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BLOOD Well Come PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE

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Presentation on theme: "BLOOD Well Come PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE"— Presentation transcript:

1 BLOOD Well Come PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE
LIAQUAT UNIVERSITY OF MEDICAL & HEALTH SCIENCE JAMSHORO

2 BLOOD INTRODUCTION BLOOD CONSISTS OF: Red Cells White cells Platelets
Plasma, in which above elements are suspended.

3 BLOOD FORMATION OF BLOOD: 2nd week→blood islands in yolk sac.
3rd week→migrate to liver and spleen chief sites of erythropoisis 5th month → bone marrow-MED. Haemopoisis. (erythropoisis). At birth→ marrow of nearly every bone. At adult life→ confined to end of long bones→axial skelaton, ribs and skull.

4 BLOOD FORMATION OF BLOOD: Diff. Into mature cells
Path. processes→ extramedullary haemopoisis in liver & spleen. NB. All peripheral blood cells are derived from single stem cell (pleuripotent steam cell), Stems cells Self renerwal Diff. Into mature cells

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6 BLOOD NB. Ist detectable CFU IS CFU-S(colony forms unit spleen, which gives rise to CFU-GEMM (i.e. Granulocyte, Erythroid cells, Monocytes, Megakaryocytes).

7 BLOOD Haemopoietic growth factors: All factors are glycoprotein
Factors include: - Erythropoietin - Colony Stimulating factors (CSF) - Interleukins (IL) Gene for most of them is 5 chromosome. And many growth factors are produced by recombinant DNA tech. e.g. GM-CSF after B.M. transplantation to accelerate neutrophil recovery.

8 Erythroiten used for anemia in CRF
B. lymphocyte N proerythoblast Pre B Totipotent stem cell Pluripotent myeloid stem cells Pre I Megak eryoblast Blast cells Myeloblast Promytocyte Monoblast T. lymphocyte Early normo Int.Normo Lat.Normo Recti. Rect Red cell Proliferative phase Maturation phase Released B. marrow E M Plat B Erythroiten used for anemia in CRF

9 BLOOD ANEMIA: CLASSIFICATION OF ANEMIA: Blood loss
Defined as a state in which the blood Hb level is below the normal range for the patient’s age and sex. CLASSIFICATION OF ANEMIA: Blood loss - Acute - Chronic inadequate production of normal RBC by Bone Marrow (hypoplasia, aplasia) - Excessive destruction of RBCS (Haemolysis)

10 MORPHOLOGICAL CLASSIFICATION:
BLOOD MORPHOLOGICAL CLASSIFICATION: Normocytic (N.MCV) Microcytic (↓MCV) Macrocytic (↑MCV)

11 BLOOD CLASSIFICATION OF RED CELL APPEARANCE
MICROCYTES (SMALL CELL) ↓MCV(>80f L) Iron Deficiency Anemia Fe content reduced Normal Fe. content - Thallesemia-Siderrobalstic anemia

12 BLOOD CLASSIFICATION OF RED CELL APPEARANCE
MACROCYTES (LARGE CELLS) ↑MCV(>96fl) Megalobalastic - B 12 - Folate Normoblastic - Liver D. Alcohol Haemlysis

13 BLOOD CLASSIFICATION OF RED CELL APPEARANCE
NORMAL CELLS MCV Normoblast Ac blood less Anemia of Ch. Disease e.g. Infection R.F. C.T. Dis. Malig. Endo.

14 BLOOD CLASSIFICATION OF RED CELL APPEARANCE
UNUSUAL CELLS Spherocyte Sickle cell Schistocytes Burr cells Howell jolly bodies Poikilocytes Blister cells

15 Blood SYMPTOMS & SIGNS OF ANEMIA
Lassitude Fatigue Breathlessness on exertion Palpitation Throbbing in head & ears Dizziness Tinitus

16 BLOOD SYMPTOMS & SIGNS OF ANEMIA
Headache Diminish of vision Insomnia Paraesthesia of finger & toes Angina

17 BLOOD SYMPTOMS & SIGNS OF ANEMIA
Pallor of - Skin - Mucous membrane - Palm of hands - Conjunctive Tachycardia Cardiac dilatation Systolic flow murmurs edema.

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20 BLOOD Anemia due to inadequate production of Red cells:
CAUSES: Deficiency of essential factors: - Iron, vit.12 Folate. Toxic factors: - Inflammatory disease, Hepatic or Renal dis.,Dgs. Endocrine Diseases: - Hypo or Hyperthyroidism, hypopittutism hypogonad:↓erythryroitin.

21 BLOOD Anemia due to inadequate production of Red cells:
CAUSES: Invasion of Bone Marrow - Leukemia, sec. ca., fibrosis. Disorders of developing Red cells. - Sideroblastic anemia, Neoplastic disorders of erythropoisic, other iodiopathic refactory anemia, heridatory disorders of Hb. Synthesis (Thallasemia) Failure of stem cells. - Hypoplastic & aplastic anemia.

22 BLOOD IRON DEFICIENCY ANEMIA
CAUSES: Poor intake Decreased absorption ↑ demands Blood loss

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24 BLOOD IRON DEFICIENCY ANEMIA
CLINICAL FEATURES: Symptomatology of iron deficeincy is mainly that of anemia. However there are charachteristic features, these are mainly epitelial changes produced by inadequate iron in the cells. - Brittle nails - Spoon-shaped nails (koilonychias) - Atrophy of the papillae of the tongue.

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26 BLOOD IRON DEFICIENCY ANEMIA
CLINICAL FEATURES: Angular stomatitis Brittle hairs A syndrome of dysphagia and glossitis (Plummer-Vinson ro Peter-Brown-Kelly syndrome). Rarely in severe deficiency parotid enlargement, spleenomegaly and failure to grow.

27 BLOOD GOOD CLINICAL HISTORY Dietary intake Self Medication –NSAIDS.
Blood in faeces (Haemrrhoid or ca. lower Bowl) P/R examination.

28 BLOOD ORAL PARENTERAL Fe sulphate 200 mg/100 Iron sorbital 1.5mg
Per kg/body wt daily l/m, never give.

29 Thank you


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