1. Blood and Blood Forming Organs Diseases and Disorders
Shelby Engel and Sarah Heins

2. Anatomy & Physiology Blood transports necessary nutrients and hormones
Color, volume, viscosity, and pH
RBCs/erythrocytes – transport oxygen
million live 120 days
Hemoglobin typically g/100 ml for males, for females
WBCs/leukocytes – infection prevention
4,500-11,000 count
>11,00 indicates infection
Platelets/thrombocytes cause blood coagulation
Clump at site of injury
Calcium builds at site
Fibrin clot is formed
Clot is removed, scar tissue
A, B, AB, O +/- blood classified by antigens in blood
Blood forming organs
Lymph nodes – protection from pathogens
Bone marrow – major blood cell-producing organ
Spleen – produces lymphocytes, plasma cells, and antibodies; filters microorganisms in blood, removes old blood from body
Liver – blood-forming organ; aids in blood coagulation
Anatomy & Physiology

3. Common Signs & Symptoms
Increases or decreases in production of cells – RBC, WBC, Platelets
HIGH VOLUME
LOW VOLUME
RBC
Erythrocytosis - reddened skin tones, bloodshot eyes, increased blood volume and pressure, increase in heart workload
Erythrocyopenia leads to anemia – headache, fatigue, pallor, shortness of breath
WBC
Leukocytosis – response to acute infection
Leukocytopenia – weakened immune system
PLATELETS
Thrombocytosis – no serious side effects
Thrombocytopenia – clotting problems, bruising, nosebleeds, blood lesions

4. Complete blood count – identifies RBCs, WBCs, and platelets; see page 128 in book
Differential – more detailed count, identifies the number of each type of leukocyte
Hematocrit – reflects the amount of red cell mass as a proportion of whole blood
Hemoglobin – reflects oxygen-carrying potential available
Mean corpuscular volume – average size of RBC
Mean corpuscular hemoglobin – average hemoglobin content
Mean corpuscular hemoglobin concentration – average hemoglobin concentration
Blood smears
Biopsy of blood-forming organs
Bleeding time test – prick earlobe and measure time until clot
Diagnostic Tests

5. Disorders of Red Blood Cells
Anemia
Iron Deficiency Anemia
Folic Acid Deficiency Anemia
Vitamin B12 Deficiency Anemia
Pernicous Anemia
Hemolytic Anemia
Sickle Cell Anemia
Hemorrhagic Anemia
Aplastic Anemia
Polycythemias
Polycythemia (Primary or Vera)
Secondary Polycythemia (Erythrocytosis)

6. Treatment –Depends on the type of anemia
Anemia = Most common
A decrease in RBC mass that can be caused by a number of different processes
Can be serious enough if not determined or corrected
Symptoms:
Shortness of breath and headache
Rapid heart beat
Dizziness
Pale skin
Weakness and fatigue
Treatment –Depends on the type of anemia
Prevention – Eating a healthy diet with foods high in iron and b complex vitamins
Vitamin B12 Deficiency Anemia
Results from dietary deficiency in B12 or inability of the digestive tract to absorb it

7. Folic Acid Deficiency Anemia
Can be related to poor diet, overcooking vegetables, and alcoholism
Infancy and pregnancy
Symptoms:
Fatigue
Weight loss
Abdominal pain
Black or bloody stools
Chest pain
Treatment – Increase intake of green leafy vegetables, mushrooms, lima beans, and kidney beans
Prevention – Diet high in folic acids

8. Pernicous Anemia
Usually affects older individuals and has an unusual cause
People affected usually have an autoimmune disorder
Symptoms:
Pallor (paleness)
Weakness
Confusion
Depression
Numbness in the hands and feet
Diagnosis – History, physical examinations, and blood testing for vitamin B12
Treatment – Depends on the cause of the deficiency
Absorption and diet – can be treated with oral vitamin tablets or injectable vitamin B12
Monthly injection for life
Not preventable

9. Hemolytic Anemia Increased destruction on RBCs Symptoms
Can be severe and lead to death
Can be brought on by exposure to chemicals such as benzene; medications, including aspirin and penicillin; and bacterial toxins
Symptoms
Pallor (paleness)
Weakness
Fatigue
Tachycardia (rapid heart rate)
Diagnosis – thorough history, physical examinations, and blood testing
Prevention – Genetic = not preventable; Acquired = preventable with proper screening

10. Sickle Cell Anemia
Hereditary anemia found in the African-American race
Causes an abnormal sickle shape of the erythrocyte
Thought to have developed a defense against malaria
Symptoms: Can be very mild to severe
Pain in the back, legs, and abdomen (most common)
Fatigue
Irritability
Swollen joints
Leg sores
Gum disease
Sickle Cell Crisis – Group of symptoms, pain is compared to cancer pain

