Ch 11 - patho

iron storage

ferritin (liver spleen, bone marrow)

Iron transport

transferrin and total iron binding capacity

Iron deficiency anemia

small, pale RBC;s

low plasma iron, low marrow iron - ferritin

High iron binding capacity - produces transferrin which binds and transfers iron

Low reticulocyte count - missing iron

Whole blood

55% of blood volume - plasma

45% of blood volume

red blood cells

monocytes

phagocytosis, immune reactions

5%

Lymphocytes

immune reactions

30%

Neutrophils

97% of granulocytes

acute inflammatory reactions

phagocytosis

Digestion of foreign debris

Granulocytes

65%

Eosinophils

2%

Allergic and anti parasitic reactions

Basophils

1%

allergic reactions

Red cells

120 days

Lymphocytes and monocytes

a week or two

Granulocytes

about 4 days

Platelets

a day or two

Mean cell volume

Red cell size

hemoglobin divided by RBC

MCV

red cell size

MCHC

hemoglobin concentration divided by RBC

MCH

average hemoglobin content in RBC

HGB divided by RBC

Mean cell hemoglobin

HGB divided by RBC

average hemoglobin content in RBC

Lymphoid cell

lymphoblast cell → prolymphocyte → lymphocyte → **immune reactions**

Basophil - myeloid cell

\
allergic reactions

Eosinophil - myeloid cell

allergic reactions, antiparasitic reactions

neutrophil - myeloid cell

phagocytosis, acute inflammation

Platelets - myeloid cell

coagulation

red blood cells - myeloid cell

oxygen transport

monocyte - myeloid cell

phagocytosis

Mean cell hemoglobin concentration

HGB divided by HCT

hemoglobin concentration divided by RBC

Most diseases of blood cells feature ----- because of an imbalance in the production or loss of cells

too many or too few cells

White blood cells are critical in the ----

defense against infection

Malignancies of Myelocytes are associated with circulation of malignant cells in the

blood (leukemia)

Most diseases that affect ---- cause a low platelet count

platelets

Too little hemoglobin

anemia


1. decreased red cell production
2. loss of red cells by hemorrhage
3. early death of red blood cells

Acute blood loss

main concern is shock

Chronic blood loss

yield iron deficient anemia hindering bone marrows ability to make hemoglobin

Abnormal menstrual bleeding and GI bleeding can lead to

iron deficiency anemia

iron deficiency anemia

RBC small ( microcytic) and pale (hypochromic)

lack iron

Microcytic

small RBCS

Hypochromic

pale

hypersplenism

overactive spleen

consumes more than normal amount of WBC, RBC or platelets

associated with enlarged spleen

Myasthenia gravis

a weakness and rapid fatigue of muscles under voluntary control

droopy eyelid and mouth

hereditary immune deficiency

T cell deficiency

Splenomegaly

enlargement of the spleen

aplastic anemia

damage to the stem cells inside bone marrow

does not produce new cells leaving the body susceptible to infection

Macrocytic

bone marrow that produces abnormally large red blood cells

Ferritin

blood protein that contains iron

low levels can lead to iron deficiency anemia

most common cause of anemias of hemorrhage

chronic blood loss

Transferrin

glycoproteins that mediate the transport of iron through blood plasma

Megaloblastic anemia

DNA replication disorder, lack B12 and folic acid. Cells end up larger

Polycythemia vera

type of blood cancer

bone marrow makes too many red blood cells thickening the blood and making blood clots

Leukopenia

a condition where the body doesn't have enough disease-fighting leukocytes in the blood. It is associated with a low white blood cell count- usually granulocytes

Iron balance

ingestion and loss

Neutropenia

lower than normal number of neutrophils

due to hypersplenism, sepsis, autoimmune disease

Lymphopenia

a disorder in which your blood doesn't have enough white blood cells called lymphocytes

possibly AIDS

Agranulocytosis

A serious condition that occurs when there is an extremely low number of granulocytes (a type of white blood cell) in the blood

susceptible to bacterial and fungal infection

Leukemia

malignant cells present throughout bone marrow

found in high numbers in peripheral blood

Lymphoma

malignant cells occur as nodular masses in lymph nodes, other organs

Band neutrophil and left shift

release of immature granulocytes from bone marrow into peripheral blood

occurs when the marrow is under stress - infection

Epstein Barr virus

most common human virus

human herpesvirus 4

Waldenstrom

a rare blood cell cancer characterized by an excess of abnormal white blood cells in the bone marrow.

