Hematology and Immunology IPHY 2400

Hematology

The medical specialty that studies the anatomy and physiology of blood

Immunology

The medical specialty of the of the lymphatic system and immune response

The formed elements, nutrients, electrolytes, oxygen, carbon dioxide, clotting factors, waste products

Function of the blood (transport of)

Lymphatic vessels, lymph fluid, lymph nodes, lymph organs

The lymphatic system consists of the ….. (four elements) that form a pathway separate from the cardiovascular system

Pathogens, foreign cells, cancer cells

The function of the lymphatic system is to provide an immune response that defends the body against:

Plasma and formed elements

Blood is composed of

Red blood cells, white blood cells, platelets

Formed elements

Plasma

The liquid component of blood

• Is a clear, straw-colored liquid that makes up 55% of blood

• Thicker than water because it contains substances like proteins (albumin - a soluble protein) and electrolytes

• Transport nutrients

• Transport metabolic wastes

Formed elements

_____ are suspended in plasma

Hematopoiesis

Formation of red blood cells and platelets

• Occurs primarily in red bone marrow

• Begins with hematopoietic stem cells

• Produces all formed elements of blood

-poiesis

Process of formation suffix

Red bone marrow

Where are hematopoietic stem cells located?

Hemorrhage

Loss of a large amount of blood due to a disease or injury; injury is often arterial

(Blood diseases)

Septicemia

Bacterial infection in the bloodstream that can lead to sepsis (body’s extreme response to an infection)

• Bacteria and their toxins trigger widespread inflammation

• May cause abnormal blood clotting and organ damage

• Can be life-threatening

(Blood diseases)

Septic/o-

Infection prefix

-emia

Condition of the blood suffix

Erythrocytes (Red Blood Cells; RBCs)

• Most numerous formed element in the blood

• Biconcave discs with no nucleus

• Contain hemoglobin (Hgb), which carries oxygen and some carbon dioxide

erythr/o-

red prefix

Release erythropoietin (EPO)

Kidney response to low RBC levels

No, no nucleus

Can the erythrocytes divide or repair? Why?

About 120 days

Lifespan of erythrocytes

Spleen

Organ that removes old RBCs from blood

Anemia

Reduced ability of the blood to carry oxygen due to too few RBCs or too little hemoglobin.

Common causes

• Iron deficiency —> insufficient hemoglobin production

  • Produces smaller, paler erythrocytes with less hemoglobin

• Decreased RBC production —> bone marrow disease/damage, chemotherapy, or radiation

• Blood loss —> hemorrhage, heavy menstruation, or chronic bleeding

(Erythrocyte diseases)

Pernicious anemia

Vitamin B12 deficiency caused by the ability to absorb B12

• Usually results from a lack of intrinsic factor, a protein produced by the stomach

• Without intrinsic factor, vitamin B12 cannot be adequately absorbed in the small intestine

• Vitamin B12 is essential for normal RBC production

(Erythrocyte diseases)

Sickle cell anemia

Inherited disorder in which an abnormal form of hemoglobin (Hgb) causes RBCs to become sickle-shaped

• Less O2 —> RBCs become sickle-shaped

• Sickle cells are rigid and less flexible

• They can block small blood vessels —> pain and tissue damage

• When blood oxygen levels are low, cells take on a crescent or sickle shape

• Sickle cells can tangle in vessels and cause pain

(Erythrocyte diseases)

About 10-20 days

Sickled RBC lifespan duration

Acute Hemolytic Transfusion Reaction

A serious immune reaction that can occur when incompatible blood is transfused

Incompatible blood —> antibodies bind donor RBCs —> hemolysis —> complications

What happens?

1. Recipient antibodies bind antigens on donor RBCs

2. Donor RBCs are destroyed (hemolysis)

3. Free hemoglobin is released into the blood and urine

4. Severe reactions can cause kidney injury, shock, and other life-threatening complications

Granulocytes

Leukocytes with visible granules

Agranulocytes

Leukocytes without obvious granules

Neutrophil, eosinophil, basophil

Three types of granulocytes

Lymphocyte, monocyte

Two types of agranulocytes

-gen

producing or causing suffix

Neutrophils

Granulocytes that eat

• Phagocytose bacteria

• Small phagocytosis image

• most abundant WBC

Eosinophils

granulocytes that attack

• Attack parasites

• Parasite image

• Parasite defense

Basophils

Granulocytes that release histamine

• Release histamine

• Histamine/inflammation image

• Inflammation

B cells

What are antibodies produced by?

