hematologic system pt 1

plasma

91% water

9% solutes (proteins, iron, nutrients) 

formed elements

45% of blood volume

erythrocytes (RBC)

99% of formed elements

oxygen transport:

120 day lifespan

leukocytes

<1%

immune defense

platelets

<1%: clotting function 

\

buffy coats

layer containing WBC and platelets

erythropoiesis

stimulation of the body to create more RBC

RBC derived from 

Erythroblasts 

substance that starts erythopoiesis

erythropoietin (from kidneys)

B12 and Folate are stored in the

liver

anemia 

decreased RBC count or Decreased hemoglobin quality/quantity 

tissue hypoxia

blood becomes less viscous (thin)

increases heart rate and stroke volume

anemia symptoms

fatigue, weakness, dyspnea, pallor

tachycardia, dizziness, SOB

impaired healing, skin changes, appetite loss

hypoxemia 

reduced oxygen in the blood 

dilates artieoles, capillaries → increases blood flow to these areas → heart failure 

increased effort to breathe/rate of depth of breath 

acute anemia

losing blood volume

bleeding out from a wound

IN THE MOMENT

macrocytic - normochromic

large - carry correct amount of hemoglobin

pernicious anemia

folate deficiency anemia

pernicious anemia (PA) 

cause: B12 deficiency due to lack of intrinsic factor 

risk factors: autoimmune gastritis, surgery, smoking, liver disease

symptoms: anemia signs + neurological (parathesia, gait issues- only anemia that affects the nerves (demyelantion)) BEEFY RED TONGUE (atrophic glossitis) 

treatment: lifelong b12 injections or high dose oral B12 

intrinsic factors

inability to absorb b12 from small intestine → insufficient creation of healthy RBC

comes from the parietal cells in the stomach

folate deficiency anemia

common in extremely malnourished people

cause: poor diet (not enough folate), alcoholism

symptoms: similar to PA, NO NEUROLOGICAL SIGNS, burning mouth (dysphagia), watery diarrhea

treatment: daily oral folate

microcytic hypochromic anemia

small, low amount of hemoglobin

iron deficiency anemia

iron deficiency anemia 

cause: poor intake, chronic blood loss, pregnancy 

early symptoms: fatigue, pale skin, SOB (all common with all anemias) 

late symptoms: Spoon nails (koilonychia), sore tongue (atrophied tongue), angular stomatits (dry sore corners of the mouth) MAJOR INDICATORS  

treatment: iron replacement + address underlying cause

normocytic- normochromic

normal and normal

posthemorrhagic anemia

sickle cell anemia

posthemorrhagic anemia

cause: acute blood loss- example: day 70 of acute anemia (120 days to get back to normal RBC)

symptoms: shock, decreased oxygen, potenital death

treatment: volume replacement, transfusion

sickle cell disease (SCD)

genetics: autosomal recessive; mutation in the hemoglobin gene (glutamic acid (ctc) instead codes for valine (cac) )

poor oxygenation and dehydration causes RBC to sickle

mechanism: RBC sickle under stress → occlusion, pain, and organ damage

symptoms: extreme pain, jaundice, fatigue, stroke risk

trait: trait=carrier, no symptoms (2 carriers = child will have disease)

disease: full expression

when clotting does not occur as quickly as it should

• easy bruising 

• persistent bleeding from minor wounds 

• swollen joints

• blood in urine

  • heavy periods 

when clotting happens quicker than it should

• develops an embolus

• DVT, PE,

  • stroke

Hemophilia A

cause: factor VIII deficiency (starting of clotting cascade) (X linked)

symptoms: joint bleeding, bruising, hematuria

treatment: factor VIII replacement

von willebrand disease (VWD) 

cause: VWF deficiency (autosomal dominant) 

symptoms: easy brusing, heavy periods, prolonged bleeding 

treatment: factor replacement, plasma infusions

factor V leiden

cause: mutation in F5 gene → resistance to activated C protein

effect: prolonged clotting→ high risk of DVT, PE, stroke

prevalence: 5% of US population; 30% of DVT/PE cases