Blood and Blood-Forming Organs Diseases and Disorders Chapter 7 Blood and Blood-Forming Organs Diseases and Disorders 1

Anatomy and Physiology Hematologic system Major functions of blood: Transport nutrients to cells Aid removal of wastes Average adult has 5 to 6 liters of circulating blood 2

Blood Components 3

Anatomy and Physiology Erythrocytes Normal count: 4.2 to 6.3 million Life span: 120 days Form in bone marrow and do not reproduce 4

Anatomy and Physiology Hemoglobin important in oxygen transport Normal hemoglobin: Male 13.5 to 18 hemoglobin in grams (g)/100 milliliters (ml) Female 12 to 16 g/100 ml 5

Anatomy and Physiology Leukocytes protect individual from infection Normal count: 4,500 to 11,000 mm3 Platelets Also known as thrombocytes Important in blood clotting 150,000 to 350,000 mm3 Note: normal values may vary some from different laboratories or sources 6

Anatomy and Physiology Blood-forming organs: Lymph nodes Bone marrow Spleen Liver Lymph system protects against pathogens 7

Anatomy and Physiology Bone marrow Major blood cell producer Spleen produces lymphocytes, plasma cells, and antibodies Filters microorganisms from blood Liver produces prothrombin and fibrinogen for blood clotting 8

Common Signs and Symptoms Erythrocytopenia Decrease in RBCs leading to anemia Symptoms: Fatigue Headache Low RBCs Pallor Shortness of breath 9

Common Signs and Symptoms Erythrocytosis Increased RBCs Symptoms: High RBCs Reddened skin tones Bloodshot eyes Increased blood volume and pressure Increased blood volume of heart 10

Common Signs and Symptoms Leukocytopenia Decreased white blood cells Weakens immune system Leukocytosis Increased white blood cells Normal response to acute infections 11

Common Signs and Symptoms Thrombocytopenia Decreased platelet count leading to coagulation problem Symptoms: Petechiae Small hemorrhages in skin Ecchymoses Large areas of bruising or hemorrhage Epistaxis, also called a nosebleed Bleeding in mouth, gums, and mucous membranes 12

Common Signs and Symptoms Thrombocytosis Increase in platelets Uncommon Usually no serious side effects 13

Diagnostic Tests Complete blood count with differential and indices Biopsy of blood-forming organs Hematocrit (Hct) reflects amount of red cell mass as proportion of whole blood Hemoglobin (Hgb) reflects blood’s oxygen-carrying potential 14

Diagnostic Tests Bleeding time determines platelet disorders E.g., hemophilia, thrombocytopenia, disseminated intravascular coagulation Prothrombin time (PT), partial thromboplastin time (PTT), and international normalized ratio (INR) measure blood’s ability to clot 15

Diagnostic Tests Biopsy Bone marrow Lymph node 16

Disorders of Red Blood Cells Anemia Decrease in oxygen-carrying ability of RBC Symptoms: Pallor Fatigue Shortness of breath Tachycardia Headache Irritability Syncope 17

Disorders of Red Blood Cells Iron deficiency anemia Loss of iron or inadequate intake of iron Causes: Blood loss Low dietary intake Treatment: Increase dietary intake of iron 18

Disorders of Red Blood Cells Folic acid deficiency anemia Folic acid needed for maturation of RBCs Causes: Poor diet Overcooking of vegetables Overconsumption of alcohol Treatment: Increase folic acid intake by eating green and yellow vegetables 19

Disorders of Red Blood Cells Pernicious anemia Lack of intrinsic factor leading to inadequate absorption of vitamin B12 Treatment: Monthly injections of vitamin B12 for life 20

Disorders of Red Blood Cells Hemolytic anemia Destruction of RBCs related to antibody–antigen reaction Disorder of immune system leading to destruction of erythrocytes Treatment: Exchange transfusion and/or splenectomy 21

Disorders of Red Blood Cells Sickle cell anemia Hereditary Found in African American race Abnormal sickle shape of erythrocyte Does not allow cell to travel smoothly through vessels Symptomatic treatment No cure 22

Disorders of Red Blood Cells Hemorrhagic anemia Loss of whole blood Also called blood loss anemia Complication is hypovolemic shock Symptoms include: Dizziness, fainting, thirst Treatment Stop bleeding Oxygen Restore blood volume 23

Disorders of Red Blood Cells Aplastic anemia Failure of bone marrow to produce blood components Causes: Chemotherapy Radiation Viruses Toxins Treatment: Avoid causative agent Bone marrow transplantation Transfusions 24

