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

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Presentation on theme: "BLOOD BLOOD PROF. Dr. RAFI AHMED GHORI DEPARTMENT OF MEDICINE LIAQUAT UNIVERSITY OF MEDICAL & HEALTH SCIENCE JAMSHORO."— Presentation transcript:

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

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

3 BLOOD FORMATION OF BLOOD:  2 nd week→blood islands in yolk sac.  3 rd week→migrate to liver and spleen chief sites of erythropoisis  5 th 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:  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. 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 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 MPlat B Erythroiten used for anemia in CRF

9 BLOOD ANEMIA:  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 BLOOD MORPHOLOGICAL CLASSIFICATION : Normocytic (N.MCV) Normocytic (N.MCV) Microcytic (↓MCV) Microcytic (↓MCV) Macrocytic (↑MCV) Macrocytic (↑MCV)

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

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

13 BLOOD CLASSIFICATION OF RED CELL APPEARANCE NORMAL CELLS  MCV Normoblast Normoblast Ac blood less Ac blood less Anemia of Ch. Anemia of Ch. Disease e.g. Disease e.g. Infection Infection R.F. R.F. C.T. Dis. C.T. Dis. Malig. Malig. Endo. 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 SYMPTOMS  Lassitude  Fatigue  Breathlessness on exertion  Palpitation  Throbbing in head & ears  Dizziness  Tinitus

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

17 BLOOD SYMPTOMS & SIGNS OF ANEMIA SIGNS  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: 1. Poor intake 2. Decreased absorption 3. ↑ demands 4. 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 BLOOD GOOD CLINICAL HISTORY  Dietary intake  Self Medication –NSAIDS.  Blood in faeces (Haemrrhoid or ca. lower Bowl)  P/R examination.

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

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