Acquired Immunodeficiency Syndrome (AIDS)

Advanced stage of HIV infection characterized by severe immune deficiency

• Human immunodeficiency virus (HIV) infects and destroys CD4+ helper T cells

• As CD4+ T-cells numbers decline, the immune system becomes less able to coordinate an effective immune response

• Severe immune deficiency increases the risk of opportunistic infections and certain cancers

(Leukocyte diseases)

Leukemia

Cancer of the lymphocytes with excessive numbers of immature leukocytes in red marrow

• Leads to anemia (too few erythrocytes)

• Leads to hemorrhage (too few thrombocytes)

• Increases susceptibility to infection (too few mature leukocytes)

• Also leads to easy bruising and fever

• Named according to the prevalent type of lymphocyte and acute or chronic onset

• Can occur in adults or children

(Leukocyte diseases)

Mononucleosis

Infectious disease caused by Epstein-Barr Virus (EBV) that causes lymph node enlargement, fever, and fatigue

Named after the increase in the number of WBCs monocytes in the blood of infected individuals

Causes

• Fever

• Fatigue

• Sore throat

• Swollen lymph glands

(Leukocyte diseases)

Megakaryocytes

Stem cells in the red bone marrow develop into large cells called….

• Shed fragments of their cytoplasm

• These cell fragments become thrombocytes (platelets)

Thrombocytes (platelets)

Cell fragments shed by megakaryocytes become….

-Thromb/o

Blood clot suffix

Aggregation

First step of blood clot formation

• Thrombocytes form clumps

Clotting factors

Second step of blood clotting

• What are released?

Coagulation

Third step of blood clotting

• Fibrin stands form, trapping erythrocytes and creating a clump

Hemostasis

Fourth step of blood clotting

• Bleeding ceases

-stasis

Stopping or standing still suffix

Deep venous thrombosis

A blood clot (thrombus) that forms in a deep vein, usually in the leg

• Risk increases with surgery, bed rest, or prolonged immobility

• The clot may break free and travel through the bloodstream

• If it lodges in a pulmonary artery, it causes a pulmonary embolism (PE)

(Thrombocyte and clotting diseases)

Embolus

If a thrombus breaks free, it becomes a ____ that travels through the bloodstream

Hemophilia

Inherited disorder caused by a deficiency of a blood-clotting factor

• Deficiency of a clotting factor —> impaired clotting —> prolonged bleeding

• Even minor injuries may cause excessive internal or external bleeding

(Thrombocyte and clotting diseases)

Phil/o-

Fondness for, affection (can also imply a “tendency to”) prefix

Thrombocytopenia

Low thrombocyte (platelet) count caused by damage to the bone marrow from radiation, chemicals, or certain drugs

Can also occur with leukemia

(Thrombocyte and clotting diseases)

Petechiae

Small, pinpoint hemorrhages

(Thrombocyte and clotting diseases)

Ecchymoses

Larger hemorrhages under the skin

(Thrombocyte and clotting diseases)

-penia

Condition of deficiency suffix

ecchym/o-

Pouring out prefix

Lymph

What is the name of interstitial fluid that enters lymphatic capillaries?

Lymph nodes

Where is lymph filtered

Ducts

What lymphatic structure empties lymph into veins near the neck

Lymphatic vessels

What does lymph flow through

• Contains valves to prevent backflow

Graft-versus-host disease (GVHD)

Donor immune cells attack the transplant recipient’s tissues

• Usually associated with bone marrow/stem cell transplantation

• May cause rash, diarrhea, and liver problems

• Severe GVHD can be life-threatening

(Lymphatic system diseases)

Microcytic, hypochromic erythrocytes

Cells produced from iron-deficiency anemia

Lymphadenopathy

Enlarged lymph nodes, often felt in the neck, armits, or groin

Common causes:

• When lymph nodes respond to an infection

• Occur with cancer or other diseases

• Cancer cells can spread through the blood or lymphatic system to other parts of the body

• Spread of cancer (metastasis)

(Lymphatic system diseases)

aden/o-

Gland prefix

Lymphedema

Generalized swelling in a limb.

