1. Chapter 7 Disorders of Blood Cells Lecture 7 The Nature of Disease Pathology for the Health Professions Thomas H. McConnell

2. Overview of Today’s Lecture –Brief review of blood –Laboratory Assessment of Formed Elements –Anemia –Polycythemia –Leukopenia, leukocytosis, and lymphadenopathy –Malignancies of WBCs and Lymphoid tissue –Disorders of the spleen and thymus

3. Blood Review Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

4. Blood Review Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

5. RBC Life Cycle Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

6. Laboratory Assessment of Formed Elements - Complete blood count (CBC) 1.WBC count (cells/μl), WBC differential (% of each type) 2.Platelet count (cells/μl) 3.RBC count (cells/μl) 4.Hematocrit (HCT = RBC % blood volume) 5.Hemoglobin (HGB = gm per 100 ml whole blood) 6.Calculation of RBC indices using 4 and 5 above -Mean cell volume, MCV = HCT/RBC (normo-, macro-, or microcytic) -Mean cell Hgb concentration, MCHC = HGB/HCT (normo- or hypochromic) -Mean cell hemoglobin, MCH = not useful in regular practice -Other studies -% reticulocytes -Type of Hb (e.g, A - normal, S - sickle, F - fetal)

7. Anemia - Abnormally low Hb in blood (so decreased O2 carrying capacity) - Can be due to - Decreased # RBCs - Decreased amount of Hb in RBCs - Both - Always a sign of an underlying condition - Typical symptoms - Chronic fatigue - Shortness of breath - Pallor - Increased HR and respirations - If severe, fainting or comatose - Treatment - Replenish RBCs - Identify cause and treat/reverse it

8. Diagnosing Anemia Figure from: http://www.medicine.mcgill.ca/ physio/vlab/bloodlab/mcv- mchc_n.htm

9. Overview of Anemia

10. Anemia – Blood Loss

11. Anemia – Increased RBC Destruction

13. Sickle Cell Anemia Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

14. Anemia – Increased RBC Destruction

16. Anemia – Insufficient RBC Production Light Micrographs from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

17. Anemia – Insufficient RBC Production Light Micrograph from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

18. Polycythemia (Erythrocytosis) Excess number of RBCs in blood Major symptoms/signs: red face, RBC count, HCT, and HB increased Relative –Increased concentration of RBCs (absolute # is unaffected) –Loss of fluid –Stress polycythemia Absolute – increase in # RBCs in body –Primary Polycythemia vera Due to BM malignancy A myeloproliferative syndrome –Secondary Something OUTSIDE BM causes problem Chronic hypoxia, e.g., smoking, lung disease, living at high altitude

19. Non-malignant Changes of Leukocytes

20. Malignancies of WBCs - Overview

22. Myeloproliferative/ Myelodysplastic Disorders

23. Lymphoproliferative Disorders - Leukemias

24. Development of Lymphoid Malignancies Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014

25. Lymphoproliferative Disorders – Lymphomas *

26. Lymphoproliferative Disorders – Plasma Cell Disorders Figure from: McConnell, The Nature of Disease, 2 nd ed., LWW, 2014