Copyright 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Anatomy and PhysiologyHematologic systemMajor functions of bloodTransport nutrients to cells Aid removal of wastesAverage adult has 5 to 6 liters of circulating blood

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Anatomy and PhysiologyNormal erythrocyte count 4.2 to 6.3 millionErythrocytes life span - 120 daysErythrocytes form in the bone marrow and do not reproduce

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Anatomy and PhysiologyHemoglobin important in oxygen transportNormal hemoglobin - Male - 13.5 to 18 gm/female 12 to 16 gm

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Anatomy and PhysiologyLeukocytes protect individual from infectionNormal leukocyte count is 4,500-11,000Platelets known as thrombocytesImportant in blood clottingNormal platelet count is 150,000-350,000

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Anatomy and PhysiologyBlood-forming organs include lymph nodes, bone marrow, spleen, liverLymph system protects against pathogensBone marrow is major blood cell producer*

Anatomy and PhysiologySpleen produces lymphocytes, plasma cells, and antibodies; filters microorganisms from the bloodResponsible for producing prothrombin and fibrinogen for blood clotting

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Common Signs and SymptomsErythrocytopenia (decrease in RBCs) leads to anemia*

Common Signs and SymptomsCommon signs and symptoms of anemia FatigueHeadacheLow RBCsPallorShortness of breath

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Common Signs and SymptomsErythrocytosis (increased RBCs) Common signs and symptoms High RBCsReddened skin tonesBloodshot eyesIncreased blood volume and pressureIncreased blood volume of the heart*

Common Signs and SymptomsLeukocytopenia (decreased white blood cells) weakens immune systemLeukocytosis (increased white blood cells) is a normal response to acute infectionsThrombocytopenia (decreased platelet count) leads to coagulation problem*

Common Signs and SymptomsSigns and symptomsPetechiae - small hemorrhages in the skinEcchymoses - large areas of bruising or hemorrhageEpistaxis - nosebleedsBleeding in mouth, gums, and mucous membranes*

Common Signs and SymptomsThrombocytosis (increase in platelets)Condition is uncommonUsually no serious side effects

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Diagnostic TestsComplete blood count with differential and indicesBiopsy of blood-forming organsHematocrit (hct) reflects amount of red cell mass as a proportion of whole bloodHemoglobin (hgb) reflects the bloods oxygen-carrying potential *

Diagnostic TestsBleeding time determines platelet disorders such as hemophilia, thrombocytopenia, disseminated intravascular coagulationPT (prothrombin time) and PTT (partial prothrombin time) measure bloods ability to clot*

Diagnostic TestsBiopsyBone marrowLymph node*

Disorders of Red Blood CellsAnemiaDecrease in oxygen-carrying ability of the RBCSymptoms PallorFatigueShortness of breath*

Disorders of Red Blood CellsAnemiaSymptoms TachycardiaHeadacheIrritabilitySyncope*

Disorders of Red Blood CellsIron-Deficiency AnemiaLoss of iron or inadequate intake of ironCauses - blood loss and low dietary intakeTreatment - increase dietary intake of iron

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Disorders of Red Blood CellsFolic Acid Deficiency AnemiaFolic acid needed for maturation of RBCsPoor diet, overcooking vegetables, or over consumption of alcoholTreatment: folic acid by eating green and yellow vegetables*

Disorders of Red Blood CellsPernicious AnemiaLack of intrinsic factor leading to inadequate absorption of vitamin B12Treatment: monthly injections of vitamin B12 for life*

Disorders of Red Blood CellsHemolytic AnemiaDestruction of RBCs related to antibody-antigen reaction Disorder of immune system leading to destruction of erythrocytesTreatment: exchange transfusion and/or a splenectomy*

Sickle Cell AnemiaHereditary; no cureFound in black race Abnormal sickle shape of the erythrocyteSickle shape does not allow the cell to travel smoothly through vesselsTreatment is symptomatic*

Disorders of Red Blood CellsAplastic Anemia - failure of bone marrow to produce blood componentsCausesChemotherapy, radiation, viruses, and toxinsTreatment: avoid causative agent, bone marrow transplantation, and transfusions*

Disorders of Red Blood CellsPolycythemia - too many blood cellsSpleen is enlarged, mucous membranes are reddened, bloodshot eyes, palms are deep red colorTreatment: donate blood at regular intervals to reduce blood volume

