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BLOOD

Well Come. BLOOD. PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE LIAQUAT UNIVERSITY OF MEDICAL & HEALTH SCIENCE JAMSHORO. BLOOD INTRODUCTION. BLOOD CONSISTS OF: Red Cells White cells Platelets Plasma, in which above elements are suspended. BLOOD. FORMATION OF BLOOD:

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BLOOD

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  1. Well Come BLOOD PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE LIAQUAT UNIVERSITY OF MEDICAL & HEALTH SCIENCE JAMSHORO

  2. BLOOD INTRODUCTION • BLOOD CONSISTS OF: • Red Cells • White cells • Platelets • Plasma, in which above elements are suspended.

  3. BLOOD • FORMATION OF BLOOD: • 2nd week→blood islands in yolk sac. • 3rd week→migrate to liver and spleen chief sites of erythropoisis • 5th month → bone marrow-MED. Haemopoisis. (erythropoisis). • At birth→ marrow of nearly every bone. • At adult life→ confined to end of long bones→axial skelaton, ribs and skull.

  4. BLOOD • FORMATION OF BLOOD: • Path. processes→ extramedullary haemopoisis in liver & spleen. NB. All peripheral blood cells are derived from single stem cell (pleuripotent steam cell), Stems cells • Self renerwal • Diff. Into mature cells

  5. BLOOD NB. Ist detectable CFU IS CFU-S(colony forms unit spleen, which gives rise to CFU-GEMM (i.e. Granulocyte, Erythroid cells, Monocytes, Megakaryocytes).

  6. BLOOD • Haemopoietic growth factors: • All factors are glycoprotein • Factors include: - Erythropoietin - Colony Stimulating factors (CSF) - Interleukins (IL) Gene for most of them is 5 chromosome. And many growth factors are produced by recombinant DNA tech. e.g. GM-CSF after B.M. transplantation to accelerate neutrophil recovery.

  7. Erythroiten used for anemia in CRF Totipotent stem cell Pluripotent myeloid stem cells Pre I Pre B Blast cells T. lymphocyte B. lymphocyte Monoblast proerythoblast Myeloblast Promytocyte Megak eryoblast Early normo Int.Normo Lat.Normo Proliferative phase Maturation phase Recti. Rect Released B. marrow Red cell N M Plat B E

  8. BLOOD • ANEMIA: • Defined as a state in which the blood Hb level is below the normal range for the patient’s age and sex. • CLASSIFICATION OF ANEMIA: • Blood loss - Acute - Chronic inadequate production of normal RBC by Bone Marrow (hypoplasia, aplasia) - Excessive destruction of RBCS (Haemolysis)

  9. BLOOD • MORPHOLOGICAL CLASSIFICATION: • Normocytic (N.MCV) • Microcytic (↓MCV) • Macrocytic (↑MCV)

  10. BLOODCLASSIFICATION OF RED CELL APPEARANCE • MICROCYTES (SMALL CELL) • ↓MCV(>80f L) Iron Deficiency Anemia • Fe content reduced • Normal Fe. content - Thallesemia-Siderrobalstic anemia

  11. BLOOD CLASSIFICATION OF RED CELL APPEARANCE • MACROCYTES (LARGE CELLS) • ↑MCV(>96fl) • Megalobalastic - B 12 - Folate • Normoblastic - Liver D. Alcohol Haemlysis

  12. BLOODCLASSIFICATION OF RED CELL APPEARANCE • NORMAL CELLS • MCV • Normoblast • Ac blood less • Anemia of Ch. • Disease e.g. • Infection • R.F. • C.T. Dis. • Malig. • Endo.

  13. BLOODCLASSIFICATION OF RED CELL APPEARANCE • UNUSUAL CELLS • Spherocyte • Sickle cell • Schistocytes • Burr cells • Howell jolly bodies • Poikilocytes • Blister cells

  14. BloodSYMPTOMS & SIGNS OF ANEMIA • SYMPTOMS • Lassitude • Fatigue • Breathlessness on exertion • Palpitation • Throbbing in head & ears • Dizziness • Tinitus

  15. BLOODSYMPTOMS & SIGNS OF ANEMIA • SYMPTOMS • Headache • Diminish of vision • Insomnia • Paraesthesia of finger & toes • Angina

  16. BLOODSYMPTOMS & SIGNS OF ANEMIA • SIGNS • Pallor of - Skin - Mucous membrane - Palm of hands - Conjunctive • Tachycardia • Cardiac dilatation • Systolic flow murmurs edema.

  17. BLOODAnemia due to inadequate production of Red cells: • CAUSES: • Deficiency of essential factors: - Iron, vit.12 Folate. • Toxic factors: - Inflammatory disease, Hepatic or Renal dis.,Dgs. • Endocrine Diseases: - Hypo or Hyperthyroidism, hypopittutism hypogonad:↓erythryroitin.

  18. BLOODAnemia due to inadequate production of Red cells: • CAUSES: • Invasion of Bone Marrow - Leukemia, sec. ca., fibrosis. • Disorders of developing Red cells. - Sideroblastic anemia, Neoplastic disorders of erythropoisic, other iodiopathic refactory anemia, heridatory disorders of Hb. Synthesis (Thallasemia) • Failure of stem cells. - Hypoplastic & aplastic anemia.

  19. BLOODIRON DEFICIENCY ANEMIA • CAUSES: • Poor intake • Decreased absorption • ↑ demands • Blood loss

  20. BLOODIRON DEFICIENCY ANEMIA • CLINICAL FEATURES: • Symptomatology of iron deficeincy is mainly that of anemia. However there are charachteristic features, these are mainly epitelial changes produced by inadequate iron in the cells. - Brittle nails - Spoon-shaped nails (koilonychias) - Atrophy of the papillae of the tongue.

  21. BLOODIRON DEFICIENCY ANEMIA • CLINICAL FEATURES: • Angular stomatitis • Brittle hairs • A syndrome of dysphagia and glossitis (Plummer-Vinson ro Peter-Brown-Kelly syndrome). • Rarely in severe deficiency parotid enlargement, spleenomegaly and failure to grow.

  22. BLOOD • GOOD CLINICAL HISTORY • Dietary intake • Self Medication –NSAIDS. • Blood in faeces (Haemrrhoid or ca. lower Bowl) • P/R examination.

  23. BLOOD • ORAL • Fe sulphate 200 mg/100 • PARENTERAL • Iron sorbital 1.5mg • Per kg/body wt daily • l/m, never give.

  24. Thank you

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