Blood and Blood-Forming Organs Diseases and Disorders Chapter 7 Blood and Blood-Forming Organs Diseases and Disorders

Anatomy and Physiology Hematologic system Major functions of blood: Transport nutrients to cells Aid removal of wastes Average adult has 5 to 6 liters of circulating blood

Blood Components

Anatomy and Physiology Erythrocytes Normal count: 4.2 to 6.3 million Life span: 120 days Form in bone marrow and do not reproduce

Anatomy and Physiology Hemoglobin important in oxygen transport Normal hemoglobin: Male 13.5 to 18 hemoglobin in grams (gm)/100 milliliter (ml) Female 12 to 16 gm/100ml

Anatomy and Physiology Leukocytes protect individual from infection Normal count: 4,500 to 11,000

Anatomy and Physiology Platelets Also known as thrombocytes Important in blood clotting Normal count: 150,000 to 350,000

Anatomy and Physiology Blood-forming organs: Lymph nodes Bone marrow Spleen Liver Lymph system protects against pathogens

Anatomy and Physiology Bone marrow Major blood cell producer Spleen produces lymphocytes, plasma cells, and antibodies to filter microorganisms from blood Liver produces prothrombin and fibrinogen for blood clotting

Animation Click Here to Play Blood Animation

Common Signs and Symptoms Erythrocytopenia Decrease in RBCs leading to anemia Symptoms: Fatigue Headache Low RBCs Pallor Shortness of breath

Common Signs and Symptoms Erythrocytosis Increased RBCs Symptoms: High RBCs Reddened skin tones Bloodshot eyes Increased blood volume and pressure Increased blood volume of heart

Common Signs and Symptoms Leukocytopenia Decreased white blood cells Weakens immune system Leukocytosis Increased white blood cells Normal response to acute infections

Common Signs and Symptoms Thrombocytopenia Decreased platelet count leading to coagulation problem Symptoms: Petechiae Small hemorrhages in skin Ecchymoses Large areas of bruising or hemorrhage

Common Signs and Symptoms Thrombocytopenia Symptoms: Epistaxis Nosebleeds Bleeding in mouth, gums, and mucous membranes

Common Signs and Symptoms Thrombocytosis Increase in platelets Uncommon Usually no serious side effects

Diagnostic Tests Complete blood count with differential and indices Biopsy of blood-forming organs Hematocrit (Hct) reflects amount of red cell mass as proportion of whole blood Hemoglobin (Hgb) reflects blood’s oxygen-carrying potential

Diagnostic Tests Bleeding time determines platelet disorders E.g., hemophilia, thrombocytopenia, disseminated intravascular coagulation Prothrombin time (PT) and partial prothrombin time (PTT) measure blood’s ability to clot

Diagnostic Tests Biopsy Bone marrow Lymph node

Disorders of Red Blood Cells Anemia Decrease in oxygen-carrying ability of RBC Symptoms: Pallor Fatigue Shortness of breath

Disorders of Red Blood Cells Anemia Symptoms: Tachycardia Headache Irritability Syncope

Disorders of Red Blood Cells Iron deficiency anemia Loss of iron or inadequate intake of iron Causes: Blood loss Low dietary intake Treatment: Increase dietary intake of iron

Disorders of Red Blood Cells Folic acid deficiency anemia Folic acid needed for maturation of RBCs Causes: Poor diet Overcooking of vegetables Over consumption of alcohol Treatment: Increase folic acid intake by eating green and yellow vegetables

Disorders of Red Blood Cells Pernicious anemia Lack of intrinsic factor leading to inadequate absorption of vitamin B12 Treatment: Monthly injections of vitamin B12 for life

Disorders of Red Blood Cells Hemolytic anemia Destruction of RBCs related to antibody-antigen reaction Disorder of immune system leading to destruction of erythrocytes Treatment: Exchange transfusion and/or splenectomy

Disorders of Red Blood Cells Sickle cell anemia Hereditary Found in African American race Abnormal sickle shape of erythrocyte Does not allow cell to travel smoothly through vessels Symptomatic treatment No cure

Disorders of Red Blood Cells Aplastic anemia Failure of bone marrow to produce blood components Causes: Chemotherapy Radiation Viruses Toxins

Disorders of Red Blood Cells Aplastic anemia Treatment: Avoid causative agent Bone marrow transplantation Transfusions

Disorders of Red Blood Cells Polycythemia Too many blood cells Symptoms: Enlarged spleen Reddened mucous membranes Bloodshot eyes Deep red color on palms

