Download - BLOOD
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BLOODPRESENTED BY:Sonika Roll No.714MDS (Ist Year)
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WELCOME TO THE WORLD OF
HAEMATOLOGY
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BLOOD
EVERYONE HAS IT,
EVERYONE NEEDS IT
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Respiratoryfor communication and protection NutritiveExcretoryHomeotasisRegulation of body temperatureChemical Functions performed by plasma proteins
FUNCTIONS OF BLOOD
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COMPOSITION OF BLOOD
BLOOD (If anticoagulated sample is allowed to stand)
(CELLS 45total % of Blood vol.)
PLASMA (clear-straw colored fluid and represents 55% of total blood volumeErythrocytes
LeucoytesThrombocytes
91% Water 9% Solids
1% inorganic
8% organic
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MAIN COMPONENTS OF BLOOD
PLASMA CELLS: RBCs WBCs PLATELETS
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RBCs and WBCs
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PLATELETS
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Na+, Cl-, HCO3-, Ca2+ (Mainly extracellular)
K+, Mg2+, Cu2+, PO43- (Mainly intracellular)
Fe2+ and Fe3+
INORGANIC COMPONENTS
Plasma Proteins Non-Protein Nitrogenous Substances - Urea (20 to 40 mg%) - Uric Acid (2 to 4 mg%) - Creatine (1-2 mg%) - Creatinine (0.6-1.2mg%) - Xanthine (Traces) - Hypoxanthine (Traces)
ORGANIC COMPONENTS
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NON NPN SUBSTANCES Neutrsl fats (30-150%) - Phospholipids e.g. Lecithin, Sphingomyelin, Cephalin (150-300 mg%) - Glucose (Fasting) 70-90 mg% - Cholesterol 150-240 mg% OTHERSUBSTANCES - Enzymes - Hormones - Antibodies
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ESTIMATION OF SPECIFIC GRAVITY OF
BLOOD COPPER SULPHATE FALLING DROP
METHOD CHLOROFORM AND BENZENE MIXTURE GLYCERINE AND WATER
SIGNIFICANCE:Screening of donor blood,mass survey in anemia,handling emergencies like burn cases.
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SPECIFIC GRAVITY OF BLOOD
• INCREASES IN• Polycythemia• Severe
dehydration• Loss of plasma in
case of burns causing hemoconcen tration.
DECREASE IN• Pregnancy• Anemia• Hemodilution• Malnutrition• Starvation• Renal disease.
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VISCOSITY OF BLOOD
INCREASES IN Polycytmemia CHF,DM Multiple myeloma Profuse sweating Severe vomitting Diarrhoea Leukemias
DECREASE IN Anaemia Oedematous state
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ELECTROPHORESIS
ELECTRO:Application of electricity. PHORESIS:means transmission. BROUGHT ABOUT BY:A.TISELIUM,1930 APPLICATION AND USES:• Seraration of proteins• Estabilizating the purity of a protein• Detecting impurities and isoenzyme.
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ELECTROPHORESIS OF SERUM PROTEINS
The serum proteins areSeparated by electrophoresis. As the current flows,the serum proteins
move towards the +ve electrode. The stronger the –ve charge on a
protein,the faster it migrates After 20 minutes,current is turned
off,proteins are stained to make them visible.
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SEPARATION OF PROTEINS
THE SEPARATED PROTEINS APPEAR AS DISTINCT BANDS.
THE PROTEIN THAT MOVES CLOSEST TO +VE ELECTRODE IS SERUM ALBUMIN
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CLINICAL INTERPRETATION OF ELECTROPHORETIC
PATTERNS: PATTERNS IN INFECTION:
Bacterial infection:increase α
globulin Viral infection:increase α globulin Chronic infection:increased α
globulin and γ globulin.
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PATTERNS IN NON
BACTERIAL INFECTION: Acute traumatic injuries: α
globulin. Tissue necrosis:α globulin. Burns: albumin, α globulin
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PATTERNS IN RENAL DISEASES: Acute nephritis: Chronic nephritis: globulin
PATTERN IN RETICULOSIS: albumin globulin, globulin.
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COMPONENTS:55% albumin (3-5g%) Avg.=4.8g%)38% Globulin (2-3g%) Avg. =2.3g%) - 13% Globulin - 14% Globulin - 11% -Globulin7% Fibrinogen 0.3g%Prothrombin 40 mg%
(Albumin/Globulin = 1.7:1)
PLASMA PROTEINS(Normal Value (6.4 - 8.3 g%)
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In Embryo: Mesenchymal CellsIn Adults: - Albumin and Fibrinogen- LIVER - Globulin: (a) Tissue macrophages (b) Plasma Cells (c) Lymphocytes
ORIGIN OF PLASMA PROTEINS
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FORMS OF PLASMA PROTEINS & THEIR
FUNCTIONSType Normal
Plasma LevelFunctions
Pre-albumin(MW=60,000)
0.03g% Binds T4 and T3
Albumin (MW=69,000)
3-5g% Controls COPTransport of ions, dyes, drugs, hormones etc.
