This document discusses pathology of blood and urine. It begins by defining pathology and describing the components of blood, including plasma, red blood cells, white blood cells, and platelets. It then discusses various blood disorders like anemias and leukemias. The document also covers the functions of white blood cells and disorders affecting white blood cell count. Finally, it discusses the composition of normal urine and pathological constituents indicating various diseases, such as glucose indicating diabetes and bile salts/pigments indicating liver dysfunction.

1. Pathology of blood
& Urine
Shalini N. Barad,
Assistant Professor,
Appasaheb Birnale College of Pharmacy.

2. • Pathology
• ( Pathos= suffering / disease, logos =discourse)
• It is branch of science that deals with study of
diseases & also deals with causes, effects,
mechanism & nature of diseases.
OR
• The science of the causes and effects of diseases,
especially the branch of medicine that deals with
the laboratory examination of samples of body
tissue for diagnostic or forensic purposes

5. • Blood—
• It is fluid connective tissue consist of plasma a
transparent, colourless fluid, & minute solid particles
/ corpuscles immersed in it.
• Blood Composition:
A. Plasma/ Serum : watery fluid portion of blood (55%)
B. Blood cells: 45%
1) RBC: Red blood cells/ corpuscles (RBCs), also called
erythrocytes, carry oxygen throughout the body.
2) WBC : White blood cells (WBCs), also called
leukocytes or leucocytes, are the cells of the immune
system that are involved in protecting the body
against both infectious disease and foreign invaders.
3) PLATELETS/ thrombocytes: Platelets are tiny blood
cells that help your body form clots to stop bleeding.

6. • functions of blood
1) Blood transports oxygen from lungs to tissues, carbon
dioxide from tissue to lungs.
2) Blood acts as vehicle for transportation of hormones,
vitamins, and other essential chemicals.
3) It maintains water balance of body
4) It maintains acid base balance of body
5) It maintains the ion balance between the cells and
surrounding fluids.
6) Blood regulate the body temperature.
7) Blood acts as defensive system by producing WBC and
various antibodies.
8) Blood regulate the blood pressure by changing its
volume and viscosity.

7. 9) It transports the cellular waste products to
excretory organs which are kidney, lungs.
• Normal range :
1) RBC-- Men= 4.5-6.5 million/ mm3
Women= 4.0-5.5 million/ mm3
2) WBC— 5000-10,000/ mm3
3) Platelets— 0.15- 0.4 million/ mm3

9. 1] Erythrocytes/ RBC—
• These are disc measuring
about 8 µ in diameter,
biconcave & without nucleus
containing haemoglobin in the cytoplasm.
• RBC are produced in bone-marrow, spleen, &
kidney.
• Life span of RBC is about 120 days.
• Worn out erythrocyte is removed from
bloodstream & destroyed in liver & spleen.
• Main function of RBC is transportation of O2 &
CO2

10. o Abnormal RBC & their significance:
A] Anaemia
• Decrease in oxygen carrying capacity of blood is called as
anaemia.
• It depends on haemoglobin content of erythrocytes .
• Reduction in blood haemoglobin level & number of
circulating erythrocytes indicate anaemia.
• Types of anaemia
1) Pernicious anaemia
2) Sickle cell anaemia
3) Iron deficiency anaemia
4) Megaloblastic anaemia
5) Aplastic anaemia
6) Haemolytic anaemia
7) Haemorrhagic anaemia

11. 1) Pernicious anaemia:
• Stomach produces intrinsic factors responsible
for absorption of vitamin B12 in small intestine.
• Inability of stomach to produce intrinsic factor
leads to insufficient absorption of this vitamin &
thereby inhibits hemopoiesis & this condition is
called as Pernicious anaemia.
• Symptoms: Shortness of breath, Tired feeling,
Numbness, tingling of fingers, neuronal
degeneration, confusion etc.
• Treatment : Vitamin B12 IM

12. 2) Sickle cell anaemia-
• It is a genetic disorder, in this the bone marrow
produce abnormal type of Hb.
• The shape of a large no. of red cells is like a sickle
cell/ crescentric and their lifespan is considerably
shortened.
• So it results from abnormal formation of RBC
having sickle shape.
• Patients with sickle cell show marked
susceptibility to infection and there is blockage of
blood supply to vital organs as sickle cells don’t
pass through small blood capillaries.

13. • Symptoms- sudden severe abdominal pain
Excretion of dark coloured urine
• Treatment :
1. Avoid going to higher altitude where oxygen
supply is less.
2. Blood transfusion in severe cases.

