Hematological Disease

1. HEMATOLOGICAL
DIEASES CONDITION
PRESENTED BY,
DIPALI SATHE

2. Anatomy & Physiology of Blood
 Most cells of multicellular organism cannot move around to obtain oxygen & nutrients or eliminate
carbon dioxide & other waste. Instead these need are met by two fluid ; Blood & interstitial fluid.
 Blood is a liquid connective tissue. Blood transport oxygen from lungs & nutrients from the
gastrointestinal tract, which diffuse from the blood into the interstitial fluid & then into body cells
 It circulates continually around the body , allowing constant communication between tissue distant
from other.
 It composed of clear, straw coloured, watery fluid called plasma with several blood cells like RBC,
WBC & platelets.
 Blood is more denser & more viscous than water & feel slightly sticky , Temp. is about 38º C about 1ºC
higher then the oral & rectal body temp.
 Alkaline in nature pH from 7.35 to 7.45.
 Colour is varying depends on oxygen is present or not.

3. COMPONENT & FUNCTION
Transportation
(Gas,
Nutrient,
Hormone)
Regulation(
pH,Tem.
,Homeostasis)
Protection(inf
ection,
clotting)

4. Component
 Whole blood has two component:
1. Blood plasma 2. Blood Cells
- If the sample of blood is centrifuged in small glass tube the cells sink in to the
bottom because of denseness & plasma form a layer on top.
- Blood is about 55% plasma & 45% cells.
- Cells are RBC, WBC& platelet.
Buffy coat composed of WBC & platelets are between plasma & RBC.
 The blood plasma is separated from formed elements(cells) & it is consist of
91.5% of water & 8.5% of solute like protein, antibody etc..
 The blood cells are RBC(red blood cells) , WBC(white blood cells) & platlets

6. FORMATION OF BLOOD CELLS
 The process by which blood cells are develop or produce called hemopoiesis.
 Before birth hemopoiesis first occur in the yolk sac of an embryo & later in
liver, spleen, thymus & lymph nodes of the fetus .
 Red bone marrow is the primary site of hemopoiesis .

7. …
 Erythropoiesis: “ it is the process of the origin, development & maturation of
erythrocytes.
 Hematopoiesis “ it is the process of origin, development and maturation of all
blood cells.
 Site : bone marrow of vertebrae, ribs, sternum, pelvis and proximal femur”.

8. Red blood cell
 Red blood cells is in bi-concave shape.
 1 RBC contain at least 2.4 million molecule of hb.(Hemoglobin)
 1 HB molecule have 2 chain 1 Alpha chain & 1 Beta chain.
 Each of this chain contain 2 iron (Fe+) and each iron contain 1 molecule of
Heme.
 Altimatility 1 Hb molecule contain 4 iron, 4 heme & this 4 iron having
capacity to contain 4 molecule of oxygen.( each for one)

9. Structure of HB molecule.

10. White Blood Cells(WBC)
 Unlike the red blood cells ,white blood cells or leukocytes have nuclei & full
complement of other organelles but they do not contain hemoglobin.
 WBCs,especially lymphocytes can live for several month or year. during the
period of infection WBCs can live only a few hours, WBCs are far less
numerous than the red blood cells.
 At about 5000-10,000 cells per microliter of blood.
 Leukocytosis is the increase in the number of WBCs about 10,000/µL is normal
& an abnormal low level WBCs below 5000/ µLvis term as leukopenia.
 The general function of white blood cells is to work against the infection with
activing the immune response.
 Life span of WBC IS 12-2 day

11. PLATELETS
 Platelet or thrombocytes are the component of blood whose function is to
react to bleeding from vessel injury by clumping, their initiating a blood clot.
 Platelets have no nucleus , they are derived from the megakaryocytes of the
bone marrow , which enters in circulation.
 The main fuction of platelet is to contribute to the hemostasis.
 Platelets are biconvex discoid structure, 2-3µm in diameter.
 Adult human have 1,50,000 to 4,50,000/ µL platelet count.

12. BLOOD GROUP & Rh BLOOD GROUP
 Based on the presence or absence of
various antigen , blood is categorized
into the different blood groups. The
surface of the erythrocytes contain a
genetically determined antigen.
 ABO blood group is based on two
glycolipid antigen called A & B.
 People having antigen A on RBc type
A & those Who having antigen B is
Type B, & having Both A & B type
Type AB , Those who having neither
having Type O.
 Rh Blood group is because of the
presence of Rh antign presence or
not on RBCs.
 Rh is found in 1st blood of rhesus
monkey.

14. POLYCYTHEMIA VERA
 Definition: “Polycythemia is an abnormal increased concentration of
haemoglobin in the blood, either through reduction of plasma volume or
increase in red cell numbers.
 People with polycythemia have an increase in hematocrite, hemoglobin or red
blood cell count above the normal limit.

15. Cause
 Mutation of Janus kinase 2 (jak 2) mutation
 Chronic hypoxia
 Long term cigarette smoking
 Familiar & genetic factor
 Long term exposure to carbon monoxide

16. types
 Primary
 Secondary
 Relative
 stress

17. .
 Primary :
Occurs when excess red blood cells are produced as a result of an abnormality
of the bone marrow. Often excess WBC & platelets are also produced.
 Secondary:
Is usually due to the increase erythropoietin production either in response to
chronic hypoxia or from an erythropoietin secreting tumour.
 Relative:
Relative is an increase in RBC without an increase in total RBC mass.
This is caused by loss of plasma volume without resultant hemo-concentration , as
seen in severe dehydration related to vomiting & diarrheal.
 Stress
Polycythaemia is a term applied a chronic state of low plasma volume which is
seem commonly in active, hard working, anxious, middle-aged men.in these people,
the red blood cell volume is low

19. Clinical manifestations
 Cyanosis
 Reddened face with engorged retinal veins
 Itching after bath
 Feeling of fullness in head with headache
 Weakness, fatigue & dizziness
 Tinnitus
 Paraesthesia ,numbness, burning
 Visual disturbance
 Nose bleed
 Abdominal bloating
 Angina
 Dyspnea
 Bone & joint pain
 Thrombophlebitis
 Weight loss
 Breathing difficulty when lying
 Chronic cough
 Night sweats & sleep disturbance
 Burning sensation over fingers
 Sleep apnea

20. Diagnosis
 History collection & physical Examination
 Blood test
 Bone marrow aspiration or biopsy
 Spo2 measurement
 Chest X Ray
 Sleep study
 ECG

21. management
 Phlebotomy:
Drawing a certain amount of blood out of the veins in procedure called
phlebotomy is usually the first treatment option for people with polycythaemia.
 This reduces he number of blood cells and decreases your volume, making it
easier for your blood to function properly.
 Low dose of aspirin : to prevent blood clot
 Medical management:
 Hydroxyurea( to supress the activity of bone marrow)
 Antihistamine
 Exercise
 Watch for sore, avoid tobacco
 Continue low dose of oxygen