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Blood Components

Blood Components. Eldhose Thekkethottiyil MS2 Jeffrey Nguyen MS2. Blood – The River of Life. Transports several vital nutrients to body tissues – Oxygen, amino acids, glucose etc. Removes waste products from cells – carbon dioxide, urea, lactic acid etc.

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Blood Components

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  1. Blood Components Eldhose Thekkethottiyil MS2 Jeffrey Nguyen MS2

  2. Blood – The River of Life • Transports several vital nutrients to body tissues – Oxygen, amino acids, glucose etc. • Removes waste products from cells – carbon dioxide, urea, lactic acid etc. • Immunological functions – WBC circulation and foreign body detection (via. Antibodies) • Coagulation • Hormonal transport • pH and temperature regulation

  3. What’s in the blood?

  4. Blood Plasma

  5. Formed Elements

  6. Formed Elements Number or % • Red Blood Cells 4-6 million/mL • Leukocytes 6,000-10,000/mL • Neutrophils 35-71% • Lymphocytes 25-45% • Monocytes 0-10% • Eosinophils 0-6% • Basophils 0-2% • Platelets 140,000-340,000/mL

  7. Red Blood Cells • Anucleate cells with biconcave shape • Engineered to provide optimum 02 transport • To survive in the microcirculation, RBCs must be deformable; biconcave shape allows for maximal deformability

  8. Erythrocyte Membrane • Consists of a bimolecular phospholipid sheath • Integral membrane proteins provide a net negative charge and facilitate diffusion of glucose and ions • Lipid sheath affixed to cytoskeleton made of spectrin, actin, ankyrin and other components

  9. Hereditary Spherocytosis • Autosomal Dominant or Recessive • Defects in any protein of RBC membrane can affect membrane integrity • Most common defect is with Ankyrin • Phagocytosis of non-deformable RBCs occur in spleen

  10. Hereditary Spherocytosis

  11. RBC Antigens

  12. Sickle Cell Anemia Composed of… 2 aglobin chains + 2 bglobin chains

  13. Single nucleotide substitution of thymine for adenine leading to amino acid change from glutamine to valine at sixth position glutamine Normal b globin gene 6th Sickle b globin gene valine Linkage of Hb S tetrads

  14. Sickle Cell Fiber Bundles

  15. Stroke Skin Ulcers Painful Crisis Priapism Acute Chest Syndrome Sickle Cell Effects

  16. Neutrophils – PMN (Polymorphonuclear) • 10-12m in diameter • First line of defense against bacterial infection • Actively engulf antibody- coated (opsonized) bacteria • Specific (secondary) cytoplasmic granules contain enzymes capable of digesting macromolecules and killing microbes

  17. Neutrophils • Multilobed nucleus with heterochromatin at the periphery. • Most organelles are absent; punctate glycogen particles in cytoplasm • Numerous granules including lighter- appearing specific granules and dense primary granules

  18. Basophils • Very few in peripheral blood (0-2%) • Nucleus obscured by large basophilic granules • Membrane fixes IgE; degranulates on exposure to specific antigen • Granules contain histamine, heparin and slow-reacting substance of anaphylaxis (SRS) • Functionally related to the tissue mast cell

  19. Basophils • Nuclear lobes appear as separate bodies but are connected • Large, irregular basophilic granules containing myelin figures (MF) • Small mitochondria

  20. Eosinophils • Moderate sized refractile eosin staining granules; bilobed nucleus • Increased blood levels with asthma, during allergic reactions and with parasitic and chronic infections • Granules contain histaminase which counters vasoactive agents of the basophil

  21. Eosinophils • Bilobed nucleus • Moderate sized granules, some with crystalline bodies within granule • Few mitochondira

  22. Lymphocytes • Smallest leukocyte in blood • Intensely-staining, spherical nucleus, smudged chromatin, thin rim of cytoplasm • Immune stimulation causes larger size, increased cytoplasm, bluer cytoplasm

  23. LymphocyteElectron Microscopic Features • Punctate cytoplasm due to free ribosomes • Several mitochondria • Centrosphere region containing centriole • Small golgi apparatus

  24. Lymphocyte Subtypes • B lymphocytes: 10-15% of peripheral lymphs; programmed to transform into plasma cells on re-exposure to specific antigen • T lymphocytes: 70-80% of peripheral lymphs primed to respond via antigen specific membrane protein on re-exposure to antigen: • Tcytotoxic - programmed to kill targeted foreign cells • Thelper - enhance B cell proliferation • Tsuppresor - suppress B cell proliferation • Tnatural killer - kill target cells without prior sensitization