15. 3) Megaloblastic Anemia-
• Megaloblastic anemia is a blood disorder having
unusually large, structurally abnormal, immature red
blood cells called megaloblasts.
• These red blood cells do not function like healthy red
blood cells.
• Causes:
1) Deficiencies of folic acid, or vitamin B12.
2) Alcohol abuse, chemotherapy, certain medications, and
some genetic conditions.
• Symptoms :
• Fatigue, muscle weakness ,loss of appetite/weight loss,
tingling in hands and feet, numbness in extremities

16. • Treatment for Megaloblastic anemia
1) Vitamin B12 &/or Folic acid supplements
2) Diet with more vitamin B12.,Folic acid

17. 4) Microcytic anemia/ Iron deficiency Anaemia:
• It is also called as iron deficiency anemia or
hypochromic anemia.
• In this deficiency of iron is due to inadequate
absorption of iron, excessive loss of iron, increased
iron requirement or insufficient intake of iron,
hemoglobin content of red cell decreased.
• The size of red cells is below average.
• Women are at higher risk, due to menstrual blood
loss and increased demand during pregnancy.
• Symptoms :
1) retarded growth
2) Loss of appetite.
3) weakness

18. 5) Aplastic anaemia:
• It occurs due to suppression/ destruction of red
bone marrow function which results in the
reduction in the number of red cells & a condition
is called as Aplastic anaemia.
• It can be caused due to gamma radiation, toxins
and some medications that inhibit enzymes
required for hemopoiesis
6) Haemorrhagic Anaemia:
• Bleeding due large wounds, stomach ulcers/ heavy
menstruation leads to excessive loss of RBCs.
• This condition is called as Haemorrhagic
Anaemia:

19. 7) Haemolytic anaemia:
• In it, RBC plasma membrane rupture
prematurely.
• Due to rupture of plasma membrane, the Hb in
RBCs is released into plasma which may damage
glomeruli in kidneys.
B] Polycythemia:
• When conc. Of RBC increases abnormally,
usually with corresponding increase in Hb level,
the condition is called as polycythemia.

20. • It is of 2 type—
1) Relative Polycythemia
2) Absolute Polycythemia
1) Relative Polycythemia:
• In it there is increase in conc. Of red cell, due to decrease
in plasma volume.
• Plasma volume can be decreased due to vomiting,
dehydration, diarrhoea.
2) Absolute Polycythemia:
• In primary Absolute Polycythemia number of RBC is
greatly increased.
• Secondary polycythemia is caused due to increase in
secretion of erythropoietin.

21. 2) Leucocytes/ WBC—
• Leukocyte / WBC are irregular, nucleated & colourless,
larger in shape than RBC & measure 10-14 u.
• WBC are produced in bone marrow, lymph nodules,
tonsils & spleen.
• WBC eat-up disease causing micro-organism
(phagocytosis) & also fragments of dead cells & help in
cleaning body.
• In case of infection like pneumonia number of WBC
increase i.e. more than 20,000mm3 & state is known as
leukocytosis.
• When no. of WBC decreases (infection like – TB) state is
known as leucopenia.

23. • types of Leukocytes.
1. Granular leukocytes:
i)Basophil
ii)Neutrophil
iii)Eosinophil
2. Agranular leukocytes:
i)Lymphocytes
--- a) T-cell
--- b) B-cell
ii)Monocyte

24. 1.Granular leukocytes:
• Presence of cytoplasmic granules is the main
characteristic & may have 2-5 lobed nucleus.
• Depending upon staining reaction with dye
granulocyte are further classified as:
i)Basophil- stain fast with alkaline dye
ii)Neutrophil- neither stain with acidic nor with basic
dye.
iii)Eosinophil- Stain fast with acidic dyes.

25. i)Basophil—
• These are characterized by irregular nucleus.
• These also produce histamine & heparin, but they
are non- phagocytic cell.
ii) Neutrophil—
• They have 3-5 lobed nuclei & their cytoplasm is
full of lysosomal granules.
• They are main phagocytic cell of WBC, they are
able to engulf & digest bacteria, protozoa, & cell
debris.
• In case of severe infection Neutrophils die &
accumulation of dead neutrophils & bacteria lead
to formation of pus.

26. iii) Eosinophil—
• These are with bi-lobed nuclei.
• Antigen- antibody complexes & also produce
anti-toxin.
• Eosinophils contain much histamine & hence
responsible for allergic reactions.
• Increase in eosinophils is called eosinophilia.
2. Agranulocytes—
• These are devoid of granules & constitutes of
25% of total leucocytes.
• They are divided in2 type—

27. A) Lymphocytes
• they have spherical nucleus & are
non-phagocytic.
• These produce antitoxin & antibodies.
• They help in healing wounds.
• X-rays diminishes & UV rays increases number of
lymphocyte.
• Types:
• B –cells-: These possess the capability to
specifically recognize each antigen & produce
antibodies (immunoglobulins) against it.

