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Chapter 10: Blood and Immunity Chapter Objectives Composition of the blood plasma. Functions of the three types of blood cells. Blood types. Immunity and the possible sources of immunity. Roots and suffixes pertaining to the blood and immunity Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms agranulocytes A white blood cell that does not have visible granules in its cytoplasm. Agranulocytes include lymphocytes and monocytes albumin A simple protein found in blood plasma antibody A protein produced in response to, and interacting specifically with, an antigen antigen A substance that induces the formation of an antibody B cell A lymphocyte that matures in lymphoid tissue and is active in producing antibodies; B lymphocyte (LIM-fō-si-t) band cell An immature neutrophil with a nucleus in the shape of a band; also called a stab cell. Band cell counts are used to trace infections and other diseases basophil A granular leukocyte that stains with basic dyes; active in allergic reactions blood The fluid that circulates in the cardiovascular system (root: hem/o, hemat/o) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms (cont’d) coagulation Blood clotting cross-matching Testing the compatibility of donor and recipient blood in preparation for a transfusion. Donor red cells are mixed with recipient serum, and red cells of the recipient are mixed with donor serum to look for an immunologic reaction. Similar tests are done on tissues before transplantation electrolyte A substance that separates into charged particles (ions) in solution; a salt. Term also applied to ions in body fluids eosinophil A granular leukocyte that stains with acidic dyes; active in allergic reactions and defense against parasites erythrocyte A red blood cell (root: erythr/o, erythrocyt/o) erythropoietin (EPO) A hormone produced in the kidneys that stimulates red-blood-cell production in the bone marrow. This hormone is now made by genetic engineering for clinical use Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms (cont’d) fibrin The protein that forms a clot in the process of blood coagulation fibrinogen The inactive precursor of fibrin formed elements The cellular components of blood gamma globulin The fraction of the blood plasma that contains antibodies; given for passive transfer of immunity granulocytes A white blood cell that has visible granules in its cytoplasm. Granulocytes include neutrophils, basophils, and eosinophils hemoglobin (Hb, Hgb) The iron-containing pigment in red blood cells that transports oxygen hemostasis The stoppage of bleeding immunity The state of being protected against a specific disease (root: immun/o) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms (cont’d) immunoglobulin (Ig) An antibody. Immunoglobulins fall into five classes, each abbreviated with a capital letter: IgG, IgM, IgA, IgD, IgE. leukocyte A white blood cell (root: leuk/o, leukocyt/o) lymphocyte An agranular leukocyte active in immunity (T cells and B cells); found in both the blood and in lymphoid tissue (root: lymph/o, lymphocyt/o) megakaryocyte A large bone marrow cell that fragments to release platelets macrophage A phagocytic cell derived from a monocyte; usually located within the tissues. Macrophages process antigens for T cells. monocyte An agranular phagocytic leukocyte neutrophil A granular leukocyte that stains with acidic or basic dyes. The most numerous of the white blood cells. A type of phagocyte. phagocytosis The engulfing of foreign material by white blood cells Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms (cont’d) plasma The liquid portion of the blood plasma cell A mature form of a B cell that produces antibodies platelet A formed element of the blood that is active in hemostasis; a thrombocyte (root: thrombocyt/o) serum The fraction of the plasma that remains after blood coagulation; it is the equivalent of plasma without its clotting factors (plural: sera, serums) T cell A lymphocyte that matures in the thymus gland and attacks foreign cells directly; T lymphocyte thrombocyte A blood platelet (root: thrombocyt/o) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders AIDS (acquired immunodeficiency syndrome) Failure of the immune system caused by infection with HIV (human immunodeficiency virus). The virus infects certain T cells and thus interferes with immunity. allergen A substance that causes an allergic response allergy Hypersensitivity anaphylactic reaction An exaggerated allergic reaction to a foreign substance (root phylaxis means. “protection”). It may lead to death caused by circulatory collapse, and respiratory distress if untreated. Also called anaphylaxis anemia A deficiency in the amount of hemoglobin in the blood; may result from blood loss, malnutrition, a hereditary defect, environmental factors, and other causes angioedema A localized edema with large hives (wheals) similar to urticaria but involving deeper layers of the skin and