MRIS 210 Chapter 17

Blood provides the major transport system of the body for essentials such as oxygen, glucose and other nutrients, hormones, electrolytes, and cell wastes. 

Blood maintain a stable pH of 7.35 to 7.45

volume of red cell mass in 100 ml of plasma

Is a clear yellowish fluid remaining after the cells have been removed

The differentiation process forms committed stem cells for each type of blood cell.  These cells then proliferate and mature, providing the specialized functional cells needed by the body

Red blood cells (donut like centers but with thin centers rather than holes) 

Insufficient oxygen

destruction of RBC

production of white blood cells

Make up 30% to 40% of WBCs 

Complete blood count

Hemoglobin content of blood

indicates the proportions of specific types of WBCs in the blood and frequently assists in the making a diagnosis

Are the most common leukocyte, comprising 50% to 60% of WBCs, they only service only 4 days, they are the first to respond to tissue damage

Mean corpuscular volume= Size of RBC

appear to migrate from the blood and enter tissue to become mast cells that can release histamine and heparin. 

Tend to combat the effects of histamine. They are increased by allergic reactions and parasitic infections

Can enter the tissue to become macrophages which act as phagocytes when tissue damage occurs

Also called platelets, are an essential part of the blood-clotting process or hemostasis. Thrombocytes are not cells!

Refers to a decreased number of circulating platelets

• ›Decreased bone marrow production
• ›Increased pooling in the spleen
• ›Decreased of blood vessel integrity result from structurally weak vessels or vessel damage due to inflammation and immune mechanisms.

• ›Rapid drop in platelet count several days after resuming drug
• ›Hemorrhagic diathesis
• ›Splenomegaly

• ›Discontinue Drug
• Splenectomy

an auto immune disorder, results in platelet antibody formation and excess destruction of platelets.

• ›Sudden onset of petechiae and purpura- acute condition
• ›Bruising, bleeding from gums, epistaxis and abnormal menses
• ›Splenomegaly

Platelet counts < 20,000/ml

corticosteroid drugs, Splenectomy and immunosuppressive agents 

• deficiencies of one or more of the known clotting factors
• ›Defective synthesis
• Inherited disease
• ›Increased consumption of the clotting factors

• ›Bleeding typically occurs after injury or trauma
• ›Large bruises, hematomas, or prolonged bleeding into GI or urinary tract or joints

(clumping) antigen-antibody reaction would occur with, for example, an incompatible blood transfusion

• ›Hemophilias
• ›Types:
• ›Hemophilia A
• ›Hemophilia B
• Hemophilia C

• ›Diagnosis-
• ›CBC, Clotting tests
• ›PTT (partial thromboplastin time) measures the presence of plasma factors that act in a portion of the coagulation pathway
• PT (prothrombin time) Test the ability of blood to clot (used to monitor patients take coumadin)

• Whole blood, packed red blood cells, or packed platelets 
• ›Bone Marrow or stem cell transplants are used to treat some cancers severe immune deficiency or severe blood cell diseases

not a disease but an indication of a disease process or alteration in body function. (Blood dyscrasia- disease)

• ›1. Impaired oxygen transport
• ›2. Changes in red cell structure
• ›3. Signs and Symptoms of pathological process causing anemia

• ›1. pallor
• ›2. Angina
• ›3. Fatigue
• ›4. dyspena
• ›5. Tachycardia
• ›6. Jaundice
• ›7. Purpura, petechiae

• genetic defect in the hemoglobin causes shape of the cell to change
• ›Cells cause obstruction in the vascular structures (spleen, bone) and causes small infarcts, cells rupture
• ›Dx: CBC, blood smear, genetic studies
• ›Trx: blood transfusions, palliative, pain meds, bone marrow transplant, counseling

• ›absence of defective synthesis of hemoglobins, hereditary (found in the Mediterranean population)
• ›S&S: splenomegaly, hepatomegaly
• ›Dx: CBC, blood smear
• ›Trx: Blood replacement

• Associated with inadequate dietary iron, chronic blood loss
• ›More common in women
• Leads to decreased hemoglobin synthesis, RBCs
• ›S&S:
• ›Fatigue
• dysphagia
• Brittle hair and nails
• Angina
• SOB
• pallor

• ›Cause: blood loss, decreased dietary intake of iron
• ›Dx: CBC, blood smear
• ›Trx: ferrous sulfate, Imferon

• ›Lack of mature erythrocytes
• ›Caused: lack of intestinal absorption of B-12.  B-12 cannot be absorbed into the bloodstream without the aid of a special substance intrinsic factor that normally found in gastric juice
• ›Dx: CBC, blood smear, serum B12
• ›Trx: Vitamin B-12 injections, treat underlying intestinal disorder if present

• Caused by malnutrition, found in alcoholics and debilitated patients
• ›Dx: CBC
• ›Trx: Folic Acid 1-5mg/day

• Failure of blood cell production due to aplasia (absence of development, formation) of bone marrow cells
• ›Cause- unknown in 66% of cases, drugs, radiation, chemicals
• ›Dx: CBC, blood smear, bone marrow aspiration
• Trx: Blood Transfusions, bone marrow transplant

• ›An increase in RBCs from over production in the bone marrow
• ›Dx: CBC, bone marrow, aspiration
• ›S&S: headache, hypertension, weight loss,
• Trx: phlebotomy, chemotherapy

• a decrease in platelets (thrombocytes) drug induced or idiopathic (unknown)
• ›S&S- bruising, bleeding, splenomegaly
• ›Dx: platelet count is below 10,000
• Trx: Splenectomy, remove drug, replace the platelets

• ›MDS- involve inadequate production of cells by the bone marrow
• ›Cause: idiopathic or following chemotherapy or radiation treatment 
• ›Dx: Blood test, Bone Marrow Biopsy
• ›Trx: transfusion replacements, bone marrow transplants
• It can progress into chronic or acute leukemia

• ›A malignant neoplasm of hematopoietic stem cells causes
• replacement of bone marrow with immature neoplastic cells in large numbers

• ›Acute myelocytic leukemia (AML) ages 13-39
• ›Chronic myelocytic leukemia (CML) ages 30-50
• ›Dx: Blood smear and bone marrow aspiration(bx)
• Trx: Chemotherapy and supportive trx, bone marrow transplant

• ›Acute lymphocytic leukemia (ALL) kids ages 2-4
• Chronic lymphocytic leukemia (AML) adults over the age of 50

• ›Cytoxan›
• Prednisone
• ›Vincristine
• Asparaginase

Malignant neoplasm of cells native to lymphoid tissue, lymphocytes and histiocytes

• ›S&S: painless, progressive enlargement of a single lymph node or group of nodes usually above the diaphram (cervical or supraclavicular) fever, night sweats, fatigue, wt. loss
• ›Dx: biopsy of lymph nodes with Reed-Sternberg cell (giant tumor cell), CT of abdomen, lymphangiography
• ›Trx: radiation & chemotherapy

• ›Same as Hodgkin’s but does not have Reed-Sternberg cell
• ›Trx and dx are the same as Hodgkin’s

• ›Malignant neoplasm of bone marrow
• ›Plasma cell cancer that generally affects older people
• ›S&S: pathologic fracture, bone pain in back, hypercalcemia from bone dissolution
• ›Dx: Bence-Jones proteins in urine
• Trx: palliative, chemotherapy, there is No cure