Download as PPTX, PDF, TXT or read online from Scribd
Download as pptx, pdf, or txt
You are on page 1/ 27
BLOOD DISORDERS
Anemia and Polycythemia
LEARNING OBJECTIVES
RED BLOOD INDICES
ANEMIA • CAUSES • CLASSIFICATION • PRESENTATION • INVESTIGATIONS • TREATMENT POLYCYTHEMIA RED BLOOD CELL INDICES • HEMATOCRIT • Percentage of whole blood that is composed of RBCs • Normal value • 41 – 53% in men • 36 – 46 % in women • Significance • Anemia • Polycythemia • Dehydration • MCV • ✕10 • Normal value • 76 -95 fl • MCH • ✕ 10 • 27- 34 pg • MCHC • ✕ 100 • 30-33 • MCD ANEMIA Causes of Anemia
Hemorrhage Marrow Nutritional Pregnancy or hemolytic failure deficiency disease Classification of anemia
Classification on Classification on Classification on Classification on the basis of the basis of the basis of size the basis of defective cell cause of cell amount of Hb formation
Anemia due to Anemia due to Microcytic Hypochromic nutritional hemorrhage anemia anemia deficiency
Anemia due to Anemia due to Normocytic Normochromic bone marrow hemolysis anemia anemia failure(aplasia)
Symptoms Signs Fatigue Tachycardia Headaches Pallor Faintness Systolic murmur Breathlessness Heart enlargement Palpitations Cardiac failure Loss of appetite Angina • Koilonychia - in iron Specifi deficiency anemia c signs • Bone deformities – in thalassemia major of • Jaundice – in hemolytic anemi anemia • Leg ulcers – in sickle-cell a disease Investigations • CBC and peripheral film ( poikilocytosis and anisocytosis) • Serum ferritin • Total iron binding capacity • Serum Vitamin B₁₂ and folic acid • Bone marrow biopsy • Hemoglobin electrophoresis TREATMENT ACCORDING TO CAUSE EFFECTS OF ANEMIA ON FUNCTION OF THE CIRCULATORY SYSTEM
EFFECTS • Increase C.O. • Increase pumping workload due to increase V.R. MECHANISM • Viscosity (1.5 times that of water) • Vascular dilatation due to hypoxia RELATIONSHIP BETWEEN ANEMIA, CARDIAC FAILURE AND EXERCISE BLOOD LOSS ANEMIA
• Restoration of fluid and RBCs after acute
hemorrhage • In chronic blood loss - Microcytic, hypochromic anemia IRON DEFICIENCY ANEMIA
• CAUSES • Reduced iron absorption • Decreased acidity • Decreased vit C • Gastric surgery • Chronic bleeding • Increased iron requirement • Iron deficient diet • Physiological loss • SIGNS AND SYMPTOMS • INVESTIGATIONS • Blood complete examination • Low Hb • Low or normal RBC count • MCV <76 fl • Low MCH & MCHC • Microcytic, hypochromic RBCs • Low ferritin • Increased TIBC • TREATMENT • Iron replacement • Blood transfusion MEGALOBLASTIC ANEMIA Causes of Vitamin B12 Causes of Folic Acid Deficiency Deficiency
1. Nutritional deficits, e. 1. Nutritional deficits
g. Chronic abuse of alcohol Goat milk Cooking Vegetarian diet 2. Increased requirement Alcoholism Pregnancy Chronic abuse of Hemolytic anemia alcohol 3. Impaired absorption 2. Impaired absorption After gastrectomy • Intrinsic factor Ileum resection deficiency Sprue Gastrectomy Ileum resection/removal METABOLISM OF VIT. B12 • Cobalamin • Microorganisms are the ultimate origin in food chain • Stomach • Amylase & Pepsin • Cobalophilins ( R protein ) • Duodenum • Proteases • I.F • Ileum • Transcobalamin 11 • Liver, B.M , GIT SIGNS AND SYPMTOMS • Neurological involvement like numbness and decreased sensations in the feet and fingers. • Other features are same as mentioned earlier in anemia INVESTIGATIONS 1. Blood complete examination • Low hemoglobin • Low or normal red blood cell count • MCV >100 fl. • Normal or increased MCH and MCHC 2 . Macrocytic and normochromic red blood cells TREATMENT • Vitamin B12 or Folic acid • Blood transfusion PERNICIOUS ANEMIA
CAUSES Lack of intrinsic factor An autoimmune condition targeting the parietal cells (atrophic gastritis) or intrinsic factor Gastrectomy APLASTIC ANEMIA
• CAUSES • Injury to stem cells of bone marrow • Exposure to high-dose radiation • Exposure to chemotherapy for cancer treatment • High doses of certain toxic chemicals, such as insecticides or benzene in gasoline • In autoimmune disorders, such as lupus erythematosus • Idiopathic aplastic anemia. • TREATMENT • Blood transfusions • Bone marrow transplantation HEREDITARY SPHEROCYTOSIS
Genetic Decreased spectrin and ankyrin POLYCYTHEMIA
TYPES 1-POLYCYTHEMIA VERA (ERYTHREMIA) • CAUSE AND MECHANISM • Genetic aberration in the hemocytoblastic cells • 7 to 8 million/mm3 • Increase WBCs and platelets • FEATURES • The hematocrit increase • Blood volume increases, • Engorged vascular system 2-SECONDARY POLYCYTHEMIA CAUSES • Hypoxia • High altitudes • Cardiac failure • 6 to 7 million/mm3, about 30 percent above normal. EFFECT OF POLYCYTHEMIA ON FUNCTION OF THE CIRCULATORY SYSTEM
Increased viscosity of the blood
Blood volume also increased
Cardiac output is not far from normal
Arterial pressure is also normal
Ruddy complexion with a bluish (cyanotic) tint to the skin