subcutaneous tissue aplastic anemia Anemia caused by bone marrow failure resulting in deficient bloodcell production, especially of red cells; pancytopenia Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) autoimmune disease A condition in which the immune system produces antibodies against an individual's own tissues (prefix auto means “self”) Cooley anemia A form of thalassemia (hereditary anemia) which affects production of the β (beta) hemoglobin chain; thalassemia major delayed hypersensitivity reaction An allergic reaction involving T cells that takes at least 12 hours to develop. Examples are various types of contact dermatitis, such as poison ivy or poison oak; the tuberculin reaction (test for TB); and rejections of transplanted tissue disseminated intravascular coagulation (DIC) Widespread formation of clots in the microscopic vessels; may be followed by bleeding caused by depletion of clotting factors ecchymosis A collection of blood under the skin caused by leakage from small vessels (root chym means “juice”) hemolysis The rupture of red blood cells and the release of hemoglobin (adjective: hemolytic) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) hemophilia A hereditary blood disease caused by lack of a clotting factor and resulting in abnormal bleeding HIV (human immunodeficiency virus) The virus that causes AIDS Hodgkin disease A neoplastic disease of unknown cause that involves the lymph nodes, spleen, liver, and other tissues; characterized by the presence of giant Reed-Sternberg cells hypersensitivity An immunologic reaction to a substance that is harmless to most people; allergy immunodeficiency A congenital or acquired failure of the immune system to protect against disease intrinsic factor A substance produced in the stomach that aids in the absorption of vitamin B12, necessary for the manufacture of red blood cells. Lack of intrinsic factor causes pernicious anemia Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) Kaposi sarcoma Cancerous lesion of the skin and other tissues, seen most often in patients with AIDS leukemia Malignant overgrowth of immature white blood cells; may be chronic or acute; may affect bone marrow (myelogenous leukemia) or lymphoid tissue (lymphocytic leukemia) lymphadenopathy Any disease of the lymph nodes multiple myeloma A tumor of the blood-forming tissue in bone marrow non-Hodgkin lymphoma (NHL) A widespread malignant disease of lymph nodes that involves lymphocytes. It differs from Hodgkin disease in that giant ReedSternberg cells are absent. Philadelphia chromosome (Ph) An abnormal chromosome found in the cells of most individuals with chronic granulocytic (myelogenous) leukemia pernicious anemia Anemia caused by failure of the stomach to produce intrinsic factor, a substance needed for the absorption of vitamin B12. This vitamin is required for the formation of erythrocytes. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) petechiae Pinpoint, flat, purplish-red spots caused by bleeding within the skin or mucous membrane (singular: petechia) purpura A condition characterized by hemorrhages into the skin, mucous membranes, internal organs, and other tissues (from Greek word meaning “purple”). Thrombocytopenic purpura is caused by a deficiency of platelets. sideroblastic anemia Anemia caused by inability to use available iron to manufacture hemoglobin. The excess iron precipitates in normoblasts (developing red blood cells) Sjögren syndrome An autoimmune disease involving dysfunction of the exocrine glands and affecting secretion of tears, saliva, and other body fluids. Deficiency leads to dry mouth, tooth decay, corneal damage, eye infections, and difficulty in swallowing. sickle cell anemia A hereditary anemia caused by the presence of abnormal hemoglobin. Red blood cells become sickle shaped and interfere with normal blood flow to the tissues. Most common in black populations of West African descent. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) splenomegaly Enlargement of the spleen systemic lupus erythematosus Inflammatory connective tissue disease affecting the skin and multiple organs. Patients are sensitive to light and may have a red butterflyshaped rash over the nose and cheeks systemic sclerosis A diffuse disease of connective tissue that may involve any system causing inflammation, degeneration, and fibrosis. Also called scleroderma because it causes thickening of the skin thalassemia A group of hereditary anemias mostly found in populations of Mediterranean descent (the name comes from the Greek word for “sea”) thrombocytopenia A deficiency of thrombocytes (platelets) in the blood urticaria A skin reaction consisting of round, raised eruptions (wheals) with itching; hives Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis and Treatment adrenaline See epinephrine CD4+ T lymphocyte count A count of the T cells that have the CD4 receptors for the AIDS virus (HIV). A count of less than 200/µL of blood signifies severe