28. • T-cells-: These can identify viruses and
microorganisms from the antigens.
• They are responsible for cell- mediated immunity.
B) Monocytes—
• These contain kidney shaped nucleus.
• These are phagocytic in action.
• These are found around inflammation & help in
removing damaged tissues.
• Functions of lymphocytes:-
1.These produce antitoxins and antibodies
2. They help in healing of wounds.
3. Play a key role in immunity.

29. bacteria
Bacteria vacuole
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Bacteria vacuole
Bacteria vacuole

30. ❑ Disorder of WBC (leucocytes):
1) Proliferative disorder
2) Leucopenia of white blood cells:
1.Proliferative disorders:
A) Leukocytosis: Increase in number of leukocytes.
• A variety of inflammatory states are responsible for
leukocytosis.
• It is further classified as –
i) Neutrophilic Leukocytosis: Increase in number of
neutrophils
• It may be due to acute bacterial infections, tissue
damage as in burns, Intoxication.
• In corticosteroid therapy

31. ii)Eosinophilic leukocytosis: Increase in
number of eosinophils
• It may be due to allergic reaction like asthma,
hay fever, Parasitic infestation, skin diseases
like dermatitis, etc.
iii) Basophilic leukocytosis: Increase in number
of basophils, it is rare disorder.
iv)Monocytosis: Increase in number of
monocytes
• It may be due to chronic bacterial infections
like TB, bacterial endocarditis, malaria or viral
infections

32. v)Lymphocytosis: Increase in number of
lymphocytes
• It may be due to certain acute infections like
Pertussis, hepatitis A, Epstein- barr virus & other
conditions like Thyrotoxicosis
B) Leukemia: Bone marrow cancer, abnormal
WBC multiply uncontrollably. (deficiency –RBC)

33. 2. Leucopenia
• Decrease in WBC count is called as leukopenia.
i) Neutropenia= reduction in no. of neutrophils in
blood is called as neutropenia.
Ii) Eosinopenia= it is characterized by reduced no. of
eosinophils in blood.
Iii) lymphopenia= reduced no. of lymphocyte count.
---- It is seen in acute viral infections autoimmune
disorders, HIV.

34. 3) Platelets:
• Platelets are also called as thrombocytes.
• They are disc shaped, non-nucleated bodies, 2-4u
in diameter & formed in red bone marrow.
• Platelets are seen in clumps in ordinary blood
films.
• The average life span of platelets is about 5- 10
days.
• Normal count= 2.5- 4.5 lac/ cubic mm of blood.
• Platelets contain thrombokinase which is liberated
when platelets come in contact with rough
surface & it plays imp role in clotting of blood.

35. • Platelets agglutination ---🡪 control bleeding &
seal leaking of blood vessels & capillaries.
• Histamine, norepinephrine & serotonin are
liberated when platelets disintegrate----🡪 they
have vasoconstrictor activity-----🡪 plays imp role
in control bleeding.

36. • Role of Platelets in health & disease
1. They initiate blood clotting
2. They are involved in healing of wound in
endothelial lining of the vessel.
3. They are involved in homeostatic mechanism.
4. They hasten clot retraction.
5.Platelets disintegration yields histamine,
serotonin and norepinephrine.

37. • Disorder related to platelets:
1) Thrombocytopenia :- are the disease conditions
caused by decrease count of thrombocytes .
Count below 1,00,000/ul
• caused due to production of platelets/ Survival
of platelets.
2) Thrombocythemia:- are the disease conditions
caused by increase count of thrombocytes.
• Having too many platelets makes it hard for our
blood to clot normally.
• It may be due to anaemia, malignancy.

38. 3) Thrombocytopenia / Purpura :
• Number of platelets are decreased .
• Purpuric symptoms are bleeding occurs beneath
the skin & mucous membrane & appearance of
lesion.
• Colour of lesion is first red-----🡪 becoming
darker-----🡪 purple----🡪 fading to brownish
yellow.
• Clotting time remains normal but bleeding time is
prolonged.

39. ❑ Urine:
• Urine is a main excretory product, excreted by
kidney.
• It contain waste products, large no. of organic &
inorganic substances.
• Normal urine : Volume= 1500- 2000 ml/ 24 hrs
• pH= 4.5- 8.2
• Physiological urine: Urine that contains normal
organic (uric acid, urea, creatinine, NH3) and
inorganic substances (chlorides, sodium,
potassium, phosphorus and sulphates) is called as
physiological urine or normal urine.

