Hemocrit (HCT): 45% by volume. Includes cells – mostly RBC’s and much smaller numbers of WBC’s and platelets
Plasma: clear, straw-colored liquid which is a complex mixture of water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes.
Blood consists of a liquid portion (plasma) and a solid portion (RBC’s, WBC’s, platelets). When blood separates, the WBC’s and platelets form a thin layer called the “buffy coat” between the plasma and the RBC’s .
A hormone, erythropoietin controls the rate of hemopoiesis
Kidneys and to a lesser extent the liver release erythropoietin in response to prolonged O 2 deficiency.
Ex. High altitudes where % of O 2 in air is reduced stimulate the release of hormone and RBC production. When O 2 level in air returns to normal, hormone decreased and rate of hemopoiesis returns to normal.
Low blood oxygen causes the kidneys and liver to release erythropoietin, which stimulates the production of red blood cells that carry oxygen to tissues.
Origin and development of blood cells from hemocytoblasts (stem cells) in bone marrow.
Hospitalization for transfusions: sickling crises of blocked circulation.
Bone marrow transplant: complete cure but 15% risk of death.
New treatment: old drug used to treat cancer, hydroxyurea. Activates slightly different form of hemoglobin in fetus. Sickle hemoglobin cannot crystallize as quickly. Sickling is delayed and enables RBC’s carrying sickled hemoglobin to more quickly reach lungs where fresh O 2 restores normal shape.
Hemoglobin molecules liberated from RBC’s broken down into heme (iron-containing portion) and globin (a protein)
Heme further decomposes into iron and biliverdin (greenish pigment)
Biliverin is converted to an orange pigment called bilirubin. Both pigments are excreted in bile.
Blood transports iron and protein to hemopoietic tissue in red bone marrow to be reused in synthesizing new hemoglobin or the liver stores the iron-protein complex
Life cycle of a red blood cell. 1.) Small intestine absorbs essential nutrients. 2.) Blood transports nutrients to red bone marrow. 3.) In the marrow, RBC’s arise from the division of less specialized cells. 4.) Mature RBC’s are released into the bloodstream, where they circulate for about 120 days. 5.)Macrophages destroy damaged RBC’s in the spleen and liver. 6.) Hemoglobin liberated from RBC’s is broken down into heme and globin. 7.) Iron from heme returns to red bone marrow and is reused. 8.) Biliverdin and bilirubin are excreted in bile.
Lack a plasma protein, von Willebrand factor, secreted by endothelial cells lining blood vessel walls which enables platelets to adhere to damaged blood vessel walls, a key step preceding actual clotting.
Sometimes causes spontaneous bleeding from mucous membranes or gastrointestinal and urinary tracts.
Blood vessel spasm, platelet plug formation, and blood coagulation provide homeostasis following tissue damage.
Universal Donor : lacks antigens A and B. Could be transfused into persons of any blood type. Does contain anti-A and anti-B so it must be transfused slowly so persons larger blood volume dilutes it minimizing chance of reaction.
Agglutination. A.) If RBC’s with antigen A are added to blood containing antibody anti-A, B.) the antibodies react with the antigens, causing clumping (agglutination). C.) Nonagglutinated blood. D.) Agglutinated blood.
Extremely rare today because physicians carefully track Rh status.
Woman who might carry Rh+ fetus is given an injection of RhoGAM composed of anti-Rh antibodies which bind to and shield and Rh+ fetal cells that might contact the woman’s cells and sensitize her immune system.
RhoGAM must be given within 72 hours of possible contact with Rh+ cells including giving birth, terminating pregnancy, miscarrying, amniocentesis.
Normal blood plasma that has been vacuum-dried to prevent growth of microorganisms
Dried plasma was developed and first used during WWII . Prior to the United States involvement in the war, liquid plasma and whole blood were used. The "Blood for Britain" program during the early 1940s was quite successful (and popular stateside). Nonetheless the decision was made to develop a dried plasma package for the armed forces because it reduced breakage and made transport, packaging, and storage much simpler.  The resulting Army-Navy dried plasma package came in two tin cans containing 400 cc bottles. One bottle contained enough distilled water to completely reconstitute the dried plasma contained in the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours.  By the end of the war the American Red Cross had provided enough blood for over six million plasma packages. Most of the surplus plasma was returned stateside for civilian use. Serum albumin replaced dried plasma for combat use during the Korean War
Inherited tendency to bleed from localized lesions of capillaries.