immunodeficiency. epinephrine A powerful stimulant produced by the adrenal gland and sympathetic nervous system. Activates the cardiovascular, respiratory, and other systems needed to meet stress. Used as a drug to treat severe allergic reactions and shock. Also called adrenaline. reticulocyte counts Blood counts of reticulocytes, a type of immature red blood cell; reticulocyte counts are useful in diagnosis to indicate the rate of erythrocyte formation Reed-Sternberg cells Giant cells that are characteristic of Hodgkin disease. They usually have two large nuclei and are surrounded by a halo Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Normal Structure and Function agglutination The clumping of cells or particles in the presence of specific antibodies bilirubin A pigment derived from the breakdown of hemoglobin. It is eliminated by the liver in bile complement A group of plasma enzymes that interacts with antibodies corpuscle A small mass or body. A blood corpuscle is a blood cell hemopoietic stem cell A primitive bone marrow cell that gives rise to all varieties of blood cells heparin A substance found throughout the body that inhibits blood coagulation; an anticoagulant plasmin An enzyme that dissolves clots; also called fibrinolysin thrombin The enzyme derived from prothrombin that converts fibrinogen to fibrin Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions agranulocytosis A condition involving a decrease in the number of granulocytes in the blood; also called granulocytopenia erythrocytosis Increase in the number of red cells in the blood; may be normal, such as to compensate for life at high altitudes, or abnormal, such as in cases of pulmonary or cardiac disease Fanconi syndrome Congenital aplastic anemia that appears between birth and 10 years of age; may be hereditary or caused by damage before birth, as by a virus graft-versus-host reaction (GVHR) An immunologic reaction of transplanted lymphocytes against tissues of the host; a common complication of bone marrow transplantation. hairy-cell leukemia A form of leukemia in which cells have filaments, making them look “hairy” hematoma A localized collection of blood, usually clotted, caused by a break in a blood vessel Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions (cont’d) hemolytic disease of the newborn (HDN) Disease that results from incompatibility between the blood of a mother and her fetus, usually involving Rh factor. An Rhnegative mother produces antibody to an Rh-positive fetus that, in later pregnancies, will destroy the red cells of an Rh-positive fetus. The problem is usually avoided by treating the mother with antibodies to remove the Rh antigen; erythroblastosis fetalis hemosiderosis A condition involving the deposition of an iron-containing pigment (hemosiderin) mainly in the liver and the spleen. The pigment comes from hemoglobin released from disintegrated red blood cells. idiopathic thrombocytopenic purpura (ITP) A clotting disorder caused by destruction of platelets that usually follows a viral illness. Causes petechiae and hemorrhages into the skin and mucous membranes. infectious mononucleosis An acute infectious disease caused by Epstein–Barr virus (EBV). Characterized by fever, weakness, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytes (resembling monocytes) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions (cont’d) lymphocytosis An increase in the number of circulating lymphocytes myelodysplastic syndrome Bone marrow dysfunction resulting in anemia and deficiency of neutrophils and platelets. May develop in time into leukemia; preleukemia myelofibrosis Condition in which bone marrow is replaced with fibrous tissue neutropenia A decrease in the number of neutrophils with increased susceptibility to infection. Causes include drugs, irradiation, and infection. May be a side effect of treatment for malignancy pancytopenia A decrease in all cells of the blood, as in aplastic anemia polycythemia Any condition in which there is a relative increase in the percent of red blood cells in whole blood. May result from excessive production of red cells because of lack of oxygen, as caused by high altitudes, breathing obstruction, heart failure, or certain forms of poisoning. Apparent polycythemia results from concentration of the blood, as by dehydration Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions (cont’d) polycythemia vera A condition in which overactive bone marrow produces too many red blood cells. These interfere with circulation and promote thrombosis and hemorrhage. Treated by blood removal. Also called erythremia, Vaquez–Osler disease septicemia Presence of microorganisms in the blood spherocytic anemia Hereditary anemia in which red blood cells are round instead of disk-shaped and rupture (hemolyze) excessively thrombotic An often-fatal disorder in which multiple clots form in blood thrombocytopenic purpura vessels (TTP) von Willebrand disease A hereditary bleeding disease caused by lack of von Willebrand