SMC, JSMU, MBBS, Blood module

1. BLOOD MODULE, INFLAMMATION & NEOPLASIA MODULE
SEMESTER-I (Batch - II, 2013)
Week 1:
No pathology/microbiology lecture
Week 2:
Microbiology:
NORMAL FLORA
Definition
Constituents of N.F
Sterile and non-sterile sites of human body
Define carrier state
Benefits and harmful effects of N.F
Tissue tropism
N.F of various sites
Importance of lactobacilli
Pathology:
No lecture
Week 3:
Host defense
Lecture Outline
 Introduction (Definition of Host Defense)
 Type of Host Defenses
o Non Specific or Innate defenses
1. Physical barriers.
a. Intact skin
b. Mucous membranes
2. Phagocytic cells
a. Neutrophils

2. b. Macrophages
c. Natural killer cells
3. Proteins
a. Complements
b. Lysosomal
c. Interferon
o Specific defenses or Acquired immunity
1) Active Immunity.
a. Antibodies
b. T lymphocytes
2) Passive Immunity.
STERILIZATION & DISINFECTION
Objectives
 Understand and utilize correct sterilization and disinfection techniques
 Distinguish between sterilization and disinfection
 List the characteristics of an ideal antiseptic
 Describe sterilizing agents and rank their effectiveness
 Discuss the time/temperature relationship in destroying microorganisms
Sterilization And Disinfection
Sepsis: Comes from Greek for decay or putrid. Indicates bacterial contamination.
Asepsis: Absence of significant contamination.
Bacteriostatic Agent: An agent that inhibits the growth of bacteria, but does not necessarily kill
them.
Germicide: An agent that kills certain microorganisms.
 Bactericide: An agent that kills bacteria. Most do not kill endospores.
 Viricide: An agent that inactivates viruses.
 Fungicide: An agent that kills fungi.
 Sporicide: An agent that kills bacterial endospores of fungal spores.
 Microorganisms
Invisible
Cause infections
 Sterilization
Destruction of all microorganisms
 Disinfectant
Destruction of harmful organisms, or pathogens on nonliving objects
 Microorganisms

3. Invisible
Cause infections
 Sterilization
 Antiseptics
Prevent growth of microorganisms without destroying them
Not harmful to patients
 Type of agents
 Chemical
 Physical
 Moist heat
 Dry heat
 Most clinics use physical agents
Steps for Chemical Sterilization
Moist heat
 Steam and boiling water
 Alone not effective
 Captured steam effective
 Autoclave
 Sealed chamber that furnishes pressurized steam for sterilization
 Inexpensive
 Sterilizes
 Instruments
 Syringes
 Needles
 Other materials
Dry heat
 Slow sterilizer
 Higher temperatures
 Penetrates
 Oil-based materials
 Closed containers
Steps of Dry-Heat Sterilization
Direct flame
 Can damage the exposed object
Time/Temperature Relationship
Other Sterilization Technology
 Filtration
 Ultraviolet irradiation
 Cold sterilization

4.  Ethylene oxide
Pathology:
Bleeding disorders sec to platelet disorders
Inherited disorders of platelet function can be classified into three pathogenically distinct
groups:
(1) defects of adhesion,
(2) defects of aggregation,
(3) disorders of platelet secretion (release reaction).
acquired defects of platelet function, two are clinically significant. The first is caused by
ingestion of aspirin and other nonsteroidal anti-inflammatory drugs
Hereditary deficiencies typically affect a single clotting factor.
Factor VIII (hemophilia A)
Factor IX (hemophilia B).
Deficiencies of vWF
Acquired deficiencies
• Vitamin K deficiency results in the impaired synthesis of factors II, VII, IX, X and protein C
• Severe parenchymal liver disease
• DIC
• Acquired deficiencies of single factors occur, but they are rare
• These are usually caused by inhibitory autoantibodies
Acquired deficiencies
• Vitamin K deficiency results in the impaired synthesis of factors II, VII, IX, X and protein C
• Severe parenchymal liver disease
• DIC
• Acquired deficiencies of single factors occur, but they are rare
• These are usually caused by inhibitory autoantibodies
Causes, incidence, and risk factors
• Inherited X-linked recessive trait
• Defective gene located on the X chromosome.
• Females have two copies of the X chromosome, so if the factor VIII gene on one
chromosome doesn't work, the gene on the other chromosome can do the job of
making enough factor VIII.

5. • Males have only one X chromosome, so if the factor VIII gene on that chromosome is
defective, they will have hemophilia A.
Most people with hemophilia A are male
• Variable severity of symptoms
• Main symptom is bleeding
• Circumcision of infant
• Infant starts crawling and walking
Adult-life
• Surgery / trauma.
• Internal bleeding may happen anywhere
• Bleeding into joints is common.
• If the patient is the first person in the family to have a suspected bleeding disorder, he
or she will undergo a series of tests called a coagulation study. Once a disorder has been
identified, other family members will need less testing to diagnose the disorder.
Hemophilia B
(Christmas Disease, Factor IX Deficiency)
DEFINITION:
• A coagulation disorder characterized by a deficiency in Factor IX resulting in a bleeding
diathesis.
CLINICAL FEATURES:
1. Hemarthrosis
2. Muscle Hematomas
3. Mucous Membranes
4. Hemorrhage Causing Peripheral Nerve Lesions
5. High Risk Hemorrhages
6. Hematuria
von Willebrand disease (vWD)
• It is the most common hereditary coagulation abnormality described in humans
• It arises from a qualitative or quantitative deficiency of von Willebrand factor (vWF)
• It is known to affect humans and dogs, cattle, horses, and cats.
• There are four types of hereditary vWD.

6. • vWD is named after Erik Adolf von Willebrand, a Finnish pediatrician who first described
the disease in 1926