N300 Hemolytic Disorders

when entire CBC is suppressed, marked decrease in the number of RBCs, WBCs, and platelets

in cases of anemia, hemorrhage, and states of hemodilution.

So, if Hb is increased, it can be found in polycythemia or in states of hemoconcentration-- which can be developed from volume depletion

• represents the percentage of RBCs compared with the total blood volume.
• Reductions adn elevations of hct are seen in teh same conditions that raise adn lower Hb. HCT= 3xHb

associated with indection, inflammation, tissue injury or death, and malignancies (leukemia or lymphoma). Doesn't tell degree of illness but can help with etilogy

• Leukopenia
• associated with bone marrow depression, severe of chronis illness, and some types of leukemia

• measures the % of each type of leukocyte
• provides clues to determine the cause

• when infections are severe, the body releases more granulocytes from the bone marrow. To meet the increased demand, mant young, immature polymorphonuclear neutrophils are released into circulation.
• Since we write in lab notes the WBCs in order of maturity, with the immature ones on the left of the sheet. So.... the existence of many immature cells will be termed a "shift to the left".

• absolute neutrophil count is less than 1000 cells/mul
• severe is less than 500 cells

150,000 to 400,000

neutrophil count of below 100,000

• bleed may occur.
• Spontaneous hemmorrhage occurs when it is below 20,000

• excessive platelets
• occurs with inflammation adn some malignant disorders
• Excessive clotting is a likely complication

deficiency in the # of RBCs, the quality of Hg, and/or the volume of packed RBCs (HCT).

a group of diseases that have an autosomal recessive genetic basis involving inadequate productino of normal hemoglobin

a disease in which the astric mucosa is not secreting IF beacuse of antibodies being directed against the gastric parietal cells and/or If itself. Causes Megaloblastic anemia

• group of disorders caused by impaired DNA synthesis. Characterized by the presence of large RBCs (megaloblasts)
• Majority result in teh deficiency of Cobalmin (vit B12) and folic acid

• Alters the structure and disrupts the function of the peripheral nerves, spinal cord and brain.
• Impairs cellular division and maturation esp in rapidly proliferating RBCs.

• Intrinsic factor
• Protein secreted by the patietal cells of teh gastric mucosa
• IF is required for colbalmin absorption in the small intestine

You can get megaloblastic anemia. Folic acid is required for DNA synthesis-- RBC formatino and maturation

• results from a decreased production of bone marrow elements.
• Pancytopenia
• Hypocellular bone marrow

• decrease of all blood cell types-- RBCs, WBCs, and platelets.
• Causes Aplastic anemia

• marrow replaces with fat
• Causes Aplastic anemia

• trauma, stroke, adn surgery-- a result of sudden hemorrhage
• Blood volume and RBCs usually diminished

bleeding ulcer, hemorrhoids, menstrual and post menopausal blood loss

destruction or hemolysis of RBSs at a rate that exceeds production.

• result from defects in the RBCs themselves caused by abnormal hemoglobin (e.g. sickle cells), enzyme deficienciesthat alter glycolysis, or RBC membrane abnormalities
• *usually hereditary

These are acquired. in this type, the patient's RBC's are normal, but damage is caused by external factors such as trapping of cells within the sinuses of the liver or spleen, antibody-mediated destruction, toxins, or mechanical injury

• Sickle Cell Disease
• Group of inherited, autosomal recessive disorders.
• Chronic form of hemolytic anemia

• 8% of African americans are heterozygous (carriers),
• 1% are homozygous (have the disease)

• An anti-sickling agent
• Erythropoietin in pt unresponsive to this

• 1. physical factors
• 2. immune reactions
• 3. infectious agents and toxins

autosomal recessive disease characterized by increased intestional iron absorption and, as a result, increased tissue iron depostition. The most common genetic disorder among whites

Increase in teh number of circulating RBCs and concentration of Hgb

neoplastic stem cells disorder increase production of RBCs, granulocytes, and platelets

most common out of the two, abnormal increase in erythropoietin causeing excessive RBC production

Burning sensation of the fingers and toes

Secondary

• a decrease in the # of circulating plateles
• Lecture= <100,000
• Book= <150,000

8-10 days

• 1. Dec. production (inherited or acquired)
• 2. Inc. destruction (immune system defect called ITP or caused by infection or drug induced) acute form found in children. Chronic form found in women 20-50
• 3. Inc. Consumption

group of hereditary sex-linked clotting factor disorders characterized by prolonged coagulation times resulting in excessive bleeding

• deficiency in factor VII (necessary for stabilization of fibrin clots)
• Most common form (80% of all cases)

deficiency in factor IX (vitamin dependent beta globulin essential in stage one of intrinsic coagulation system as an influence on teh amount of thromboplatin available)

deficiency of von Willebrand factor which is necessary for factor VII activity and platelet adhesion.

disseminated intravascular coagulation

• abnormal initiation and acceleration of clotting adn simultaneous hemorrhage
• Paradoxical bleeding occurs as a result of consumption of clotting factors and platelets

Always an underlying condition

a decrease in the total WBC count (granulocytes, monocytes, and lymphocytes)

a deficiency of granulocytes (neutrophils, eosinophils, and basophils)

• reduction in neutrophils-- some use this interchangeably with granulocytopenia.
• Neutrophils are monitored closely becuase they play a major role in phagocytizing pathogenic microbes-- indicates a patients risk for infection.

4000-11000

• <2000
• <500

• •Malignant disorder of blood forming tissues of the bone marrow, spleen, and lymph system
• characterized by unregulated proliferation of WBCs and their precursors.

–Acute lymphocytic leukemia (ALL)

•Peak ages 2-4

• •Immature granulcytes
• proliferate and accumulate in marrow

• •More common in men peaks between
• ages 50-70

• •Abnormal and incompetent
• lymphocytes proliferate and accumulate in lymph nodes and spleen

• •Al age groups but peak is around
• age 60

• •Uncontrolled proliferation of myeloblasts
• which are precursors to granulocytes and accumulate in bone marrow

•Uncommon under age 20

• •Uncontrolled proliferation of
• granulocytes resulting in increased circulating blast cells

• •Marrow expands into long bones,
• and spleen

• Lymphomas are a group of
• malignant neoplasms that affect the lymphatic system resulting in the proliferation of lymphocytes

Hodgkin's and Non-Hodgkins

•More common in men and Whites

• •Peaks 15-35 years of age &
• 55-70 years of age

• •Possible causes (Epstein Barr
• virus/familial pattern, exposure to toxins)

• •Originates in lymph node and
• infiltrates the spleen, lung and liver

•Reed-Sternberg cell present

•Most common form of lymphoma

•Affects adults 50-70 years old

•More common in men and whites

• •Link to viral infections, immune
• disorders, genetic abnormalities, exposure to chemicals, infection with
• H-pylori

•Reed-Sternberg cells are absent

• •Lymphoma originates outside lymph
• and infiltrates the lymph nodes