Patients lose capillary network connects between veins and arteries. Most affected areas are lips, tongue, nasal mucosa, finger tips, lungs, brain, liver, and gastrointestinal tract. Treatments include, iron supplements, laser cautery, antifibrinolytic agents, transfusions
Shift or transient neutrophilia is generally a very short-lived condition, often lasting less than sixty minutes. This increase in actively circulating neutrophils is usually associated with vigorous exercise, but can also develop following an injection of epinephrine, a seizure, or an intense emotive response, such as fear or rage. All of the neutrophils in circulation are fully mature since they simply have been transferred from the marginal pool, which in a normal adult is comprised of cells that have already fully developed in the bone marrow. When true neutrophilia occurs, however, some of the neutrophils observed in the blood may be immature forms that were released by the bone marrow before their development was complete due to an insufficient number of mature cells to meet the demands of the body. Typically this excessive demand is related to a bacterial infection, which results in the release of chemoattractants that bind to certain neutrophil receptors and initiate their activity so that they can aid in the body’s immune response.
Concentrated suspension of red blood cells from which the plasma has been removed.
Leukocyte depleting filters. Packed red blood cells, the most commonly transfused blood component, can restore the blood's oxygen-carrying capacity. This component may be given to a person who is bleeding or who has severe anemia. The red blood cells are separated from the fluid component of the blood (plasma) and from the other cellular and cell-like components. After this step, the red blood cells are concentrated so that they occupy less space, thus the term "packed." Red blood cells can be refrigerated for up to 42 days. In special circumstances—for instance, to preserve a rare type of blood—red blood cells can be frozen for up to 10 years. Transfusing only selected blood components allows the treatment to be specific, reduces the risks of side effects, and can efficiently use the different components from a single unit of blood to treat several people.
Abnormal depression of all the cellular components of blood
This peripheral blood picture is from an anemic patient with a low white cell count, and a low platelet count. A reduction in all the formed elements of the blood is called a 'pancytopenia'. It often indicates bone marrow failure (leukemia), but can also occur from peripheral destruction of cells, as in hypersplenism (overactive spleen). Also occurs in people with AIDS.
Lowers blood’s oxygen carrying capacity causing anemia. In all cases, the treatment of poikilocytosis depends on its cause. For example, poikilocytosis can be caused by a vitamin deficiency, in which case the treatment is to take Vitamin B12 or folic acid. It can be caused by a digestive disease, such as celiac disease , in which case the solution may lay in treating the underlying celiac disease so that nutrients can be properly absorbed.
Presence of disease-causing microorganisms or their toxins in the blood.
Septicemia is a serious, life-threatening infection that gets worse very quickly. It can arise from infections throughout the body, including infections in the lungs, abdomen, and urinary tract. It may come before or at the same time as infections of the bone ( osteomyelitis ), central nervous system ( meningitis ), or other tissues. Septicemia can rapidly lead to septic shock and death. Septicemia associated with some organisms (germs) such as meningococci can lead to shock , adrenal collapse, and disseminated intravascular coagulopathy , a condition called Waterhouse- Friderichsen syndrome . Septicemia can begin with spiking fevers and chills, rapid breathing and heart rate, the outward appearance of being seriously ill (toxic) and a feeling of impending doom. These symptoms rapidly progress to shock with decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood-clotting abnormalities evidenced by a specific type of red spots on the skin (petechiae and ecchymosis). The Pope died from septic shock April 2005
Hemolytic anemia caused by defective proteins supporting cell membranes of red blood cells.
The cells are abnormally spherical.
Though the spherocytes have a smaller surface area through which oxygen and carbon dioxide can be exchanged, they in themselves perform adequately to maintain healthy oxygen supplies. The misshapen but otherwise healthy red blood cells are mistaken by the spleen for old or damaged red blood cells and it thus constantly breaks them down, causing a cycle whereby the body destroys its own blood supply (auto- hemolysis ).
Group of hereditary hemolytic anemias resulting from very thin, fragile erythrocytes.
The genetic defect results in synthesis of an abnormal hemoglobin molecule. The blood cells are vulnerable to mechanical injury and die easily. To survive, many people with thalassemia need blood transfusions at regular intervals.