Chapter 7 Blood and Blood-Forming Organs Diseases and Disorders
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Transcript of Chapter 7 Blood and Blood-Forming Organs Diseases and Disorders
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Anatomy and Physiology
Hematologic system Major functions of blood
Transport nutrients to cells Aid removal of wastes
Average adult has 5 to 6 liters of circulating blood
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Anatomy and Physiology
Normal erythrocyte count 4.2 to 6.3 million
Erythrocytes life span - 120 days Erythrocytes form in the bone marrow
and do not reproduce
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Anatomy and Physiology
Hemoglobin important in oxygen transport
Normal hemoglobin - Male - 13.5 to 18 gm/female – 12 to 16 gm
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Anatomy and Physiology
Leukocytes protect individual from infection Normal leukocyte count is 4,500-11,000 Platelets known as thrombocytes Important in blood clotting Normal platelet count is 150,000-350,000
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Anatomy and Physiology
Blood-forming organs include lymph nodes, bone marrow, spleen, liver
Lymph system protects against pathogens
Bone marrow is major blood cell producer
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Anatomy and Physiology
Spleen produces lymphocytes, plasma cells, and antibodies; filters microorganisms from the blood
Responsible for producing prothrombin and fibrinogen for blood clotting
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Common Signs and Symptoms Erythrocytopenia (decrease in RBCs)
leads to anemia
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Common Signs and Symptoms Common signs and symptoms of
anemia FatigueHeadacheLow RBCsPallorShortness of breath
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Common Signs and Symptoms Erythrocytosis (increased RBCs) Common signs and symptoms
High RBCsReddened skin tonesBloodshot eyesIncreased blood volume and pressureIncreased blood volume of the heart
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Common Signs and Symptoms Leukocytopenia (decreased white blood
cells) weakens immune system Leukocytosis (increased white blood
cells) is a normal response to acute infections
Thrombocytopenia (decreased platelet count) leads to coagulation problem
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Common Signs and Symptoms Signs and symptoms
Petechiae - small hemorrhages in the skinEcchymoses - large areas of bruising or
hemorrhageEpistaxis - nosebleedsBleeding in mouth, gums, and mucous
membranes
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Common Signs and Symptoms Thrombocytosis (increase in platelets) Condition is uncommon Usually no serious side effects
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Diagnostic Tests
Complete blood count with differential and indices
Biopsy of blood-forming organs Hematocrit (hct) reflects amount of red cell
mass as a proportion of whole blood Hemoglobin (hgb) reflects the blood’s
oxygen-carrying potential
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Diagnostic Tests
Bleeding time determines platelet disorders such as hemophilia, thrombocytopenia, disseminated intravascular coagulation
PT (prothrombin time) and PTT (partial prothrombin time) measure blood’s ability to clot
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Diagnostic Tests
BiopsyBone marrowLymph node
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Disorders of Red Blood Cells Anemia
Decrease in oxygen-carrying ability of the RBC
Symptoms ○ Pallor○ Fatigue○ Shortness of breath
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Disorders of Red Blood Cells Anemia
Symptoms ○ Tachycardia○ Headache○ Irritability○ Syncope
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Disorders of Red Blood Cells Iron-Deficiency Anemia
Loss of iron or inadequate intake of ironCauses - blood loss and low dietary intakeTreatment - increase dietary intake of iron
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Disorders of Red Blood Cells Folic Acid Deficiency Anemia
Folic acid needed for maturation of RBCsPoor diet, overcooking vegetables, or over
consumption of alcohol
Treatment: folic acid by eating green and yellow vegetables
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Disorders of Red Blood Cells Pernicious Anemia
Lack of intrinsic factor leading to inadequate absorption of vitamin B12
Treatment: monthly injections of vitamin B12 for life
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Disorders of Red Blood Cells Hemolytic Anemia
Destruction of RBCs related to antibody-antigen reaction
Disorder of immune system leading to destruction of erythrocytes
Treatment: exchange transfusion and/or a splenectomy
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Sickle Cell Anemia
Hereditary; no cure Found in black race Abnormal sickle shape of the erythrocyte Sickle shape does not allow the cell to
travel smoothly through vessels Treatment is symptomatic
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Disorders of Red Blood Cells
Aplastic Anemia - failure of bone marrow to produce blood components
CausesChemotherapy, radiation, viruses, and toxins
Treatment: avoid causative agent, bone marrow transplantation, and transfusions
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Disorders of Red Blood Cells Polycythemia - too many blood cells Spleen is enlarged, mucous membranes
are reddened, bloodshot eyes, palms are deep red color