40. • Pathological urine:
Urine that contains substances essential to the
body or tissues (like sugar, bile salts, albumin etc.),
in addition to normal organic & inorganic
substances, is called as pathological or abnormal
urine.
• In short, subs which are not present in normal i.e
abnormal urine.
• Such urine indicates some disease or disorder or
derailment in body physiology.

41. Abnormal constituent of urine

42. • Abnormal constituent of urine:--
1) Sugar—
• Presence of sugar in urine is called glucosuria.
• This is associated with sugar level in blood
exceeding threshold level.
• Presence of sugar in urine indicate either
deficiency of Insulin- DM/ hyperfunction of
anterior pituitary endocrine gland.
• Diabetes is characterised by- polyuria, polydipsia
& polyphagia.

43. 2) Ketone bodies:
• acetone, Acetoacetic acid and β –hydroxy butyric
acid are called ketone bodies.
• Ketosis occur in DM, carbohydrate starvation,
pregnancy, & in anaesthesia. Even in excessive fatty
acid oxidation.
• It indicates abnormality in carbohydrate
metabolism.
3) Albumin:
• Severe exercises, high protein meal in pregnancy
there is physiological proteinuria while in nephritis
& nephrosis it is pathological.

44. • Proteinuria may be due to high BP / by irritation of
kidney by poisons.
4) Bile pigments & salts—
• Bile salt= sodium glycocholate, sodium
taurocholate Bile pigments= bilirubin & biliverdin.
• Presence of these subs imparts greenish yellow--🡪
greenish brown------🡪 approaching to black colour
to urine.
• In defective liver function bile salts & pigments are
present In urine, for eg- Jaundice.
5) Blood—
• Snake venom causes haemolysis which results in
presence of Hb in the urine.

45. • the appearance of blood in urine is called as
Hematuria, may be due to T.B., cancer, renal
stone.
6) pus—
• Presence of pus in urine is called as pyuria.
• Albumin always accompanies with pus.
• Inflammation to urinary bladder, urethra, pelvis of
kidney results---🡪 pyuria.

46. ❏ How acetone and sugar are detected in urine?
• Acetone:
• Rothera’s test : 5 ml urine sample +( NH4)SO4 to saturate it
completely + 2 drops of sodium nitroprusside solution + 2ml
strong ammonia solution from side of test tube wait for 10 min
permanganate color develops, ketones like acetone present
• Sugar:
• Benedict’s test: 5ml urine+ 5ml Benedict’s reagent boil for 2
minutes & cool --------->Green/ yellow/ red ppt obtained ----🡪
indicates presence of sugar according to concentration
• OR
• Fehling’s test: 2ml Fehling’s A+ 2ml Fehling’s B, boil for few
minutes, add 2-3 ml of urine ,boil again. red/ yellow ppt obtained
indicates presence of sugar

47. • Tests for detection of Glucose in urine
i) Benedict’s test: 5ml urine+ 5ml Benedict’s
reagent boil for 2 minutes & cool
• Green/ yellow/ red ppt obtained indicates
presence of sugar according to concentration
ii) Fehling’s test: 2ml Fehling’s A+ 2ml Fehling’s B,
boil for few minutes, add 2-3
• ml of urine ,boil again. red/ yellow ppt obtained
indicates presence of sugar.

48. • Define Ketonemia. How it occurs?
• The presence of high ketone bodies in blood is
called as Ketonemia.
• In starvation, degradation of fatty acid increases
to meet the energy need of the body. This causes
an overproduction of acetyl CoA which cannot be
fully handled by citric acid cycle.
• TCA cycle is also impaired due to deficiency of
oxaloacetate, since most of it is diverted
• for glucose synthesis to meet the essential
requirements for tissues like brain. This results in
• accumulation of acetyl CoA, its diversion for over
production of ketone bodies and thereby
• increased level of ketone bodies in blood.

49. ❏ Glycogen storage diseases: these
• diseases are referred to as the diseases caused by
accumulation of polysaccharide I.e. glucose progressive
cirrhosis of liver cells produce a condition in which
glycogen
• does not get converted to glucose and hence glycogen in
blood goes on increasing.
• It is group of disorder like
I)Van-G ierke’s disease
ii) Pomp,es diseases
iii)Limit dextinosis
iv) Amylopectinosis. (Optional)
❏ Glycosuria- Appearance of usually high amount of glucose
in the urine is called as glycosuria
❏ Galactosemia- Due to deficiency of enzyme galactose 1
phosphate uridyl transferase and galactokinase which
increases galactose concentration leading to cataract.
❏ fructose intolerance: High concentration of fructose in
blood.

50. Thank You