Disorders of Red Blood Cells Polycythemia Treatment: Donate blood at regular intervals to reduce blood volume

Disorders of White Blood Cells Mononucleosis Also known as kissing disease Symptoms: Fatigue Sore throat Swollen glands

Disorders of White Blood Cells Mononucleosis Diagnosis by increased monocytes in white blood cells (WBCs) Treatment: Rest Analgesics Throat gargles

Disorders of White Blood Cells Leukemia Malignant neoplasm of blood-forming organs Abnormal production of immature leukocytes May be acute or chronic Acute forms affect children, progress rapidly, and may be fatal

Disorders of White Blood Cells Leukemia Chronic forms affect older adults, are often asymptomatic, and may not be fatal Classified as: Myelogenous Affecting bone marrow Lymphocytic Affecting lymph nodes

Disorders of White Blood Cells Leukemia Diagnosis by bone marrow biopsy Symptoms: Fatigue Headache Sore throat

Disorders of White Blood Cells Leukemia Symptoms: Dyspnea bleeding of mucous membranes of mouth and gastrointestinal (GI) system Bone and joint pain Enlargement of lymph nodes, liver, and spleen Infections common

Disorders of White Blood Cells Leukemia Treatment: Aggressive chemotherapy Once in remission, bone marrow transplant to replace neoplastic tissue with normal tissue Remission at 50 percent

Disorders of White Blood Cells Hodgkin’s disease Most common lymphoma Symptoms: Painless enlargement of lymph nodes in neck Weight loss Fever Primarily affects young adults Average age of 35

Disorders of White Blood Cells Hodgkin’s disease Cause thought to be viral Diagnosis by presence of Reed-Sternberg cell in lymphatic tissue Treatment: Radiation Chemotherapy If in remission for five years or more, complete cure possible

Disorders of White Blood Cells Non-Hodgkin’s lymphoma (NHL) Lymphomas lacking Reed-Sternberg cell Symptoms: Painless enlargement of lymph nodes of neck, axilla, and inguinal areas Fever Night sweats Weight loss

Disorders of White Blood Cells Multiple myeloma Malignant neoplasm of plasma cells or B-lymphocytes Increases with age Peaks in 70s Plasma cells multiply abnormally in bone marrow Causes weakness Leads to fractures and bone pain

Multiple Myeloma

Disorders of White Blood Cells Multiple myeloma Diagnosis by honeycombed bone pattern, hypercalcemia, Bence-Jones protein found in blood and urine, and bone marrow biopsy Treatment: Chemotherapy Radiation Not effective Poor prognosis

Disorders of Platelets Hemophilia X-linked hereditary bleeding disorder Several types Type A Most common Male children from asymptomatic mothers Lack protein necessary for clot formation

Disorders of Platelets Hemophilia Symptoms: Epistaxis Bruising Prolonged bleeding Diagnosis by blood test

Disorders of Platelets Hemophilia Treatment: Prevention of injury Treat symptoms Blood transfusions Concentrated form of clotting protein No cure

Disorders of Platelets Thrombocytopenia Also known as thrombocytopenia purpura Decrease in platelets leading to inability to normally clot blood Symptoms: Abnormal bleeding in skin, mucous membranes, and internal organs Petechiae

Disorders of Platelets Thrombocytopenia Symptoms: Ecchymoses GI hemorrhages Epistaxis Hematuria

Disorders of Platelets Thrombocytopenia Diagnosis by platelet count and bleeding time Treatment: Avoid tissue trauma to reduce bleeding Vitamin K Transfusions of platelets Splenectomy

Disorders of Platelets Disseminated intravascular coagulation (DIC) Abnormal clotting followed by abnormal bleeding Usually follows major trauma E.g., complicated childbirth, surgery, tissue destruction, septicemia, snakebite, shock Multiple clots in capillaries Life-threatening

Disorders of Platelets DIC Symptoms: Petechiae Ecchymosis Hematoma Hematuria GI bleeding

Disorders of Platelets DIC Symptoms: Hematemesis Blood in stool Treatment: Heparin Platelets

Disorders of Platelets Rare diseases Thalassemia Primarily affects people of Mediterranean descent Fragile, thin RBCs form defective hemoglobin

Disorders of Platelets Rare diseases von Willebrand’s disease Hereditary Congenital Deficiency in clotting factor and platelet function Also known as angiohemophilia Affects females and males

Effects of Aging Age-related changes in other systems (e.g., immune, digestive) leave older adults more susceptible to infections and nutritionally related blood disorders Decreased iron Poor nutrition