Treatment: donate blood at regular intervals to reduce blood volume
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Disorders of White Blood Cells Mononucleosis - “kissing disease” Symptoms
Fatigue, sore throat, and swollen glands
Diagnosis - Increase monocytes in WBC Treatment: rest, analgesics, and throat
gargles
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Disorders of White Blood Cells Leukemia - malignant neoplasm of
blood-forming organs Abnormal production of immature
leukocytes Classified as acute or chronic Acute forms affect children, progress
rapidly, and may be fatal
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Disorders of White Blood Cells Chronic forms of leukemia occur in older
adults, often asymptomatic, and may not be lethal
Classified as Myelogenous - affecting bone marrowLymphocytic - affecting lymph nodes
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Disorders of White Blood Cells Bone marrow biopsy to confirm
diagnosis Symptoms
Fatigue HeadacheSore throat
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Disorders of White Blood Cells Symptoms
Dyspnea bleeding of mucous membranes of the mouth and GI system
Bone and joint painEnlargement of lymph nodes, liver, and
spleen
Infections are common
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Disorders of White Blood Cells Treatment of Leukemia
Aggressive chemotherapyOnce in remission, a bone marrow
transplant to replace neoplastic tissue with normal tissue
Remission: 50 percent
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Disorders of White Blood Cells Hodgkin’s Disease
Most common lymphomaPainless enlargement of lymph nodes in
neck, weight loss, and feverPrimarily affects young adults with average
age of 35
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Disorders of White Blood Cells Hodgkin’s Disease
Cause thought to be viral Diagnosis made by presence of Reed-
Sternberg cell in lymphatic tissue
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Disorders of White Blood Cells Hodgkin’s Disease
Treatment ○ Radiation○ Chemotherapy○ If kept in remission for 5 years or longer,
complete cure may be possible
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Disorders of White Blood Cells Non-Hodgkin’s
Lymphomas lacking Reed-Sternberg cellSymptoms:
○ Painless enlargement of lymph nodes of neck○ Axilla and inguinal areas○ Fever, night sweats, and weight loss
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Disorders of White Blood Cells Non-Hodgkin’s
Affects adults: average age of 50Treatment: radiation and chemotherapy
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Disorders of White Blood Cells Multiple Myeloma
Malignant neoplasm of plasma cells or B-lymphocytes
Increases with age, peaking in seventiesPlasma cells multiply abnormally in bone
marrow causing weakness and leading to fractures and bone pain
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Disorders of White Blood Cells Diagnosis of Multiple Myeloma
Honeycombed bone patternHypercalcemiaSpecial protein called Bence Jones found in
blood and urineBone marrow biopsy
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Disorders of White Blood Cells Multiple Myeloma
Treatment○ Chemotherapy○ Radiation○ Treatment is not effective and prognosis is
poor
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Disorders of Platelets
HemophiliaX-linked hereditary bleeding disorderSeveral types of hemophilia – Type A is
most commonMale children from asymptomatic mothersLack protein necessary for clot formation
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Disorders of Platelets
HemophiliaEpistaxis, bruising, and prolonged bleedingDiagnosis confirmed by blood test; no cureTreatment: prevention of injury and treat
symptomsBlood transfusions and concentrated form of
clotting protein
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Disorders of Platelets
Thrombocytopenia Thrombocytopenia purpuraDecrease in platelets leading to inability to
normally clot blood
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Disorders of Platelets
Thrombocytopenia Characteristics:
○ Petechiae○ Abnormal bleeding in skin, mucous membranes,
and internal organs○ Ecchymoses, GI hemorrhages, epistaxis,
hematuria
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Disorders of Platelets
Diagnosis made by platelet count and bleeding time
TreatmentAvoid tissue trauma to reduce bleedingVitamin KTransfusions of plateletsSplenectomy
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Disorders of Platelets
Disseminated Intravascular Coagulation (DIC)Abnormal clotting followed by abnormal bleedingUsually follows major trauma such as
complicated childbirth, surgery, tissue destruction, septicemia, snakebite, and shock
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Disorders of Platelets
DICMultiple clots in capillaries Symptoms: petechiae, ecchymosis,
hematoma, hematuria, GI bleeding, hematemesis, blood in stool
Treatment: heparin and platelets Life threatening
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Disorders of Platelets
Rare DiseasesThalassemia
○ Affects primarily people of Mediterranean descent
○ RBCs are fragile and thin and form defective hemoglobin
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Disorders of Platelets
Rare DiseasesVon Willebrand’s Disease
○ Hereditary○ Congenital ○ Deficiency in clotting factor and platelet
function○ Also called angiohemophilia○ Affects females as well as males
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