factor, a substance necessary for blood clotting Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis Bence Jones protein A protein that appears in the urine of patients with multiple myeloma Coombs test A test for detection of antibodies to red blood cells such as appear in cases of autoimmune hemolytic anemias electrophoresis Separation of particles in a liquid by application of an electrical field; used to separate components of blood. ELISA Enzyme-linked immunosorbent assay. A highly sensitive immunologic test used to diagnose HIV infection, hepatitis, and Lyme disease, among others. monoclonal antibody A pure antibody produced in the laboratory; used for diagnosis and treatment Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Term Diagnosis (cont’d) pH A scale that measures the relative acidity or alkalinity of a solution. Represents the amount of hydrogen ion in the solution Schilling test Test used to determine absorption of vitamin B12 by measuring excretion of radioactive B12 in the urine. Used to distinguish pernicious from nutritional anemia seroconversion The appearance of antibodies in the serum in response to a disease or an immunization Western blot assay A very sensitive test used to detect small amounts of antibodies in the blood Wright stain A commonly used blood stain Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Treatment anticoagulant An agent that prevents or delays blood coagulation antihistamine A drug that counteracts the effects of histamine and is used to treat allergic reactions. apheresis A procedure in which blood is withdrawn, a portion is separated and retained, and the remainder is returned to the donor. Apheresis may be used as a suffix with a root meaning the fraction retained, such as plasmapheresis, leukapheresis. autologous blood A person's own blood. May be donated in advance of surgery and transfused if needed. cryoprecipitate A sediment obtained by cooling. The fraction obtained by freezing blood plasma contains clotting factors. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Treatment (cont’d) desensitization Treatment of allergy by small injections of the offending allergen. This causes an increase of antibody to destroy the antigen rapidly on contact homologous blood Blood from animals of the same species, such as human blood used for transfusion from one person to another. Blood used for transfusions must be compatible with the blood of the recipient immunosuppression Depression of the immune response. May be correlated with disease but also may be induced therapeutically to prevent rejection in cases of tissue transplantation protease inhibitor An anti-HIV drug that acts by inhibiting an enzyme the virus needs to multiply Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations Ab Antibody Ag Antigen AIDS Acquired immunodeficiency syndrome ALL Acute lymphoblastic (lymphocytic) leukemia AML Acute myeloblastic (myelogenous) leukemia APTT Activated partial thromboplastin time BT Bleeding time CBC Complete blood count CLL Chronic lymphocytic leukemia CML Chronic myelogenous leukemia crit Hematocrit Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) DIC Disseminated intravascular coagulation diff Differential count EBV Epstein–Barr virus ELISA Enzyme-linked immunosorbent assay EPO Erythropoietin ESR Erythrocyte sedimentation rate FFP Fresh frozen plasma Hb, Hgb Hemoglobin Hct, Ht Hematocrit HDN Hemolytic disease of the newborn HIV Human immunodeficiency virus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) IF Intrinsic factor Ig Immunoglobulin ITP Idiopathic thrombocytopenic purpura lytes Electrolytes MCH Mean corpuscular hemoglobin MCHC Mean corpuscular hemoglobin concentration mcL Microliter MCV Mean corpuscular volume MDS Myelodysplastic syndrome mEq Milliequivalent NHL Non-Hodgkin lymphoma Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) PCV Packed cell volume pH Scale for measuring hydrogen ion concentration (acidity or alkalinity) Ph Philadelphia chromosome PMN Polymorphonuclear (neutrophil) poly Neutrophil polymorph Neutrophil PT Pro time; prothrombin time PTT Partial thromboplastin time Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) RBC Red blood cell; red-blood-cell count seg Neutrophil SLE Systemic lupus erythematosus T(C)T Thrombin (clotting) time TTP Thrombotic thrombocytopenic purpura vWF von Willebrand factor WBC White blood cell; white blood (cell) count Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Suffixes for Blood Suffix Meaning Example Definition of Example -emia,* -hemia condition of blood polycythemia increase in cells (cyt) in the blood -penia decrease in, deficiency of cytopenia deficiency of cells in the blood -poiesis formation, production hemopoiesis production of blood cells *A shortened form of the root hem plus the suffix -ia. