Hematopoietic
making blood
Blood is derived from stem cells in bone marrow they differentiate into...
RBCs, WBCs and platelets
Blood components
Two components
-Blood cells:
--Leukocytes-WBCs
--Thrombocytes-Platelets
--Erythrocytes-RBCs
-Plasma
Red blood cells are made in the...
Red bone marrow
Leukocytes
Only 1% blood volume except for when you have an infection then they are the most prominent in the body
-Role in inflammatory and immune processes
--They are going to increase when the immune system is being targeted to fight off the infection
Neutrophils
-Granulocyte
(55%-65% of all WBCs)-makes up the majority of WBCs
-Defend against pathogens
-Mediate the inflammatory response
-Short life span
-First to respond during an immune response
Lymphocytes
20-30%
-Long life span
-Defend against foreign microbes in immune response
-B lymphocytes: Bone marrow
-T lymphocytes: in thymus
-Natural Killer (NK) cells
Monocytes and Macrophages
3-8% of all WBCs
-Called macro phased
-Engulf larger and greater quantities of foreign substances than neutrophils
-Role in chronic inflammation
-Involved in immune system
--Activate lymphocytes
--Present antigens to T cells
*These monocytes and macrophag
Neutropenia
Decrease in neutrophils (<1500 cells/uL)
-Seen in:
--Chemotherapy
--Patients receiving radiation
--Patients with aplastic anemia
-Great risk for infection
--Because there is not first line response to antigen
Leukopenia
Absolute decrease in WBCs
Agranulocytosis
Severe neutropenia (<200 cells/uL)
Leukocytosis
too many WBCs-this is side effect of many drugs that affect leukopenia
-If you have an infection you are going to see leukocytosis an increase in WBCs-more blood cells are going to try and fight off foreign body
Infectious Mononucleosis
-Caused by Epstein Barr virus (EBV)
Primarily effects the WBC lines
-Infects the lymphatic tissue and spreads to the B lymphocytes
-Part of the side effects of having mono significant inflammation in the lymph tissue
-Sore throat for an extended period of
How long is the incubation period for Infectious Mononucleosis?
4-8 weeks
-Exposed, it infects immune system, B cells begin to proliferate and don't experience symptoms
-90% of all Americans have come in contact with the virus
-Common along college aged kids
-Prodromal Period (the period from onset to the period of in
Malignant Lymphoma
Two types: hodgkins lymphoma
-Solid tumors: neoplastic lymphoid tissue cels
-Tend to see a hardened mass around lymphatic tissue
-6th most common cancer in US
Non-Hodgkin
Three times more frequent than Hodgkin
-Uncontrolled lymph node and lymphoid tissue growth, bone marrow involvement, symptoms (fever, chronic fatigue, weight loss)
--These three things able
--This is why sometimes when teens get mono people thin that they
Leukemia
Malignant neoplasms (fancy way of saying cancer) of cells (usually WBC) originally derived from stem cells
-Raplacement of bone marrow with immature neoplastic cells
--Instead of bone marrow producing all healthy blood cells the cancer takes over the bone
You want cancer cells to be more differentiated then you can tell the difference between them and see where they originated so that you can target the exact spot
...
Leukemias are classified according to:
Cell type: Lymphocytic or myelocytic
Acute or chronic
Acute Leukemia
Clinical manifestations:
-Bone marrow depression
--Fever
--Bleeding
-^Due to suppression of WBCs as well as platelets
-Bone pain and tenderness
-Increased vulnerability to infection
--Due to immaturity of WBCs-they are not as effective
-Hematological abno
Multiple Myeloma
Disease of the plasma
-Cancer of plasma cells
-The plasma cells that grow in the bone marrow tend to become enlarged and mutated
-Two characteristics: very enlarged blood cells that look very unique and different-owl like cells because they look they have
Main Sites of Multiple Myeloma
Bones, bone marrow
-Proliferation and activation of osteoclasts that lead to bone resorption and destruction and destruction (this is why the bone looks honey)
-Predisposed to pathological fractures and hypercalcemia (high calcium); they break down the bo
If you do not have enough carriers of oxygen (RBCs) to the tissue, they are going to be _____ easily like walking up a flight of stairs. The might also be_______ because of the lack of oxygen reaching the head.
-Fatigued
-Confused
Hemoglobin
Rate of synthesis depends on availability of iron
Erythropoiesis
Production of RBCs
-Produced in the bone marrow
Reticulocytes
Released from bone marrow
Immature RBCs
Signify rate of RBC production
Maturation of reticulocytes to erythrocytes
24-48 hours
Why would a trained athlete do things like practice at high altitudes?
More RBCs are produced when you are at a higher altitude so that the body is able carry more oxygen to the body tissues. When you come back down to sea level the body is able transport more oxygen through all the RBCs that were produced without working th
Erythropoietin
Substance which is secreted from the kidneys which stimulates the production of RBCs
*People with kidney disease cannot produce this so they have a problem making RBCs and eventually become anemic
How long does a blood cell live for?
120 days
Destruction of RBCS
By phagocytic cells in the spleen, liver, lymph nodes and bone marrow
-One this happens the iron from the RBC is recirculated to the bone marrow
-Bilirubin is produces--> goes to liver--> conjugated to water-soluble form--> excreted in bile
-Yellow sclera
Hemoglobin Lab Values
Indicates hemoglobin content of the blood
Men: 14-16.5 g/dL
Women: 12-15 g/dL
Hematocrit Lab Values
Indicates volume of cells in 100 mL of blood
Men: 40-50%
Women: 37-47%
Anemia
Abnormally low hemoglobin levels (decrease in production) or low number of circulating RBCs (increased destruction) or BOTH!
Tissue Hypoxia
Tissues are not getting enough oxygen, this can also manifest as confusion because you are not getting enough O2 to the brain
What are some conditions in which there is bleeding?
-Diseases, trauma (gunshot wound, stabbing, etc)
What are the types if anemia that happen because of increased destruction of RBCs?
Hemolytic Anemia
and
Sickle Cell Anemia
What are the types of anemia that happen because of an inability to produce RBCs?
-Folic Acid deficiency Anemia
-Aplastic Anemia
-Iron deficiency
-Cobalamin (Vitamin B12)-deficiency anemia
Vitamin B12 can be found in all _____ foods
Animal
*This is going to be a problem for vegetarians who avoid dairy products, meat, fish
How is B12 absorbed?
By binding to intrinsic factor
-Protein secreted by gastric parietal cells of the gastric mucosa
-Intrinsic factor absent in atrophic gastritis
How can pernicious anemia meds be given?
IM, because cannot be absorbed by food and cannot be given IV
What is B12 essential for?
Synthesis of DNA
-For cell division
--If you don't have this the cells re not going to divide and going to become macrocytic (very large)
Also important for neurological function, so without this is can cause dysfunction
-Abnormally fatty acids cannot be
Where might we see a deficiency in B12?
In vegetarians who avoid dairy products, meat, fish