11. Sickle Cell Anemia cont.
Diagnosis – History and blood testing
Two blood tests
1st = Measures the amount of normal and abnormal hemoglobin in the blood
2nd = Measures the percent of red sickle cells after mixing a small drop of blood with a deoxygenating agent
Treatment – No cure and treatment is symptomatic
Increased fluid intake can help by increasing blood volume and improve sickle cell movement
Prevention – Genetic counseling and decision to avoid childbearing

12. Hemorrhagic Anemia
Loss of whole blood and can be called blood loss anemia
Common complication = hypovolemic shock
Symptoms
Pallor (paleness)
Cool clammy skin
Tachypnea
Tachycardia
If large amounts of blood is lost symptoms can include:
Dizziness
Fainting
Extreme thirst (result from dehydration)
Diagnosis – History and physical examinations
Treatment – Acute blood loss = apply oxygen, intravenous fluids and liquids taken by mouth; Severe blood loss = blood transfusion
Prevention – Accident prevention and controlling chronic bleeding

13. Aplastic Anemia Failure of bone marrow to produce blood components
Due to injury or destruction of blood-forming area of the bone marrow
Causes : Chemotherapy, radiation, viruses, and chemical toxins
Symptoms: This decrease in blood cells leads to anemia, infection, and hemorrhage
Diagnosis – History and physical examination with blood testing
Treatment – Severe cases have a poor prognosis with 50% fatality
Discontinuing or avoiding the causative agent
Bone marrow transplantation or blood transfusion
Prevention – Avoiding causative agent, but often the agent is unknown which makes prevention impossible

14. Polycythemia (Primary or vera)
Condition of too many blood cells
Caused by hyperplasia of the cell-forming tissues of the bone marrow
Symptoms:
Raised blood pressure
Enlarged spleen
Bloodshot eyes
Redness of skin
Shortness of breath
Dizziness
Diagnosis – Can be accidently discovered through routine blood testing
Treatment – Reduce the red cell count, blood removal at regular intervals will reduce the volume (common treatment)
Prevention – Cannot be prevented

15. Secondary Polycythemia (Erythrocytosis)
Red cell numbers increase
Symptoms:
Headaches
Weakness
Fatigue
Lightheadedness
Shortness of breath
Diagnosis – History, physical exam, and blood testing
Treatment – Treated by addressing the cause of the disorder
Prevention – Stopping the causative factor or by doing the things that deprive the body of needed oxygen, avoiding smoking, and avoid living in high altitudes

16. Disorders of White Blood Cells
Common problems of the hematologic system
Mononucleoisis
Leukemia
Lymphoma
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma
Multiple Myeloma

17. Mononucleoisis, the “kissing disease”
Primarily affects children and young adults
Contagious by direct contact with saliva
Last several weeks
Epstein-Barr Virus (EBV)
Fatigue, sore throat, fever, swollen lymph glands, spleen enlargement
Diagnosed by WBC count high
Rest, analgesics, throat gargles, avoiding sports activities
Prevent through good oral hygiene
Mononucleoisis, the “kissing disease”

18. Leukemia Malignant neoplasm of the High production of
blood-forming organs
High production of
leukocytes, causing decrease
in erythrocytes and platelets
Acute common in children;
chronic common in older adults
Cause is unknown
Fatigue, headache, sore throat, dyspnea, bleeding of the mucous membranes, bone and joint paint, enlarged lymph nodes
Diagnosed by clinical history and blood studies, or bone marrow biopsy
Treated by aggressive chemotherapy and a bone marrow transplant
Complete remission occurs 50% of the time
No known ways to prevent

19. Lymphomas Neoplasms that affect lymphoid tissue
Lead to impaired immunity
Most common type of blood cancer
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma
Multiple myeloma

20. Hodgkin’s Disease Most common lymphoma
Orderly spread of disease from one lymph node group to another
Cause is thought to be viral
Painless enlargement of the lymph nodes in the neck, weight loss, fever
Primarily affects young adults, average age of 35
Men at higher risk than women
Reed-Sternberg
Diagnosed with lymph node and bone marrow biopsy
Treated with radiation and chemotherapy
Complete cure after 5 years of remission
93% cure rate – one of the most curable forms of cancer
20% mortality rate
No known preventive measures
Hodgkin’s Disease

21. Non-Hodgkin’s Lymphoma
Not containing the Reed-Sternberg cell characteristics; more widespread than Hodgkin’s
Affects more older adults, average age of 50 years
Men are affected 1.5X more often than women
Cause is unknown
Patients who receive/have received immuno-suppressive medication 100X more likely chance of developing NHL
Painless enlargement of lymph nodes in neck, axilla, and inguinal areas; fever, night sweats, weight loss
Diagnosed by absence of Reed-Sternberg, and lymph node and bone marrow biopsy
Combination of radiation and chemotherapy
Those at increased risk – exposure to pesticides, solvents and fertilizers
Cure rate of 63%
Mortality rate of 33%