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Blood Plasma • 90% water • Rest contains: – Nutrients – Electrolytes (dissolved salts) – Gases – Albumin (protein) – Clotting factors – Antibodies – Wastes – Enzymes – Hormones • Relative acidity (pH) steady at 7.4 Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Blood Cells • Produced in red bone marrow • Three kinds: – 1) Red = erythrocytes – 2) White = leukocytes – 3) Platelets = thrombocytes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Erythrocytes • Main function: carry oxygen to cells • Most numerous of blood cells • Short lifespan (120 days) requires constant replacement • Production regulated by erythropoietin (hormone made in kidneys) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Leukocytes • Five different types: – Granulocytes • Neutrophils • Eosinophils • Basophils – Agranulocytes • Lymphocytes • Monocytes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Leukocytes (cont’d) • Protect against foreign substances • Relative numbers of each different for different disease conditions Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Platelets • Important for hemostasis • Most active during coagulation – Stick together to plug injury site – Interact with clotting factors in plasma to make wound-sealing clot – Convert fibrinogen to threads of fibrin – Threads of fibrin trap blood cells and plasma to make clot Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Blood Types • Determined by genetically inherited proteins • Most familiar groups are ABO and Rh – Type A, B, AB, O – Rh-positive, Rh-negative • Important to match for blood transfusions • Compatible types determined by cross-matching Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Immunity • Protection against disease • Innate: – Based on genetic makeup – Include: • Unbroken skin • Cilia • Mucus • Bactericidal body secretions • Reflexes • Lymphoid tissue • Phagocytes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Immunity (cont’d) • Adaptive: – Acquired during life, specific to disease organism – T cells – B cells Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for Blood and Immunity Root Meaning Example Definition of Example myel/o bone marrow myelogenous originating in bone marrow hem/o, hemat/o blood hemopathy any disorder of blood erythr/o, erythrocyt/o red blood cell erythroblast immature red blood cell leuk/o, leukocyt/o white blood cell leukocytosis increase in the number of leukocytes in the blood Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for Blood and Immunity (cont’d) Root Meaning Example Definition of Example lymph/o, lymphocyt/o lymphocyte lymphocytic pertaining to lymphocytes thromb/o blood clot thrombolytic pertaining to lymphocytes thrombocyt/o platelet, thrombocyte thrombocytopoiesis formation of platelets immun/o immunity, immune immunization system production of immunity Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Adaptive Immunity • Natural Adaptive: – Active: contact with disease organism – Passive: transfer of antibodies • Naturally (placenta or mother’s milk) • Artificial Adaptive: – Active: vaccine – Passive: immune serum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for Chemistry Root Meaning Example Definition of Example azot/o nitrogenous compounds azoturia increased nitrogenous compounds in the urine (-uria) calc/i calcium (symbol Ca) calcification deposition of calcium salts ferr/o, ferr/i iron (symbol Fe) ferrous pertaining to or containing iron sider/o iron sideroderma deposition of iron into the skin kali potassium (symbol K) hyperkalemia* excess of potassium in the blood natri sodium (symbol Na) natriuresis excretion of sodium in the urine (ur/o) ox/y oxygen (symbol O) hypoxia deficiency of oxygen in the tissues * The i in the root is dropped. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Blood • Anemia – Decrease in hemoglobin in blood – Can result from: • Too few red blood cells • Cells are too small • Too little hemoglobin Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Blood (cont’d) • Key tests involve blood counts, mean corpuscular volume, mean corpuscular hemoglobin concentration • Symptoms include fatigue, shortness of breath, heart palpitations, pallor, irritability Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Anemia Due to Impaired Production • Aplastic anemia = destruction of bone marrow – May be caused by drugs, toxins, viruses, radiation, or bone marrow cancer • Nutritional anemia (includes pernicious anemia) = deficiency of vitamin B12 – Caused by iron deficiency Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Anemia Due to Impaired Production (cont’d) • Pernicious anemia = lack of intrinsic factor • Sideroblastic anemia = body doesn’t use iron properly Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Anemia Due to Destruction • Hemorrhagic anemia – Results from blood loss • Thalassemia (includes Cooley anemia) – Hereditary disease causing rupture of red cells – Affects production of hemoglobin Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Anemia Due to Destruction (cont’d) • Sickle cell anemia – Mutation alters hemoglobin molecule – Deformed cells