  25. Monocytes • Largest leukocyte • Indented nucleus • “Ground-glass” cytoplasm; few faint non-specific granules • The mononuclear phagocyte from which all macrophages are derived • Monocyte-macrophages are antigen presenting cells (APCs)

  26. MonocyteElectron Microscopic Features • Markedly indented nucleus • Golgi, centriole and mitochrondria • Small dark granules represent lysosomes containing enzymes and other peptides important for host defense

  27. Granulocytes PMN Basophil Eosinophil Band

  28. Platelets • Anuclear • Derived from precursor megakaryocytes • Average life span is 5-9 days • Key player in blood homeostasis (low vs. high numbers) • Produces PDGF (platelet derived growth factor) and TGF-Beta. These factors play a very important role in angiogenesis and connective tissue repair • Normal levels – 150,000 – 400,000/uL of blood

  29. Complete Blood Count (CBC)

  30. Basic Metabolic Panel • CHEM-7 • Sodium • Potassium • Chloride • Bicarbonate • BUN • Creatinine • Glucose • Calcium (not part of CHEM-7 but often is part of BMP) • Why perform the test? • Evaluate kidney function • Blood acid-base balance • Blood sugar levels • Electrolytes • Normal Levels • BUN: 7 to 20 mg/dL • CO2 (carbon dioxide): 20 to 29 mmol/L • Creatinine: 0.8 to 1.4 mg/dL • Glucose: 64 to 128 mg/dL • Serum chloride: 101 to 111 mmol/L • Serum potassium: 3.7 to 5.2 mEq/L • Serum sodium: 136 to 144 mEq/L

  31. Diagnostic Tests Complete Blood Count (CBC) Bone Marrow Biopsy Lymph Node Biopsy Peripheral Blood Smear Lumbar Puncture Cytogenetic s Immunophenotyping

  32. Diagnostic Tests Complete Blood Count (CBC) Bone Marrow Biopsy Lymph Node Biopsy Peripheral Blood Smear Lumbar Puncture Cytogenetics Immunophenotyping

  33. Peripheral Blood Smear • A drop of blood from a sample of patient’s blood is applied to a glass slide and spread across to form a thin film • Fixed with methanol • Stained • Viewed under microscope • Allows us to see what the blood cells look like and see if there are any abnormalities Source: Wikipedia

  34. Peripheral Blood Smear www.pathologyoutlines.com

  35. Cytogenetics Definition: A branch of genetics that is concerned with the structure and function of chromosomes Example: FISH-Fluorescent In Situ Hybridization Allows use to look for DNA mutations that are specific for certain diseases

  36. FISH Wikipedia

  37. FISH BCR-ABL Translocation in Chronic Myelogenous Leukemia

  38. Immunophenotyping Technique used to study protein expression on the surfaces of cells Cell are labeled with antibody that binds to specific protein on cell membrane Mixture is passed through flow cytometer that is able to count the number of cells and characterize the surface protein expression In certain disease states (ieleukemias) cells have a characteristic set of proteins that are expressed on their cell surface

  39. Flow Cytometry

  40. Anemia Definition: A reduction in hemoglobin concentration of the blood Symptoms: shortness of breath, weakness, lethargy, palpitation, headache, confusion, visual disturbances (severe) Signs: pallor (pale), tachycardia (fast heart rate), systolic flow murmur , spoon nails (iron-deficiency anemia), leg ulcers

  41. Signs of Anemia Pallor “Spoon nails”

  42. Sickle-Cell Anemia A type of anemia in which there is a mutation in the β-globin gene: a glutamic acid is changed to a valine Causes hemoglobin to polymerize into long fibers during conditions of low oxygen (extremities) Polymerization leads to deformation of the red blood cell Deformed red blood cells sickle and can clog up small blood vessels leading to infarction of various organs

  43. Sickle-Cell Morphology Normal Red Blood Cell Sickled Red Blood Cell

  44. Sickle-Cell Anemia • Clinical course: general mild symptoms of fatigue punctuated by painful crises, which can be induced by infection, acidosis, dehydration, stasis, and deoxygenation • Complications: infarctions, stroke • Treatment: prophylaxis, folic acid, vaccinations, hydroxyurea, stem cell transplantation

  45. Questions?

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