22. Multiple Myeloma Malignant neoplasm of plasma cells
Causes weakness in the bone, leading to fractures and bone pain
Cause is unknown
Occurs increasingly with age, peaking in 70s, more common in men
One of the most common neoplasms affecting the bone
Decrease in other blood components, causing anemia, leukocytopenia and thrombocytopenia
Causes excessive blood calcium levels, tissue damage, kidney failure
Diagnosed with X-ray, high calcium levels, presence of Bence Jones protein, excessive plasma cells
Treatment is poor – death is usually within 2-3 years
Prevent by avoiding herbicides, petroleum products, heavy metals and radiation

23. Disorders of Platelets and Clotting
Platelet disorders vary in terms of cause, severity, and treatment
All share common symptom of bleeding
Many of these disorders are inherited
Hemophilia
Thrombocytopenia
Disseminated Intravascular Coagulation (DIC)

24. Hemophilia
Group of bleeding disorders characterized by abnormally slow clotting and long bleeding times
X-linked hereditary bleeding disorder
Commonly occurs in male children
Hemophiliacs lack a blood protein that plays a role in clot formation
Symptoms:
Frequent nosebleeds
Bruising
Prolonged bleeding in a male child (can indicate hemophilia)
Can be mild to severe
Severe cases are called hemarthrosis or bleeding into joints, which is painful, and recurrent episodes can lead to joint deformity

25. Hemophilia cont.
Diagnosis – Confirmed by obtaining a detailed medical history, physical examination, and blood testing
Blood tests include measurement of clotting time and the presence of blood proteins
Treatment – No cure
Aimed at prevention of injury and treatment of symptoms
Whole blood transfusions can be needed
Prevention – Because it is inherited it can only be prevented by genetic testing of possible carriers with the decision to not have children

26. Thrombocytopenia
Decrease in platelets that leads to an inability to clot blood normally
Can be due to inadequate or abnormal platelet production or destruction
Cause is unknown
Symptoms:
Abnormal bleeding in the skin, mucous membranes, and internal organs
Small hemorrhagic spots on skin; larger purplish hemorrhagic spots
Frequent nosebleeds
Blood in urine
Diagnosis – Individual clinical history along with platelet count and bleeding time

27. Thrombocytopenia cont.
Treatment :
Avoid tissue trauma to reduce potential bleeding
Administration of vitamin K to improve clotting
Transfusion on platelets
Prevention- Most cases are not preventable, but there are two steps that can be taken to prevent complications
Avoid taking medications that decrease platelet aggregation or stickiness, thus making them less likely to clot. (Ex: Aspirin or Ibuprophen)
Avoid heavy drinking because alcohol slows platelet production

28. Disseminated Intravascular Coagulation
Abnormal clotting followed by abnormal bleeding
Blood starts to coagulate or clot throughout the entire body
Usually follows major trauma such as blood transfusion reaction, surgery, septicemia, complicated childbirth, massive tissue destruction, shock, malignancy, or snakebite
Symptoms:
Black and blue fingers and toes
Large thrombus formation (can lead to life-threatening pulmonary embolism)
Oozing of blood
Vomiting
Blood in stool
Symptoms associated with anemia

29. DIC cont. Diagnosis – History of trauma and blood studies
Treatment – Identifying and treating underlying cause can stop DIC
Medications
Heparin – an anticoagulant medication to halt the formation of thrombi
Platelet administration to increase clotting ability
Difficult to manage
This condition is usually life-threatening and can lead to death
Often times it is referred to as “Death Is Coming” (DIC)
Prevention – Getting prompt medical treatment for any condition that might bring on this disorder

30. Rare Diseases Thalassemia Von Willebrand’s Disease Lymphosarcoma
Hereditary hemolytic anemia
Mediterranean descent
Dysfunctional RBCs leading to anemia symptoms
Von Willebrand’s Disease
Hereditary, congenital bleeding disorder
Deficiency in clotting and platelet function
Lymphosarcoma
Similar to Hodgkin’s Disease
With remission, prognosis is good

31. Childhood Diseases: Acquired Immunodeficiency Syndrome & Leukemia
Acquired Immunodeficiency Syndrome (AIDS ) affects thousands of children in the US
1980s – HIV infection mainly acquired through blood transfusions
Today – Most all HIV infections in children are a result of maternal-fetal transfer through blood (also called perinatal transmission)
Symptoms: Many children to not experience symptoms and live a normal life for years
Diagnosis – When T-cell count drops below 200 cells per microliter
Treatment – Good nutrition, antiviral drugs, and other support therapies
Prevention- prevent mother-to-child transmission, provide pediatric treatment, and prevent infection among adolescents

32. References Cancer.gov CDC.gov
Human Diseases, 3rd Ed., M. Neighbors & R. Tannehill-Jones