Function of plasma proteins: Albumin = ? Globulins = ? Fibrinogen = ? Hematologic System

Function of Plasma Proteins: Albumin: Maintains plasma oncotic pressure and maintain blood volume. Serves as a carrier. Globulins: Alpha - transports bilirubin Beta - transports iron Gamma - antibodies of immune system Fibrinogen: Helps form fibrin for blood clotting. Prothrombin (II) - Thrombin (IIa) - Fibrinogen - Fibrin Albumin : A protein in the blood plasma that helps keep fluids from leaking out of blood vessels and into other tissues.

Hematologic System Flashcards by Benjamin Kozak

A specialized connective tissue, has cells (erythrocytes, leukocytes) suspended in liquid matrix (plasma) and cells have certain functions = ?

Hematologic System

Blood:

Is a specialized connective tissue, has cells (erythrocytes, leukocytes) suspended in liquid matrix (plasma) and cells have certain functions.
About 5 liters of blood continuously circulates in human body.
7-8% of the total body weight.

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Blood Composition = ?

Hematologic System

Blood Composition:

(a) Plasma (55%)
Proteins (7%)

Albumin (54%) = Protein in the blood plasma that helps keep fluid from leaking out of blood vessels into other tissues.
Fibrinogen (7%) = Protein produced by the liver that helps stop bleeding by helping blood clots form.
Globulins (38%) = Group of proteins in the blood that are important for liver function, blood clotting, and fighting infection.
Others (1%)

(b) Water (91.5%)

Electrolytes
Hormones, enzymes
Nutrients, carbohydrates, fats
Gases
Waste products

(d) Red blood cells: 4.8-5.4 billion /ul
(e) Platelets: 150,000-400,000 /ul
(f) White blood cells: 5,000-10,000 /ul

Neutrophils (60-70%)
Lymphocytes (20-25%)
Monocytes (3-8%)
Eosinophils (2-4%)
Basophils (0.5-1%)

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Fuction of plasma = ?

Hematologic System

Plasma:

As a transport vehicles for nutrients, chemical messengers, metabolites.
Maintain electrolytes and acid/ base balance.

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Function of plasma proteins:

Albumin= ?
Globulins = ?
Fibrinogen = ?

Hematologic System

Function of Plasma Proteins:

Albumin:

Maintains plasma oncotic pressure and maintain blood volume.
Serves as a carrier.

Globulins:

Alpha - transports bilirubin
Beta - transports iron
Gamma - antibodies of immune system

Fibrinogen:

Helps form fibrin for blood clotting.
Prothrombin (II) - Thrombin (IIa) - Fibrinogen - Fibrin

Albumin: A protein in the blood plasma that helps keep fluids from leaking out of blood vessels and into other tissues.

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Serum = ?

Hematologic System

Serum = Plasma - Fibrinogen

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Small, biconcave disk, diameter 6-8micro meter, high elasticity (easily deform into any shape = ?

Hematologic System

Red Blood Cells (RBCs):

Small, biconcave disk, diameter 6-8micro meter, high elasticity (easily deform into any shape.

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Histology Identification

Hematologic System

Erythrocytes:

Red blood cells (RBCs), are one of the major types of blood cells found in vertebrates.
Primarily responsible for carrying oxygen from the lungs to the body’s tissues and transporting carbon dioxide from the tissues back to the lungs for exhalation.

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Histology Identification

Hematologic System

Neutrophil:

The most abundant type of white blood cell in humans and are essential for defending the body against bacterial and fungal infections.
They are part of the innate immune system, which provides the first line of defense against pathogens.
Phagocytosis: Neutrophils are highly mobile and capable of migrating to sites of infection or inflammation.

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Histology Identification

Hematologic System

Platelets:

Thrombocytes, are small, colorless cell fragments found in the blood.
They play a crucial role in blood clotting (hemostasis) to prevent excessive bleeding when a blood vessel is injured.
When a blood vessel is damaged, platelets become activated and adhere to the site of injury, forming a temporary plug to stop bleeding.
Platelets are produced in the bone marrow.
They also release chemical signals to attract more platelets and facilitate the formation of a stable blood clot.

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Histology Identification

Hematologic System

Lymphocytes:

Lymphocytes are a type of white blood cell (leukocyte) that plays a key role in the body’s immune system.

(I) T lymphocytes (T cells):

These lymphocytes mature in the thymus gland and play a central role in cell-mediated immunity.
They are involved in recognizing and destroying infected or abnormal cells, regulating immune responses, and coordinating the immune system’s actions.