Occurs after surgery when a chain of lymph nodes are removed; tissue fluid in that area cannot drain like normal

• removal or enlargement of lymph nodes most common in U.S

• Obstruction (e.g. parasite) more common in developing countries

(Lymphatic system diseases)

Elephantiasis

Lymphedema caused by a parasite

• Most commonly a nematode

• The microscopic larvae carried by mosquitoes

• Adults thrive in human lymphatic system, blocking lymph nodes and collecting vessels

(Lymphatic system diseases)

Lymphoma

Cancerous tumor of lymph cells, nodes or tissue

(Lymphatic system diseases)

Splenomegaly

Enlargement of the spleen that is felt on palpation

Splen/o-

Spleen prefix

Diabetes mellitus (DM), type 1

Affects the pancreas

(Autoimmune diseases)

Graves disease

Affects the thyroid

(Autoimmune diseases)

Hashimoto thyroiditis

Affects the thyroid

• Body makes antibodies that attack the cells in your thyroud

(Autoimmune diseases)

Gluten sensitivity enteropathy

Affects the intestines (small intestine)

(Autoimmune diseases)

Inflammatory bowel

Affects the intestines (small and large intestine)

(Autoimmune diseases)

Multiple sclerosis (MS)

Affects the nerves

(Autoimmune diseases)

Myasthenia gravis

Affects the muscles

(Autoimmune diseases)

Psoriasis

Affects the skin

(Autoimmune diseases)

Scleroderma

Affects the skin and blood vessels

(Autoimmune diseases)

Vitiligo

Affects the skin

• Causes your skin to lose its color or pigment

(Autoimmune diseases)

Rheumatoid arthritis (RA)

Affects the joints

(Autoimmune diseases)

Systemic lupus erythematosus (SLE)

Affects the connective tissue, skin, kidneys, lungs

(Autoimmune diseases)

Blood smear

Blood is smeared thinly on a glass slide and hematoxylin and eosin dyes are applied

• Blood characteristics can be observed when examined under a microscope

• Performed as a follow up to abnormal complete blood count (CBC)

(Blood cell tests)

Type and crossmatch

Determines ABO blood type and Rh factor of recipient and donor blood.

• Recipient’s antibodies are mixed with donor cells

• If the antibodies and cells agglutinate, the two bloods are NOT compatible

(Blood cell tests)

Agglutin/o-

Clumping; sticking prefix

Antigen

Each blood type is named for an…

Anti-B

Group A antibodies produced

A antigen

Group A antigens produced

None

Antibodies produced by group AB

A and B antigens

Antigens produced by group AB

Anti-A and Anti-B

Antibodies produced by group O

None

Antigens on group O

Complete blood count (CBC)

A group of blood tests performed together to determine number, type, and characteristics of formed elements

• Also measures hematocrit (HCT)=percentage of red blood cells (RBCs) in blood

(Blood cell tests)

Coagulation time tests

Measures the length of time it takes blood to clot

All test results are reported as an International Normalized Ratio (INR) no matter the test type

(Blood cell tests)

Blood chemistries

Measures the levels of substances in the blood

• Electrocytes

• Albumin

• Total protein

• ALT, AST, BUN

• Creatinine

• Bilirubin

• Glucose

• LDH

• Cholesterol

• Uric acid

(Blood cell tests)

Ferritin

Indirectly measures the amount of iron stored in the body by measuring the amount present in the blood; detects iron deficiency anemia

(Blood cell tests)

Blood donation

Procedure in which a unit of whole blood is collected from a donor

(Medical procedures)

Blood transfusion

Procedure in which donor blood is given to a recipient

• Whole blood corrects blood loss

• Packed red cells avoid fluid overload

• Platelets are given for thrombocytopenia or cancer

• Plasma is given to patients with hemophilia

(Medical procedures)

Phlebotomy

Procedure to make a small hole in the vein and collect a blood sample with a vacuum tube

(Medical procedures)

Plasmapheresis

Procedure that separates a unit of donated blood into red cells and plasma

(Medical procedures)

Apher/o-

Withdrawal prefix