lymphoma Neoplasms (cancers) or cells that originate in the lymphoid tissue. Bleeding disorders Uncontrolled bleeding 10  How many RBC’s should we have? The most common test to determine whether you have enough red blood cells is the Complete Blood Count (CBC) test. (Measures Hgb, Hct, RBC count, MCV (Mean Corpuscular Volume), WBC count, platelet count, and others) The normal hemoglobin ranges are: Males: 14 - 18 g/dL Females: 12 - 16 g/dL average hemoglobin value for men is 16 g/dL and for women is 14 g/dL. “Normal" varies from person to person. 11  Anemia Two classifications of anemia 1.Etiological based on etiology 2.Morphological Based on cell appearance 12  Anemia - Classification Etiological 1. Decreased hematopoiesis (decreased production of red blood cells) a. Bone marrow failure (aka aplastic anemia) b. Deficiency of essential nutrients Such as iron deficiency Vitamin B12 deficiency Folic acid deficiency 13  Anemia Classification Etiological…continued 2. Abnormal Hematopoiesis (usually a result of a genetic abnormality) Sickle Cell Anemia Thalassemia Spherocytosis Inherited blood disorder: RBCs are round like a sphere 14  Anemia Classification Etiological…continued 3. Loss or Destruction of RBCs Bleeding Immune hemolysis (breakdown of RBCs) Antigen-antibody reaction Infection (malaria) 15  Diagnosis based on Morphology Damjanov Pg. 202 16  Diagnosis based on Morphology (branch of science that studies the structure and function) Based on blood studies Blood smears RBC’s size and shape Measurement of hemoglobin content Chemical analysis of hemoglobin 17  Blood smear findings Normocytic, normochromic anemia RBC appear normal, occurs after a massive blood loss, chronic infection or metabolic disease Microcytic, hypochromic RBC’s are small and pale Most often caused by iron deficiency and thalassemia Macrocytic, normochromic RBC normal in color but are large Most often caused by vitamin B12 and folic acid deficiency Abnormal RBC shapes i.e., sickle cell anemia, spherocytosis 18  Diagnosis based on Morphology Damjanov Pg. 202 19  Anemias we will discuss Iron Deficiency Anemia Sickle Cell Anemia Thalassemia (case study) 20  Iron Deficiency Anemia The most common form of anemia Caused by inadequate supply of iron for optimal formation of RBC’s Therefore, the RBC’s are smaller (microcytic) and have less color (hypochromic). 21  Iron Deficiency Etiology Inadequate dietary intake of iron Iron malabsorption Due to some GI disease Blood loss Due to heavy menses (50-70ml or greater!) Hemorrhage from trauma GI ulcers (i.e. stomach or duodenum) Cancer (i.e. carcinoma of large intestine) Pregnancy Increases iron requirement 22  Iron Deficiency Anemia Signs and Symptoms Initially, asymptomatic Hypoxia → Fatigue Irritability Mental confusion – unable to concentrate Pale skin color Headache Dyspnea on exertion Increased susceptibility to infection 23  Iron Deficiency Anemia Diagnostic Investigations Biochemical data (blood studies) CBC: (Hgb, Hct, RBC count, MCV, WBC count) –Low hemoglobin levels (