(II) B lymphocytes (B cells):

These lymphocytes mature in the bone marrow. They are responsible for producing antibodies (immunoglobulins), which are proteins that recognize and bind to specific antigens (foreign substances such as viruses or bacteria), marking them for destruction by other immune cells.
B cells also play a role in the immune memory, providing long-term protection against pathogens.

(III) Natural killer (NK) cells:

These lymphocytes are part of the innate immune system and are responsible for recognizing and destroying abnormal cells, such as infected or cancerous cells.
NK cells can directly target and kill these cells without prior sensitization or activation.

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Hematologic System

Eosinophil:

Eosinophils are primarily involved in combating parasitic infections and modulating allergic responses.
Eosinophils are recruited to sites of inflammation or infection by various chemotactic factors, including cytokines, chemokines, and lipid mediators

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5 Facts about RBCs = ?

Hematologic System

Red Blood Cells:

Most common type of blood cell, non nucleated biconcave disk.
Large surface area, thin membranes.
Primary function is to transport oxygen to the tissues and transport carbon dioxide out of the tissues for excretion.
Helps regulate acid / base balance.
Oxygen poorly soluble in plasma, 95% is carried bound to hemoglobin
Each molecule of hemoglobin carries 4 molecule of oxygen.
Production of red blood cells is called as erythropoiesis / hematopoiesis (bone marrow is the primary site).
Most iron is recycled in the body after release fromdying red blood cells, careful regulation of ironabsorption in small intestine.
Small amount of iron is lost and needs to be replaced

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Mature RBCs have lifespan = ?

Hematologic System

Mature RBCs have lifespan of 120 days.

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Hematocrit = ?

Hematologic System

(a) Hematocrit

The measure of the proportion of blood that is cellular, expressed as a percentage.
Polycythemia: High hematocrit
Height of erythrocyte column / height of whole blood column x 100
Women = 37-47
Men = 42-52
Volume of cells in 100 ml of blood.
Centrifuge a blood sample, represented as percentage.

(b) Hematopoiesis:

Production of blood cells.
Derived from hematopoietic stem cells

Low hematocrit (anemia) may suggest conditions such as iron deficiency, vitamin B12 deficiency, or chronic diseases.
High hematocrit may be associated with conditions like dehydration, lung diseases, or polycythemia.

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Abnormally low number of red blood cells or levels of hemoglobin= ?

Hematologic System

Anemia:

Abnormally low number of red blood cells or levels of hemoglobin
Impairs blood oxygen carrying capacity.
Can cause tissue hypoxia
Common acquired / inherited disorder of erythrocytes

In adults, anemia is diagnosed:
* Hematocrit <41% in males
* Hematocrit <37% in females

Hemoglobin: < 13.5 g/dl in males
Hemoglobin: <12 g/dl in females

Cause:

Reduction of hemoglobin content
Presence of abnormal hemoglobin
Decrease in the number of circulating erythrocytes
- Blood loss (chronic GI blood loss- aspirin/ NSAIDS; GI ulcers, cancers)
- Destruction of erythrocytes
- Inadequate red blood cell production
- Defective red blood cell production

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Clinical features of anemia include = ?

Hematologic System

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Anemia - Clinical Features:

Weakness
Fatigue
Dyspnea
Hypoxia of brain tissue - headache, faintness
Pallor (absence of underlying red tones)
Tachycardia and palpitations

Severe cases:

Ventricular hypertrophy and heart failure
Increase respirator rate
Diffuse bone pain

Typesof anemia = ?

Hematologic System

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Types of Anemia: Red cell characteristics seen in different types of anemia.

(a) Microcytic and hypochromic red cells, characteristic of iron deficiency anemia.
(b) Macrocytic and misshaped red blood cells, characteristic of megaloblastic anemia.
(c) Abnormally shaped red blood cells seen in sickle cell disease.
(d) Normocytic and normochromic red blood cells, as a comparison.

Occurs when iron is not enough to meet the demands of hemoglobin production or loss of iron through bleeding= ?

Hematologic System

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Iron Deficiency Anemia:

Occurs when iron is not enough to meet the demands of hemoglobin production or loss of iron through bleeding.

(a) Cause:

Decreased iron consumption.
Decreasediron absorption.
Increased bleeding (mensuration,certain cancers)
Increased iron demand (women ofchild bearingage and pregnant women).
Iron is stored in transport proteins like ferritin and transferrin.

(b) Notes:

Iron is needed for hemoglobin production andformation of erythrocytes.
Common worldwide cause of anemia affecting people of all ages.

Groups at risk for iron deficiency anemia = ?

Hematologic System

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Groups at risk:

Pregnant women
Women with heavy menstrual bleeding
Infants and younger children
Frequent blood donors
People with cancer, GI diseases/ surgery-who report of chronic blood loss
Vegetarian diet
Iron Deficiency Anemia

RDA for iron = ?