block blood vessels and prevent tissues from receiving oxygen Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Coagulation Disorders • Thrombocytopenia – Deficiency in number of platelets • Disseminated intravascular coagulation – Widespread clotting, obstructing circulation to tissues • Hemophilia – Hereditary deficiency of specific clotting factor – Sex-linked disease: Passed from mother to son Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Neoplasms • Leukemia – Rapidly dividing, but incompetent white blood cells – Causes unknown, but may include radiation, heredity – Symptoms: anemia, fatigue, easy bleeding, splenomegaly, hepatomegaly – Causes: exposure to radiation, hereditary, viral infection Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Neoplasms (cont’d) • Leukemia (cont’d) – Categories: myelogenous, lymphocytic • Acute • Acute myeloblastic • Acute lymphoblastic • Chronic • Chronic granulocytic • Chronic lymphocytic – Treatment includes: chemotherapy, radiation therapy, bone marrow transplantation Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Neoplasms (cont’d) • Hodgkin disease – Disease of lymphatic system that may spread – Contains Reed-Sternberg cells (giant cells in lymph nodes) • Non-Hodgkin lymphoma – Also malignant enlargement of lymph nodes – More common, deadly than Hodgkin disease • Multiple myeloma – Cancer of blood-forming cells in bone marrow Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Immunity • Hypersensitivity – Commonly known as allergy – More sensitive to allergens (pollen, dust) • Anaphylactic reaction – Severe generalized allergic response – Must be treated with epinephrine (adrenaline) • Delayed hypersensitivity reaction – Involves T cells and takes 12 hours for onset (poison ivy) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Immunity (cont’d) • Immunodeficiency – Any failure in immune system (AIDS) • Starts with HIV infection • Leaves individual susceptible to other infections • Pneumocystis jirovicii pneumonia • Thrush • Cryptosporidium infections • Kaposi sarcoma Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Immunity (cont’d) • Autoimmune disorder – Immune response to own tissues – Cause may be: • Failure of immune system • Body cells altered by mutation or disease Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects: Immunity (cont’d) • Autoimmune disorder (cont’d) – Examples: • Systemic lupus erythematosus • Systemic sclerosis • Sjögren syndrome • Pernicious anemia • Rheumatoid arthritis • Graves disease • Fibromyalgia syndrome Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. Erythrocyte is the scientific name for a: (a) white blood cell (b) lymphocyte (c) red blood cell (d) muscle cell Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. Erythrocyte is the scientific name for a: (a) white blood cell (b) lymphocyte (c) red blood cell (d) muscle cell Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. Leukocyte is the scientific name for a(n): (a) platelet (b) embolus (c) white blood cell (d) neuron Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. Leukocyte is the scientific name for a(n): (a) platelet (b) embolus (c) white blood cell (d) neuron Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. Platelets, or thrombocytes, are involved in: (a) inflammation (b) digestion (c) immunity (d) blood clotting Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. Platelets, or thrombocytes, are involved in: (a) inflammation (b) digestion (c) immunity (d) blood clotting Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The white blood cells active in immunity are the: (a) hematids (b) lymphocytes (c) adipose cells (d) chondrocytes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The white blood cells active in immunity are the: (a) hematids (b) lymphocytes (c) adipose cells (d) chondrocytes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. Substances produced by immune cells that counteract microorganisms and other foreign materials are called: (a) antibodies (b) antigens (c) anticoagulants (d) Rh factors Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. Substances produced by immune cells that counteract microorganisms and other foreign materials are called: (a) antibodies (b) antigens (c) anticoagulants (d) Rh factors Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. A deficiency of hemoglobin results in the disorder called: (a) hypertension (b) chromatosis (c) anemia (d) hemophilia Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. A deficiency of hemoglobin results in the disorder called: (a) hypertension (b) chromatosis (c) anemia (d) hemophilia Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. A neoplastic overgrowth of white blood cells is called: (a) anemia (b) leukemia (c) fibrosis (d) cystitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. A neoplastic overgrowth of white blood cells is called: (a) anemia (b) leukemia (c) fibrosis (d) cystitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins