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DISORDERS OF BLOOD CELLS & VESSELS CHAPTER 7 HEMATOPOIESIS • • • • Generation of blood cells Lymphoid progenitor cells = lymphocytes (WBCs) Myeloid progenitor cells = all other blood cells Red blood cells transport oxygen • Hemoglobin is the compound in RBCs to which oxygen attaches for transport from lungs to tissues • Synthesis depends on iron, vitamin B12, vitamin B6, & folic acid WHITE BLOOD CELLS ACTIVE IN IMMUNITY AND INFLAMMATION • Hormones and inflammatory and immune molecule mediators stimulate production of WBCs & platelets • Leukocytes fight microbes & other invaders • Promote the repair process LIFE SPAN OF BLOOD CELLS Varies, shorter life span than other tissues Rapid cell turnover RBCs have longest life out of blood cells Disease of blood cells are d/t early cell death or destruction • The number of WBCs, RBCs, & platelets in blood is a function of their life span and the rate of their production versus the rate of their loss • • • • ANEMIA • Low hemoglobin in blood • Always a sign of some underlying condition • Diagnosis: • CBC • Look at RBCs for either: • Failed Bone marrow production • Hemorrhage or destruction • Treatment: • Replace RBCs • Identify cause and reverse it SICKLE CELL DISEASE • Autosomal recessive genetic disorder of hemoglobin synthesis • Hemoglobin is molecularly defective and unstable • Causing early RBC death • Clinical and Pathologic findings: • • • • Obstruction of small blood vessels Anemia Hemolysis Infections WHITE BLOOD CELL MALIGNANCIES • Myeloid malignancies • Myeloid cells-precursors of granulocytes, RBCs, and megakaryocytes • Examples: Acute or chronic myeloid leukemia • Lymphoid malignancies • Lymphoid cells: B,T, or natural killer lymphocytes • Example: Acute or Chronic lymphoid leukemia ACUTE MYELOID LEUKEMIA (AML) • AML: Increased numerous of myeloblasts in bone marrow and blood • Occurs in all ages, common in adults over 50 years • Sudden onset, symptoms appear rapidly as bone marrow becomes packed with malignant cells • Symptoms: bone pain, lymphadenopathy, enlarged spleen & liver, neurologic defects • Diagnosis: >20% of bone marrow cells must be myeloblasts • Treatment: Chemotherapy, CHRONIC MYELOID LEUKEMIA (CML) • Slow, progressive disease • Rare in children • Moves through 3 phases: • Indolent period • Accelerated phase-resistant to treatment, increase anemia and thrombocytopenia • Evolution into AML-infection and hemorrhage dangerous threats ACUTE LYMPHOID LEUKEMIA (ALL) • Malignant proliferation of immature lymphocyte precursors • Usually B cells • Most common malignancy of children • Clinically same as AML CHRONIC LYMPHOID LEUKEMIA (CLL) • Slow onset • Most patients asymptomatic, disease uncovered due to presence of another condition • Constitutional S/S: • Malaise, loss of appetite • Mild fever • Weight loss