Hematologic System

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RDA for Iron:

Clinical features - Iron Deficiency Anemia = ?

Hematologic System

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Clinical features - Iron Deficiency Anemia:

(a) Mild anemia causes mild and vague symptoms like fatigue.

Brittle nails with koilonychias (spoon shaped).
Unusual food cravings (pica; ice, clay, soil, paper).
Headache
Irritability
Delayed healing
Tachycardia, palpitations
Decreased appetite

(b) Neurologic impairment:

Confusion and memory loss; mitochondrial damage
Neurologic damage (development delays in children).

Diagnosis and treatment of iron deficiency anemia = ?

Hematologic System

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Diagnosis and Treatment - Iron Deficiency Anemia:

(a) Diagnosis:

Low hemoglobin and hematocrit
CBC (erythrocyte count, hemoglobin levels)
RBCs microcytic and hypochromic
Serum ferritin (major iron storage protein in the body)
Serum iron

(b) Treatment:

Treating the cause of iron deficiency
Consuming iron rich foods like liver, red meat, fish, beans, raisins, green leafy vegetables
Iron supplements, use of iron fortified formulas and cereals for infants
Foods / supplements with high vitamin C = promotes the absorption of iron.

Megaloblastic Anemia = ?

Hematologic System

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Megaloblastic Anemia:

Caused by impaired DNA synthesis- large immature erythrocytes

(a) Causes:

B12 deficiency, vitamin B12 (cobalamine) is necessary for DNA synthesis = decreased cell division and cell maturation
Less B12 absorption (alcohol intake, Crohn’s disease)
Chronic gastritis, autoimmune destruction of gastric mucosa, gastrectomy
Folic acid deficiency(rare in US due to supplementation)
Grains and cereals are supplemented
Pregnancy increases the requirement- link seen between its deficiency and neural tube defects
Other causes - alcohol intake, poor diet

Pernicious anemia = ?

Hematologic System

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Pernicious anemia:

specific form of megaloblastic anemia.
Caused by atrophic gastritis and absence of intrinsic factors - absorption of vitamin B12.

Megaloblastic Anemia: * Clinical features= **?** ## Footnote *Hematologic System*

**Megaloblastic Anemia - Clinical Features**: * Bleeding gums * Diarrhea * Anorexia * Demyelination: breakdown of myelin - peripheral nerves / spinal column / cerebrum. * Paresthesia of hands and feet, imbalance esp in dark, loss of DTRs , loss of sensation, confusion, dementia * Impaired sense of smell * Personality / memory changes * Mild jaundice

Megaloblastic Anemia: * Diagnosis and treatment = **?** ## Footnote *Hematologic System*

**Diagnosis**: * Serum vitamin B12 * CBC * Intrinsic factor antibodies * RBCs larger in size (macrocytic) * Gastric analysis **Treatment**: * Vitamin B12 injections * Oral/ sublingual / nasal Vitamin B12

Result from excessive and/or premature destruction or hemolysis of erythrocytes; an increase in erythropoiesis = **?** ## Footnote *Hematologic System*

**Hemolytic Anemia**: **Causes**: * Idiopathic * Autoimmunity * Infections * Genetics * Blood transfusion reactions **Types**: * Sickle cell anemia * Thalassemia

Hemolytic Anemia: * Causes = **?** * Types = **?** ## Footnote *Hematologic System*

Hemolytic Anemia: **Causes**: * Idiopathic * Autoimmunity * Infections * Genetics * Blood transfusion reactions **Types**: * Sickle cell anemia * Thalassemia

Genetic type of hemolytic anemia, erythrocytes have crescent or sickle shape = **?** ## Footnote *Hematologic System*

**Sickle Cell Anemia**: * Genetic type of hemolytic anemia, erythrocytes have crescent or sickle shape * Caused by abnormal type of hemoglobin called as S Hemoglobin * Sickle shape cells are fragile, stiff and distorted, deliver less oxygen to body tissues, can clog small blood vessels, can break into pieces that disrupts blood flow * RBCs lifespan is reduced to 16 days, further contributing to symptoms * 1 in 600 African Americas have sickle cell disease, also seen in people from south and central America, the Caribbean and the middle east

Sickle Cell Anemia: * Role of Hemoglobin S = **?** * Triggers = **?** ## Footnote *Hematologic System*

**Sickle Cell Anemia**: * Hemoglobin S distorts the shape of erythrocytes esp when the blood supply of oxygen is low; repeated episodes of deoxygenation - permanently sickled. * HbS also cause damage to endothelial cells that line blood vessels. **Triggers**: * Dehydration * Stress * High altitude * Fever * Cold * Physical excretion