Multiple Myeloma

a cancer that forms in a type of white blood cell called a plasma cell.

Acute lymphocytic leukemia

a type of cancer of the blood and bone marrow 

progresses rapidly and creates immature blood cells

50% cure rate

Chronic lymphocytic leukemia

A type of cancer of the blood and bone marrow spongy and progresses slowly coming from the lymphocytes

B cell

prone to infection

10 year survival rate

Hodgkin lymphoma

starts with epstein barr virus in immunocompromised patients

Defective T cells

non hodgkin lymphoma

B cells - aggressive

Diffuse type - non hodgkin lymphoma

abnormal histology, aggressive

Follicular type - non hodgkin lymphoma

microscopic pattern resembles normal lymphoid follicles

less aggressive, better prognosis

Lymphoid cells

lymphocytes

Myeloid stem cells - red blood cells

polycythemia vera

Myeloid stem cells - megakaryocyte

malignant thrombocythemia

protein electrophoresis

plasma cell disease

myeloid cells

granulocytes or monocytes

Response to bacterial infection

granulocytosis - mainly neutrophils

Response to viral infection

lymphocytosis

Response to parasitic infection

eosinophilia, eosinophilic, leukocytosis

Band neutrophils (immature cell) and left shift occur following:

sever injury and bacterial sepsis

Infectious mononucleosis

(lymphocytosis) self resolving, young people

Caused by EPstein - Barr virus infecting B lymphocytes

Lymphadenopathy

enlarged swollen nodes

lymphadenitis

infection of lymph node

Reactive hyperplasia/ reactive lymphadenitis

lymph node is not itself infected, just responding

Cat scratch disease (subacute regional lymphadenitis)

a rickettsia like microorganism infection, children, teens

Lymphoid stem cell - B cell

plasma cell → benign plasma cell proliferations, multiple myeloma, waldenstrom

Lymphoid stem cell - natural killer cell + T cells

Lymphomas, lymphocytic leukemias

Myeloid stem cells - monocyte

myelodysplasia

acute myeloid leukemia

Myeloid stem cell - granulocyte

chronic myeloid leukemia

acute myeloid leukemia

acute myeloid leukemia

a type of cancer that starts in the blood forming cells of the bone marrow

immature WBC’s present

most common type of acute leukemia in adults

progresses rapidly

evolution from chronic myeloproliferative disorder

young: 50% 5 yr survival rate

older: 10% 5 yr survival rate

chronic myeloid leukemia

a type of cancer that starts in the blood forming cells of the bone marrow

progresses slowly

evolution into acute myeloid leukemia

myelodysplasia

a group of disorders caused when something disrupts the production of blood cells

Spherocytosis

an inherited disease that changes the shape of and decreases the life of red blood cells - leads to anemia

disk like shape

GLucose-6-P dehydrogenase deficiency

a genetic disorder that affects red blood cells, which carry oxygen from the lungs to tissues throughout the body. In affected individuals, a defect in an enzyme called glucose-6-phosphate dehydrogenase causes red blood cells to break down prematurely

Hemoglobinopathies

a group of disorders passed down through families (inherited) in which there is abnormal production or structure of the hemoglobin molecule

examples: sickle cell disease, thalassemias

Sickle cell anemia

an abnormal form of hemoglobin that causes the red cells to become rigid, and sickle shaped

thalassemia

a blood disorder passed down through families (inherited) in which the body makes an low amount of hemoglobin

Excessive bleeding is associated with

1. fragile blood vessels
2. low platelet count or defective platelet function
3. decreased coagulation factor activity

Lupus anticoagulant

autoimmune antibody

interferes with tests

looks like poor coagulation but opposite is true (venous thrombosis)

Factor V leiden

genetic defect deactivating coagulation factor V- venous thrombosis

foot strike hemolysis

the repeated and forceful impact of the feet with the ground is thought to cause direct injury to the erythrocytes within the capillaries

malaria

a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans.

Sickle cell disease

* genetic autosomal recessive defect in hemoglobin formation
* The altered hemoglobin causes red cells to be deformed into a sickle shape
* Malformed RBC’s clog capillaries and impair blood flow
* prematurely destroyed by the spleen

Polycythemia

too many red cells