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

2. 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

3. Blood Components 3

4. 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

5. 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

6. 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

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

8. 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

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

10. 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

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

12. 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

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

14. 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

15. 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

16. Diagnostic Tests
Biopsy
Bone marrow
Lymph node 16

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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

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

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

39. 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

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

41. 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

42. 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

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

44. 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

45. 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