Sickle Cell Anemia: * Clinical Manifestations = **?** | *NOT complications* ## Footnote *Hematologic System*

**Sickle Cell Anemia - Clinical Manifestations**: * Symptoms develop after 4-5 months of age, most patients live into their 50’s * Symptoms because of vessel occlusion, difficulty of RBCs to passage through small blood vessels and hypoxia * Swelling in hands and feet (sickle cells occlude the blood vessels) with fever is the first symptom * Painful episodes (blood clogging/ ischemia) lasting for hours / days, necrosis – can occur suddenly

# Sickle Cell Anemia: Clinical Manifestations Sickle Cell Anemia: * Complications = **?** ## Footnote *Hematologic System*

**Sickle Cell Anemia - Clinical Manifestations**: Complication depends upon the area of occlusion * Bone: osteomyelitis, bone pain * Eye: retinopathy, blindness * Liver: jaundice (breakdown of RBCs), hepatomegaly * Anemia * Kidneys: hematuria * Skin: ulcers * Brain: stroke * Heart: angina, chest pain, coughing, difficulty breathing- life threatening * Spleen: more prone to damage by HbS * Spleen sequestration (spleen-low oxygen - sickle cell - ischemia-blood trapped in the spleen, life threatening, sudden weakness, pale, tachycardia, left quadrant abdominal. pain), hypospleenism (reduced spleen function), susceptibility to infections. * Lungs (acute chest syndrome- chest pain, dyspnea, cough)- sudden occlusion - death.

Cell Anemia: * Treatment ## Footnote *Hematologic System*

**Cell Anemia - Treatment**: No known cure, no single treatment. Treatment focused on prevention: * Avoidance of sickling triggers * Other measures: * Oxygen therapy * Pain medications, relaxation techniques * Blood transfusion * Bone marrow transplantation * Vaccination (should get all recommended vaccinations including flu) - risk of infections in children **Drugs**: * Hydroxyurea - synthesis of more normal Hb * Stem cell transplantation

Thalassemia: * What is it = **?** * Results in = **?** * Clinical Features = **?** ## Footnote *Hematologic System*

**Thalassemia**: * Genetic, results in abnormal Hb, absence of alpha or beta globin * Occurs most commonly in Mediterranean descent, also in individuals of African, Indian and Asian descent **Results in**: * Hypercoagulability * Ineffective erythropoiesis * Hemolysis * Compensatory response- hyperplasia in bone marrow **Clinical Features**: * Delayed growth development, osteoporosis * Jaundice * Dark urine * Cardiomegaly * Heart failure * Hepatomegaly * Splenomegaly infections * Poor appetite

Diseases of platelets = **?** ## Footnote *Hematologic System*

Diseases of Platelets: * Vital component of coagulation process * Normal: 150,000 – 350,000 cells/ml (1) **Thrombocytosis**: * Increased platelets * Thrombosis and hemorrhage * Thrombotic events include- deep vein thrombosis and pulmonary embolism. * **Treatment**: Platelet lowering drugs, aspirin (**2**) Thrombocytopenia: * Decreased platelets levels, increased risk of bleeding and infection. * History of bruising, purpura, petechiae, bleeding from gum, nose bleeds (epistaxis), melena, abnormal menstrual bleeding.

Inherited bleeding disorder that results in decreased coagulation = **?** ## Footnote *Hematologic System*

**Hemophilia**: * Inherited bleeding disorder that results in decreased coagulation * X chromosome, males can have the disease and females can be carriers * 1 in every 5000 male births * Severity of disorder depends upon the clotting factors present **Main symptom**: Bleeding in soft tissues, GI tract, joints. * Circumcised * When infant starts crawling and walking 9in joints- swelling, inflammation, contractures, disabilities) * Surgery/ trauma * Internal bleeding, bleedings into joints (hemarthrosis) * Petechiae (spots that appear on skin because of bleeding), bruising, GI bleed, hematuria

Hemophilia: * Treatment ## Footnote *Hematologic System*

**Hemophilia - Treatment**: * Replace the clotting factor through transfusion * Bleeding precautions

Disorders of WBCs = **?** | *7* ## Footnote *Hematologic System*

**Disorders of WBCs**: * Leukocytosis: increased WBCs * Leukocytopenia: decreased WBCs * Neutropenia: decreased number of circulating neutrophils * Neutrophilia: increase in number of circulating neutrophils * Lymphocytosis: increased lymphocytes * Lymphocytopenia: decreased lymphocytes * Leukemia: cancer of leukocytes

Hematologic System Flashcards

(38 cards)