Unit G: Hematology

1. Unit G: Hematology

2. Specific Objectives • Discuss characteristics and treatments of common blood disorders.

3. DISORDERS OF THE BLOOD ANEMIA There just aren’t enough of us! • A deficiency in the number of red cells.

4. IRON-DEFICIENCY ANEMIA • Usually in women, children and adolescents • Deficiency of iron in the diet causing insufficient hemoglobin synthesis • Treat with iron supplements and green, leafy vegetables!! http://www.grinningplanet.com/2004/12-28/green-leafy.jpg Fe &

5. APLASTIC ANEMIA Bone Marrow • Bone marrow does not produce enough red and white blood cells • Caused by drugs or radiation therapy

6. SICKLE CELL ANEMIA • Chronic blood disease inherited from both parents. • Causes the red cells to form in abnormal sickle shape. • Sickle cells break easily and carry less oxygen. • Occurs primarily in blacks • Treatment – blood transfusions and Iv fluids.

7. Microscopic look at sickle cell library.thinkquest.org/.../images/sicklecell.jpg

8. Incidence and Prevalence • More common in certain ethnic groups. • Evolved as a protection against malaria-people with sickle trait were more likely to survive malaria outbreaks in Africa than those individuals with normal hemoglobin. • One out of every 500 African Americans are effected by sickle cell disease. • 8%, or one in 12, African Americans have sickle cell trait.

9. Contusion • A bruise, also called a contusion, is a type of relatively minor hematoma of tissue in which capillaries are damaged by trauma, allowing blood to seep into the surrounding tissues.

10. Lab test to evaluate blood • Hematocrit • Red cell count • Hemoglobin

11. Hematocrit ratio of the volume of red cells to the volume of whole blood. • normal range for hematocrit varies between sexes • 45% to 52% for men • 37% to 48% for women.

12. Red cell count • signifies the number of RBCs in a volume of blood. The normal range • Men- 4.7 to 6.1 million cells/ul (microliter) • women- 4.2 to 5.4 million cells/ul,

13. Hemoglobin • A protein in RBCs that carries oxygen and gives blood its red color. The normal range for hemoglobin differs between the sexes • Men 13 to 18 grams • Women 12 to 16 grams

14. What causes blood clots? • Blood clots form when there is damage to the lining of a blood vessel, either an artery or a vein. The damage may be obvious, such as a laceration, or may occur on the microscopic level. As well, blood will begin to clot if it stops moving and becomes stagnant.

15. How does a blood clot form? • Complex mechanisms exist in the bloodstream to form clots where they are needed. If the lining of the blood vessels becomes damaged, platelets are recruited to the injured area to form an initial plug. These activated platelets release chemicals that start the clotting cascade, using a series of clotting factors produced by the body. Ultimately, fibrin is formed, the protein that crosslinks with itself to form a mesh that makes up the final blood clot.

16. EMBOLISM "moving blood clot" An embolism is an obstruction in a blood vessel due to a blood clot or other foreign matter that gets stuck while traveling through the bloodstream

17. Thrombus“Stationary Clot” • The medical term for a blood clot is a thrombus. When a thrombus is formed as part of a normal repair process, there is little consequence. Unfortunately, there are times when a thrombus will form when it is not needed, and this can have significant consequences.

18. ErythroblastosisFetalis • Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be life threatening.

19. HDN may develop when a mother and her unborn baby have different blood types (called "incompatibility"). The mother produces substances called antibodies that attack the developing baby's red blood cells.

20. The most common form of HDN is ABO incompatibility • The least common form is Rh incompatibility, which can almost always be prevented.

21. Signs and symptoms • HDN can destroy the newborn baby's blood cells very quickly, which can cause symptoms such as: • Edema (swelling under the surface of the skin) • Newborn jaundice

22. Treatment • After birth, a transfusion may need to be performed. • Drugs used to treat allergic reactions (antihistamines and steroids) • Light therapy using bilirubin lights • Medicines to raise blood pressure if it drops too low

23. HEMATOMA • Localized, clotted mass of blood found in an organ, tissue or space. • Caused by an injury that causes a blood vessel to rupture 208.96.47.3/.../dermatlas/hematoma_1_050501.png

24. What Is Hemophilia? • Arare, inherited bleeding disorder in which your blood doesn’t clot normally. If you have hemophilia, you may bleed for a longer time than others after an injury. • People born with hemophilia have little to none of a protein needed for normal blood clotting. • May need injections of the missing clotting factor to stop bleeding.

25. It most often affects males. • About 18,000 people in the United States have hemophilia. • The main symptom of hemophilia is bleeding. Mild cases may go unnoticed until later in life, when they occur during surgery or after trauma.

26. LEUKEMIA • Is cancer of the blood or bone marrow. A person who has leukemia suffers from an abnormal production ofleukocytes (white blood cells). 

27. Long-term exposure to chemicals such as benzene or formaldehyde • Prolonged exposure to radiation is a risk factor. • Family history increases your risk

28. Symptoms • Unexplained fevers • Frequent infections • Night sweats • Fatigue (feeling tired or washed out) • Weight loss • Easy bleeding or bruising

29. Treatment • Leukemia treatment falls into two categories -- treatment to fight the cancer and treatment to relieve the symptoms of the disease/side effects of the treatment. • The most widely used treatment is chemotherapy-the use of powerful drugs to kill leukemia cells.

30. Multiple Myeloma • Multiple myeloma is cancer that startsin the plasma cells in the bone marrow. • Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells.

31. Plasma cells help your body fight infection by producing proteins called antibodies. • Multiple myeloma mainly affects older adults. Past treatment with radiation therapy raises your risk for this type of cancer.

32. Multiple myeloma causes a low red blood cell count (anemia). • As the cancer cells grow in the bone marrow, bone or back painbecomes a major symptom.

33. Treatment • Dexamethasone • Radiation therapy • Bone marrow transplant • Survival depends on the pts. age and stage of disease. Some cases are very aggressive, while others take years to get worse.

34. POLYCYTHEMIA There’s TOO MANY!!! • Polycythemia -condition that results in an increased level of red blood cells in the bloodstream. • There is an increase in hematocrit, hemoglobin, or red bloodcellcounts above normal limits. • Polycythemia can be divided into two categories; primary and secondary.

35. What causes polycythemia? • In primary polycythemia, intrinsicfactors in RBCproduction cause an increase in red cell count. (inherited causes) • In secondary polycythemia, external factors result in polycythemia. (factors causing chronic hypoxia- such as COPD)

36. Septicemia • “Blood Posioning” • Aserious, life-threatening infection that gets worse very quickly. It can arise from infections throughout the body, • Bone (osteomyelitis) • Central nervous system (meningitis) • Heart (endocarditis)

37. Symptoms • Chills • High fever • Rapid breathing • Rapid heart rate • The symptoms quickly progress to: • Confusion or other changes in mental status • Red spots on the skin (petechiae) • Shock

38. Treatment • Septicemia is a serious condition that requires a hospital stay. • Antibiotics to treat the infection • Fluids and medicines by IV to maintain the blood pressure • Oxygen • Plasma or other blood products to correct any clotting problems

39. Time is ticking…you better start studying!!