Focuses majorly on blood disorders

1. Blood Disorders.

2. • Anaemia is defined as a haemoglobin concentration in blood below
the lower limit of normal range for the age and sex of individual.
• In adults , the lower extreme of normal range for male is taken as
13.0g/dland 11.5g/dl for females. Newborn infants have higher
haemoglobin level therefore 15g/dl as lower limit at birth whereas
at 3 months it is taken as 9.5g/dl .
• the major parameters for determining anaemia are red blood cell
count,haematocrit,(PCV),and absolute
values(MCV,MCH,MCHC)provide alternate means for assessing
anaemia.
Anaemia

3. Classification of Anaemia:
Morphologic
classification:

4. Pathophysiologicclassificationofanaemia
1. Anaemia due to increased blood loss: is further divided into 2 types
a) Acute post haemorrhagic
anaemia
b)chronic blood loss
2. Anaemias due to impaired red cell production:
a) cytoplasmic maturation defects:
i)deficient haem analysis : iron deficiency anaemia.
ii) deficient globin synthesis: thalassaemic syndrome.
b)nuclear maturation defects
c)defect in stem cells proliferation and differentiation
d) anaemia of chronic disorder
e)bone marrow infiltration
f) congenital anaemia

5. Pathophysiology of Anaemia:
• Subnormal level of haemoglobin causes lowered oxygen
carrying capacity of blood .this in turn initiates
compensatory physiologic adaptions such as :
• invreased release of oxygen from haemoglobin
• increased blood flow to the tissues.
• maintaince of blood volume.
• redistribution of blood flow to maintain the cerebral blood
supply.
• eventually tissue hypoxia develop causing impaired
function of the affected tissue.

6. The haemoglobin level at which symptoms and signs of anaemia
develops depends upon 4 main factors.
i)the speed of onset of anaemia.
ii) the severity of anaemia
iii) the age of patient
iv) the haemoglobin dissociation curve.
Signs and symptoms:
In symptomatic cases of anaemia the presenting
features are : tiredness,easy fatigue,generalized
muscular weakness,lethargy,and headache In older
patients there may be symptoms of cardiac
failure,angina pectoris etc.

7. In order to to confirm or deny the presence of
anaemia it's type and it's cause , the following plan of
investigation is generally followed.
a) haemoglobin estimation
b) peripheral blood film examination
c)red blood indices
d) leukocytes and platelets count
e)reticulocyte count
f) erythrocytes sedimentation rate
g)bone marrow examination

8. Haemolytic Anaemia

9. Laboratory
approach:

11. accquired haemolytic anaemia:

12. Thalassaemia
• The thalassaemia are diverse group of
hereditary disorders in which there is
reduced rate of synthesis of one or more
of globin polypeptide chains.
• therefore thalassaemia is quantitative
abnormalities of polypeptide globin
chain synthesis.they are genetically
transmitted disorder.

13. Classification of thalassaemia

14. Pathogenesis of thalassaemia

17. Leukaemias:
The leukaemias are group of disorders characterised by
malignant transformation of blood forming cells.The
proliferation of leukaemic cells takes place , primarily in
bone borrow and in certain form in lymphoid tissues.
In general leukaemias are classified on basis of cell types
predominantly involved into myeloid and lymphoid,acute
and chronic. Thus the main types are:acute myeloblastic
leukaemias and acute lymphoblastic leukaemias and chronic
myeloid leukaemias and chronic leukaemias,etc.

22. Laboratory Findings
The diagnosis of acute leukaemias is made by combination of routine
blood picture and bone marrow examination coupled with
cytochemical stains and certain biochemical investigation.
The blood picture : findings of routine haematological
investigation are under,anaemia, thrombocytopenia,white blood
cell.
Bone marrow examination : an examination of bone marrow
aspirate or trephine reveals the following features:
cellularity,leukaemia cells,megakaryocytes,cytogenetics.
Cyrochemistry: myeloperoxidase,Sudan black ,periodic acid acid
Schiff,non specific esterase,acid phosphatase.

23. Polycythemia Vera.

24. Clinical features :
PV is a disease of late middle
life and mainly
found in males.this generally
runs chronic but
in slow progressive course.
clinical features are result of
hyperviscosity
hypervolemia
hypermetabloism
and decrease cerebral
perfusion.

25. Acquired Neutropenia:

27. Infectious mononucleosis

29. 05

30. Thrombocytopenia

33. Heparin induced thrombocytopenia (HIT)