Pathology of bood & urine- Composition of blood, Pathology of Blood and Urine , Anemia & its Type, Abnormal constituents of Blood

1. Pathology of Blood & Urine
Presented by
Nileema Modhave
Assistant Professor
Department of Pharmaceutical Chemistry

2. Pathology of Blood
Blood is a specialized fluid connective tissue.
Functions:
 Transport respiratory gases & nutrients.
 Remove metabolic wastes
 Maintain temperature, pH, and fluid volume
 Protection from blood loss- platelets
 Prevent infection- antibodies and WBC
 Regulation of Blood Pressure

3. Composition of Blood
• The blood is made up of cells
that are suspended in liquid
called plasma.
• Plasma makes up 55% of the blood.
• Plasma is made of 90% water and
10% proteins, lipids, carbohydrates,
amino acids, antibodies, hormones,
electrolytes, waste, salts, and ions
• Blood cells make up the remaining
45% of the blood.
• Red blood cells make up 99% of the blood cells.
• White blood cells and platelets make up the other 1%.

4. Characteristics of Blood
1. Specific gravity: 1.057
Increases when water is lost due to Sweating, Diarrhoea,
cholera or Exudation of fluid into tissues.
Decreases when large quantity of water intake, severe
haemorrhage, injection of saline.
2. Viscosity: 4.7
Increases in acidosis, hyperglycemia, hypercalcemia,
polycythemia, cyanosis.
Decreases in anemia, fever, exercise, oedema, lymphatic
leukemia, maleria.
3. Erythrocyte sedimentation rate:(M-0-6.5 F- 0-15 mm/hr)
Increases with rise in O2, cholestrol, fibrinogen, α-globulin
Decreases with rise in CO2, albumin, nucleoprotein,
lecithin

5. Characteristics of Blood
4. pH: 7.36 - 7.45
5. Coagulation time: 3-4 mins.
6. Bleeding time: 2-5 mins.
7. Volume: 5 ltrs.
Increases with rise in temperature, exercise, emotional
excitement, pregnancy, congestive heart failure, administration
of mineralocorticoids.
Decreases with loss of whole blood, plasma, water, anemia.

6. Red Blood Corpuscles: M- 5 F- 4.5 million/cubic mm
Functions:
1 Transport of oxygen & carbondioxide.
2 Maintains acid-base & ion balance, viscosity of blood.
Causes of Variations:
1 Count is lowest during sleep & gradually rises.
2 Muscular exercise raises count.
3 At high altitude count raises.
4 High external temperature increases count.
5 Injection of adrenaline & excitement increases the
count.

7. Hemoglobin: M- 14- 17 gm F- 12-16 gm
It is a chromoprotein consisting of two parts
1 Globin (96 %)
2 Haem- iron containing pigment.

8. Anemia
Shortness of breath
Palpitations
Dizziness
Fatigue
Decreased energy
Vertigo

9. Anemia- when blood has low O2 carrying capacity; insufficient
RBC or iron deficiency.
Types of Anemia-
Iron-deficiency = lack of absorption or loss of iron
Blood Loss
Deficiency of Iron

10. Anemia
• Aplastic = destruction of bone marrow / failure of the
bone marrow to produce enough RBCs
Causes of aplastic anemia include
chronic exposure to toxic chemicals;
cancer treatments (radiation therapy; chemotherapy);
infections (certain viral infections);
medications (for examples, chloramhenicol, carbamazepine,
and phenytoin);.
genetic abnormalities.

11. Sickle cell anemia (defective RBCs)
A hereditary form of anemia in which
the red blood cells become
sickle-shaped (shaped like a crescent)
and less able to carry oxygen.

12. Pernicious Anemia (Megaloblastic
Anemia)
• A decrease in red blood cells when the body
can't absorb enough vitamin B12.

13. • Pernicious = lack of intrinsic factor for vitamin B12
absorption , B12 is essential for normal RBC formation
and maturation
• Megaloblastic anemia– less intake of B12
• Sickle cell anemia (defective RBCs)
• Thalassemia = hereditary deficiency of hemoglobin
• Heamorrhagic Anemia-excessive loss of RBC in
bleeding
• Heamocytic anemia- RBC plasma membrane rupture
due to toxins, parasites

14. White Blood Cells : 6000-11000/cu. mm.
Functions:
1 Phagocytosis
2 Antibody formation
3 Repair inflammation by forming fibroblasts.
4 Basophil leucocytes secrete heparin which prevents
intravascular clotting.
5 They exert antihistaminic function.
Types:
1. Neutrophils
2. Eosinophils
3. Basophils
4. Lymphocytes
5. Monocytes

15. • 1.Granular leucocytes:
i)Basophil ii)Neutrophil iii)Eosinophil
• 2.Agranular leucocytes:
i)Lymphocytes a) T-cell b) B-cell ii)Monocytes

16. What are lymphocytes? Explain their role in health
and disease
Lymphocyte: Lymphocytes are among agranulocytes ( leucocytes/
WBCs). These have spherical nucleus and are nonphagocytic.
Types:
B –cells: These possess the capability to specifically recognize each
antigen & produce antibodies (immunoglobulins) against it.
T-cells: These can identify viruses and microorganisms from the
antigens .They are responsible for cell- mediated immunity.
Role in Health and diseases:
• These produce antitoxins and antibodies
• They help in healing of wounds.
• Increase in number of lymphocytes in blood (lymphocytosis) is
observed in viral infection like Hepatitis A, Bordetella pertusis.