Disorders of Red Blood Cells Polycythemia Too many blood cells Symptoms: Enlarged spleen Reddened mucous membranes Bloodshot eyes Deep red color on palms Treatment: Donate blood at regular intervals to reduce blood volume 25

Disorders of White Blood Cells Mononucleosis Caused by virus Symptoms: Fatigue Sore throat Swollen glands 26

Disorders of White Blood Cells Leukemia Malignant neoplasm of blood-forming organs Abnormal production of immature leukocytes May be acute or chronic Acute forms affect children, progress rapidly, and may be fatal 27

Disorders of White Blood Cells Leukemia Chronic forms affect older adults, are often asymptomatic, and may not be fatal Classified as: Myelogenous Affecting bone marrow Lymphocytic Affecting lymph nodes 28

Disorders of White Blood Cells Leukemia Symptoms: Fatigue Headache Sore throat Dyspnea Bleeding of mucous membranes of mouth and gastrointestinal (GI) system Bone and joint pain Enlargement of lymph nodes, liver, and spleen Infections common 29

Disorders of White Blood Cells Leukemia Diagnosis by bone marrow biopsy Treatment: Aggressive chemotherapy Once in remission, bone marrow transplant to replace neoplastic tissue with normal tissue Remission at 50% 30

Disorders of White Blood Cells Hodgkin’s disease Most common lymphoma Symptoms: Painless enlargement of lymph nodes in neck Weight loss Fever Primarily affects young adults Average age of 35 31

Disorders of White Blood Cells Hodgkin’s disease Cause thought to be viral Diagnosis by presence of Reed–Sternberg cell in lymphatic tissue Treatment: Radiation Chemotherapy If in remission for 5 years or more, complete cure possible 32

Disorders of White Blood Cells Non-Hodgkin’s lymphoma (NHL) Lymphomas lacking Reed–Sternberg cell Symptoms: Painless enlargement of lymph nodes of neck, axilla, and inguinal areas Fever Night sweats Weight loss 33

Disorders of White Blood Cells Multiple myeloma Malignant neoplasm of plasma cells or B-lymphocytes Increases with age Peaks in 70s Plasma cells multiply abnormally in bone marrow 34

Disorders of White Blood Cells Multiple myeloma Diagnosis by honeycombed bone pattern, hypercalcemia, Bence Jones protein found in blood and urine, and bone marrow biopsy Treatment: Chemotherapy Radiation Not effective Poor prognosis 35

Disorders of Platelets Hemophilia X-linked hereditary bleeding disorder Several types Type A Most common Male children from asymptomatic mothers Lack protein necessary for clot formation 36

Disorders of Platelets Hemophilia Symptoms: Epistaxis Bruising Prolonged bleeding Diagnosis by blood test 37

Disorders of Platelets Hemophilia Treatment: Prevention of injury Treat symptoms Blood transfusions Concentrated form of clotting protein No cure 38

Disorders of Platelets Thrombocytopenia Also known as thrombocytopenia purpura Decrease in platelets leading to inability to normally clot blood Symptoms: Abnormal bleeding in skin, mucous membranes, and internal organs Petechiae 39

Disorders of Platelets Thrombocytopenia Symptoms: Ecchymoses GI hemorrhages Epistaxis Hematuria 40

Disorders of Platelets Thrombocytopenia Diagnosis by platelet count and bleeding time Treatment: Avoid tissue trauma to reduce bleeding Vitamin K Transfusions of platelets Splenectomy 41

Disorders of Platelets Disseminated intravascular coagulation (DIC) Abnormal clotting followed by abnormal bleeding Usually follows major trauma E.g., complicated childbirth, surgery, tissue destruction, septicemia, snakebite, shock Multiple clots in capillaries Life-threatening 42

Disorders of Platelets DIC Symptoms: Petechiae Ecchymosis Hematoma Hematuria GI bleeding Hematemesis Blood in stool Treatment: Heparin or infusion of platelets 43

Rare Diseases Thalassemia Von Willebrand’s disease Lymphosarcoma Primarily affects people of Mediterranean descent Fragile, thin RBCs form defective hemoglobin Von Willebrand’s disease Hereditary, congenital Deficiency in clotting factor and platelet function Lymphosarcoma A type of lymphoma Symptoms similar to Hodgkin’s disease 44

Effects of Aging Age-related changes in other systems (e.g., immune, digestive) leave older adults more susceptible to infections and nutritionally related blood disorders Decreased iron Most common disorder is anemia Poor nutrition 45