Week 11 Blood Pathology PDF

Occurs in the bone marrow, stimulated by...

Occurs in the bone marrow, stimulated by Erythropoietin Production and Maturation of RBCs Vitamin B12 and Folic acid are essential for RBC maturation Life span of 100-120 days Red Blood Cells (RBCs) Undergo apoptosis, with the membrane becoming increasingly fragile until it breaks Metabolism of RBCs Caused by blood loss RBCs go to the spleen or liver to die, Caused by decreased production or faulty releasing hemoglobin (Hb) which is then RBCs recycled Anaemia Iron deficiency anaemia (leading cause) Caused by destruction of RBCs, e.g., issues with the spleen The percentage of overall blood volume composed of RBCs Normal values: Males 45-55%, Females 35- Haematocrit 45% Main cause of elevated haematocrit is reduction in plasma volume, e.g., dehydration, excessive diuresis Functional unit of the RBC, carries oxygen to tissues Normal values: Males 130-160g/L, Females 120-150g/L Haemoglobin 250 million Hb molecules per RBC Complete Blood Examination Low concentration impairs tissue (CBE) oxygenation Hb binds to the iron (Fe) molecule Normal values: 4-12 x 10*9/L Polymorphonuclear neutrophils (62.0%) Polymorphonuclear eosinophils (2.3%) 5 different types of cells: Polymorphonuclear basophils (0.4%) Monocytes (5.3%) White Cell Count Lymphocytes (30.0%) Granulocytes and monocytes produced in bone marrow Production of white blood cells: Lymphocytes produced in glandular tissues (lymph glands, spleen, thymus, tonsils) Lymphocyte life span: 4-8 hrs in blood, 4-5 days in tissues Particles of megakaryocyte cells Size is 1/5 of RBC Respond to endothelial injury Fully replaced every 10 days Platelets (Thrombocytes) Normal value: 150-450 x 10*9/L 1. Adhesion: stop and glue to the injury site 2. Activation: Change shape, expose receptors and signal! 3 roles: Adhesion, Activation, and Aggregation 3. Aggregation: Connect to each other via receptors to form a plug This primary plug activates the Normal values: 11-15 seconds coagulation cascade Measures the extrinsic pathway and the clotting ability of factors I (fibrinogen), II Prothrombin Time (PT) (prothrombin), V, VII, and X Comprehensive Prolonged PT can be associated with liver disease, oral anticoagulants, and Summary of Blood obstructive biliary disease Pathology Normal values: 0.9 - 1.3 Coagulation Studies International Normalised Ratio (INR) Standardizes the measurement of PT INR of 1 = same as the rest of the population, INR of 2 means PT twice the rest of the population Normal value: 30-40 seconds Activated Partial Thromboplastin Time (aPTT) Measures the effectiveness of the common and intrinsic pathways Normal values: Ionised 1.1-1.3mmol/L, Serum Calcium 2.1-2.5mmol/L Calcium (Ca) Essential for muscle contractility, cardiac function, neural transmission, and clotting Normal values: 3.5-4.5 mmol/L Potassium (K) Maintains the inside of the cell positive, important for protein synthesis, and acid- base balance Electrolytes Normal values: 135-145 mmol/L Sodium (Na) Most abundant ion in the extracellular compartment, major determinant of intravascular osmolarity, and helps regulate volemia Normal values: 0.7-1.0 mmol/L Magnesium (Mg) Mostly found intracellularly, critical for metabolic processes using ATP, increases intestinal absorption of Ca, and helps regulate the Na/K ATPase pump Normal values: < 150 U/L Enzyme found in the heart, skeletal muscle, and brain Creatinine Kinase (CK) Levels rise within 6 hours of damage 3 isoenzymes: CK-BB (Brain), CK-MM (Muscle), CK-MB (Myocardium) Biochemistry Mainly a marker of skeletal muscle damage Normal values: < 10 mmol/L Urea (or Blood Urea Nitrogen, BUN) Waste product of metabolized protein, excreted by the kidneys Renal Function Normal values: < 100 mmol/L Creatinine Catabolic product of creatine phosphate, excreted entirely by the kidneys Alanine Amino Transferase (ALT) < 55 U/L Aspartate Amino Transferase (AST) < 45 Liver Transaminases U/L Released when hepatocytes break Normal value < 100 U/L Highest concentrations in the liver, biliary Alkaline Phosphatase (ALP) tract, and bones Liver Function Can point to biliary disease without liver disease Normal value < 25 U/L (2-24) Bilirubin Orange-yellow pigment, by-product of Hb metabolism, eliminated via bile Normal value 35-45 U/L (34-48) Albumin Produced in the liver, essential for colloid osmotic pressure