17. Lekocytosis: Increase in number of
leukocytes
Neutrophilic Leukocytosis: Increase in number of neutrophils It may be due
to acute bacterial infections, tissue damage as in burns, Intoxication, In
corticosteroid therapy
Eosinophilic leukocytosis : Increase in number of eosinophils It may be due
to allergic reaction, Parasitic infestation
Basophilic leucocytosis: Increase in number of basophils is in itching due to
histamin release
Monocytosis: Increase in number of monocytes It may be due to certain
bacterial infections or viral infections
Lymphocytosis: Increase in number of lymphocytes It may be due to
certain acute infections like Pertussis, certain chronic infections like TB,
AIDS, other conditions like Thyrotoxicosis
Leukemia: Bone marrow cancer

18. Leukopenia: Decrease in number of
leukocytes
Neutropenia: Decrease in number of neutrophils It
may be due to infectious diseases(typhoid
,influenza, measles ) Septicaemia; Anaphylaxis;
Chronic infection as in TB
Eosinopenia: Decrease in number of eosinophils It
may be due to adrenal steroids
Lymphopenia : Decrease in number of lymphocytes
Cause- Infectious disease, steroid therapy,
autoimmuno disorder,radiation &chemotherapy

19. Platelets : 150000-400000
Purpura (Thrombocytopenia): No. of platelets
are decreased due to hemorrhage. It prolongs
bleeding time.
Thrombocytosis (or thrombocythemia): increase
in platelets due to bone marrow disorder

20. Platelets / Thrombocytes
They are small, irregularly shaped non-nucleated cell
fragments, 2–3 µm in diameter. The average lifespan of a
platelet is normally just 5 to 9 days. They are approximately
150000-400000/microlitre
Functions:
1 Form Platelet plug in hemostasis
2 Vascular spasm
3 Blood clotting
Abnormal Condition:
Purpura (Thrombocytopenia) No. of platelets decrease.
Haemorrhage occurs beneath the skin & mucous membrane. It
prolongs bleeding time.
Thrombocytosis Increase in no. of Platelets.

21. Pathology of Urine
Urine is a chief excretory fluid eliminated through kidney.
Pathological Urine/ Abnormal urine: urine that contains substance
essential to the body or tissue (like sugar, bile salts , albumin) in
addition to normal organic& inorganic substance
Normal Constituents:
Organic: Urea, Uric acid, Creatinine
Inorganic: Chlorides, Phosphates, Sulphates, ammonia ,calcium
Abnormal Constituents:
Glucose, Proteins, Blood, Ketone bodies, Bile pigments, Pus.
Urine Constants:
Volume: 1-2L/day
Colour: Pale yellow
pH: 4.5-8.2
Density/ Sp. Gravity: 1.01-1.05
Odour: Aromatic

22. Sr.
No.
Abnormal
constituent
Associated disease Test for dectection
1 Sugar Diabetes mellitus (Glycosuria) Benedicts &
Fehlings test
2 Protein proteinuria-Severe exercise, high
protein diet, pregnancy, kidney
disease.
Sulphosalicylic acid
& Hellers Nitric
acid (Ring) test
3 Ketone bodies Ketonuria /Ketosis
Causes: Excessive fat metabolism,
diabetes, starvation, pregnancy.
Rothera’s test
4 Bile salt Obstructive Jaundice Sulphur powder test
5 Bile Pigment Obstructive hemolytic Jaundice,
hepatic jaundice
Modified Gmelins
test
6 Blood Haematuria
Causes: Tb, Cancer, Renal stones,
acute inflammation of kidney.
Benzidine test
7 Pus Pyuria- inflammation of urinary
bladder, urethra, kidney

23. Abnormal constituents of urine, their significance & Identification tests
Proteins: (proteinuria)
Causes: Severe exercise, high protein diet, pregnancy, kidney disease.
Identification tests: Sulphosalicylic acid & Hellers Nitric acid (Ring) test
Glucose: (Glycosuria) Diabetes mellitus
Identification tests: Benedicts & Fehlings test
Ketone bodies: (Ketonuria) Ketosis
Causes: Excessive fat metabolism, diabetes, starvation, pregnancy.
Identification tests: Rothera’s test
Bile salts: Obstructive Jaundice
Identification tests: Sulphur powder test
Bile pigments: Obstructive hemolytic Jaundice, hepatic jaundice
Identification tests: Modified Gmelins test
Blood: (Haematuria)
Causes: Tb, Cancer, Renal stones, acute inflammation of kidney.
Identification tests: Benzidine test

24. Important Questions
• What are lymphocytes ? Explain their role in health and disease.
• What is anaemia ? Write in brief about sickle cell anaemia
• What is ‘anaemia’? Describe ‘sickle-cell’ anaemia
• Pathological urine
• How will you identify following constituents in the given sample of urine:
• (i) Ketone bodies (ii) Proteins (iii) Blood
• Define the following: (i) Jaundice (ii) Pyaria (ii) Haematouria
• What are abnormal constituents of urine ? Give their significance in diseases.
• Define anaemia. Enlist different types of anaemia. Explain aplastic anaemia and
megaloblastic anaemia.
• How acetone and sugar are detected in urine ?
• Define ‘Physiological and Pathological’ urine. Write various
• abnormal constituents of urine with their related diseases.
• Microcytic anaemia Anuria.
• How will you detect the following from the given sample of urine :
• (i) Sugar (ii) Blood