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Disorders of White Blood CellsMononucleosis - kissing diseaseSymptoms Fatigue, sore throat, and swollen glandsDiagnosis - Increase monocytes in WBCTreatment: rest, analgesics, and throat gargles*

Disorders of White Blood CellsLeukemia - malignant neoplasm of blood-forming organsAbnormal production of immature leukocytesClassified as acute or chronicAcute forms affect children, progress rapidly, and may be fatal*

Disorders of White Blood CellsChronic forms of leukemia occur in older adults, often asymptomatic, and may not be lethalClassified as Myelogenous - affecting bone marrowLymphocytic - affecting lymph nodes*

Disorders of White Blood CellsBone marrow biopsy to confirm diagnosisSymptoms Fatigue HeadacheSore throat*

Disorders of White Blood CellsSymptoms Dyspnea bleeding of mucous membranes of the mouth and GI systemBone and joint painEnlargement of lymph nodes, liver, and spleenInfections are common*

Disorders of White Blood CellsTreatment of Leukemia Aggressive chemotherapyOnce in remission, a bone marrow transplant to replace neoplastic tissue with normal tissueRemission: 50 percent*

Disorders of White Blood CellsHodgkins DiseaseMost common lymphomaPainless enlargement of lymph nodes in neck, weight loss, and feverPrimarily affects young adults with average age of 35*

Disorders of White Blood CellsHodgkins DiseaseCause thought to be viral Diagnosis made by presence of Reed-Sternberg cell in lymphatic tissue*

Disorders of White Blood CellsHodgkins DiseaseTreatment RadiationChemotherapyIf kept in remission for 5 years or longer, complete cure may be possible*

Disorders of White Blood CellsNon-Hodgkins Lymphomas lacking Reed-Sternberg cellSymptoms: Painless enlargement of lymph nodes of neckAxilla and inguinal areasFever, night sweats, and weight loss*

Disorders of White Blood CellsNon-Hodgkins Affects adults: average age of 50Treatment: radiation and chemotherapy*

Disorders of White Blood CellsMultiple MyelomaMalignant neoplasm of plasma cells or B-lymphocytesIncreases with age, peaking in seventiesPlasma cells multiply abnormally in bone marrow causing weakness and leading to fractures and bone pain

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Disorders of White Blood CellsDiagnosis of Multiple MyelomaHoneycombed bone patternHypercalcemiaSpecial protein called Bence Jones found in blood and urineBone marrow biopsy*

Disorders of White Blood CellsMultiple MyelomaTreatmentChemotherapyRadiationTreatment is not effective and prognosis is poor*

Disorders of PlateletsHemophiliaX-linked hereditary bleeding disorderSeveral types of hemophilia Type A is most commonMale children from asymptomatic mothersLack protein necessary for clot formation*

Disorders of PlateletsHemophiliaEpistaxis, bruising, and prolonged bleedingDiagnosis confirmed by blood test; no cureTreatment: prevention of injury and treat symptomsBlood transfusions and concentrated form of clotting protein*

Disorders of PlateletsThrombocytopenia Thrombocytopenia purpuraDecrease in platelets leading to inability to normally clot blood*

Disorders of PlateletsThrombocytopenia Characteristics: PetechiaeAbnormal bleeding in skin, mucous membranes, and internal organsEcchymoses, GI hemorrhages, epistaxis, hematuria*

Disorders of PlateletsDiagnosis made by platelet count and bleeding timeTreatmentAvoid tissue trauma to reduce bleedingVitamin KTransfusions of plateletsSplenectomy*

Disorders of PlateletsDisseminated Intravascular Coagulation (DIC)Abnormal clotting followed by abnormal bleedingUsually follows major trauma such as complicated childbirth, surgery, tissue destruction, septicemia, snakebite, and shock*

Disorders of PlateletsDICMultiple clots in capillaries Symptoms: petechiae, ecchymosis, hematoma, hematuria, GI bleeding, hematemesis, blood in stoolTreatment: heparin and platelets Life threatening*

Disorders of PlateletsRare DiseasesThalassemiaAffects primarily people of Mediterranean descentRBCs are fragile and thin and form defective hemoglobin*

Disorders of PlateletsRare DiseasesVon Willebrands DiseaseHereditaryCongenital Deficiency in clotting factor and platelet functionAlso called angiohemophiliaAffects females as well as males*

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