Globulin(MW=Variable)
2-3g% Depending upon types
Fibrinogen(MW=3,50,000)
0.3g% Helps in blood clotting
Prothrombin(MW=68,000)
40 mg% Helps in blood clotting
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FORMS OF GLOBULIN GLYCOPROTEIN LIPOPROTEIN:α globulin+lipid HDL LDLVLDL CHYLOMICRONS TRANSFERIN:PLASMA CONC.=0.24g% HAPTOGLOBINS: globulin,MW:90,000 NORMAL PLASMA LEVEL:0.12% CERULOPLASMIN
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CERULOPLASMIN:0.04% COAGULATION FACTORS FETUIN:present in foetus and
newborns Growth promoting factor.MW=45000
ANGIOTENSINOGEN: HAEMAGGLUTININS:antibodies
against red cell antigen.
α
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IMMUNOGLOBULINS(Ig) :γ globulin
Ig G Ig M Ig A Ig D Ig E
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FUNCTIONS OF PLASMA PROTEINS
COAGULATION OF BLOOD MAINTAINS COP ACROSS THE
CAPILLARY WALL. MAINTAINS VISCOSITY OF BLOOD PROVIDE STABILITY TO BLOOD MAINTAINS SYSTEMIC ARTERIAL B.P MAINTAINS ACID BASE BALANCE
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IMMUNE RESPONSE TRANSPORT FUNCTION RESERVIOR FUNCTION
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VARIATION IN PLASMA PROTEIN CONCENTRATION: DECREASES IN HAEMORRHAGE(result in decrease
in all forms of plasma proteins-fibrinogen,globulin,albumin and regenerated in the same order)
INCREASES IN SECONDARY TO
BURNS DEHYDRATION DIABETES
INSPIDUS
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DECREASE IN ALBUMIN LEVEL
PHYSIOLOGICAL in infacy and
newborns. Pregnancy.
PATHOLOGICAL Impaired protein
synthesis: Hepatitis Liver cirrhosis Severe malnutrition Malabsorption
Excessive loss Burns,nephrosis
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INCREASE IN γ GLOBULIN:due to destruction of tissues in
Multiple Myeloma TB,Lymphatic leukemia Cirrhosis of liver,acute hepatitis Nephritis
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FIBRINOGEN INCREASE IN: PREGNANCY MALARIA TISSUE INJURY ACUTE/CHRONIC
INFECTIONS.
DECREASE IN: CONGENITAL(rare) CARCINOMA
PROSTATE EXTENSIVE
CARDIAC SURGERY.
INTRAVASCULAR COAGULATION.
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RBCs
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HISTORY OF RBC In 1658, the Dutch biologist Jan
Swammerdam was the first to describe red blood cells. He had used an early microscope
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ERYTHROCYTES GENERAL
STRUCTURE: Circular,biconcave,
non nucleated disc. mature RBC has
no nucleus,ribosome,mitochondria.
RBC contains Hb.
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RBC CONTAINING Hb
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The cell member of RBC contain circular pores,which are concered with ingress and egress of water and electrolytes.
Below cell membrane is contractile layer of lipoprotein SPECTRIN arranged in fibrillar manner.
It maintains the shape n flexibility of RBC membrane;also contains blood group antigen.
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PRESENCE OF ANTIGENS ON RBCs
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COMPOSITION OF RBCs:
62.5% water 35% Hb(29.5+-2.5pg/RBC) 2.5%:SUGAR LIPIDS:Cephalin,cholesterol,lecithin PROTEINS:Glutathione,albumin like Insoluble protein,act as reducing
agent thus prevents damage to Hb.
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ENZYMES:Glycolytic pathway,carbonic anhydrase,catalase.
VITAMIN DERIVATIVES
IONS:Na,K,PO ,SO
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DIAMETER:• 6.5-8.8 m(avg.7.3 m)• Thickness at periphery:2.0-2.4 m• at centre:1.2-1.5 m• SURFACE AREA:140 m• VOLUME:78-94 m (86+8 m)
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DIAMETER OF RBC
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LIFE SPAN:120 days SITE OF DESTRUCTION:Tissue
macrophage. FUNCTIONS:same as that of Hb. :helps in identification of
blood group specific antigens.
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LIFE CYCLE OF RBC
Kidney releases erythropoietin
That travels to red bone marrow and stimulates RBC production
RBCs enter circulation
Old ones destroyed in spleen.
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OSMOTIC FRAGILITY OF RBCs
Ease with which the RBCs are broken down in hypotonic solution
Expressed in terms of conc. Of hypotonic solution in which cells are hemolysed.
RBCs in isotonic solution:no change RBCs in hypotonic solution(<0.9%
NaCl):swell up and finally burst. RBCs in hypertonic
solution(>0.9%NaCl):red cells shrink.
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VARIATION IN SIZE,SHAPE N STRUCTURE OF RBCs
ANISOCYTOSIS:Variation in size POIKILOCYTOSIS:Variation in shape SPHEROCYTOSIS:RBCs spherical n fragile ANEMIA:Reduction in no.of RBCs less
than 4million/cumm or Hb less than 12g% or both
POLYCYTHEMIA:RBC count >6million/cumm.
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VARIATION IN NUMBER OF RBCs
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VARIATION IN SHAPE OF RBCs
ACANTHOCYTES ECHINOCYTES(Burr cells) ECHINOCYTES (Crenated or berry
cells) KNIZOCYTES LEPTOCYTES OVALOCYTES/ELLIPTOCYTES DREPANOCYTES SPHEROCYTES
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STOMATOCYTE CODOCYTES DACROCYTES SCHIZOCYTE RBC AGGLUTINATION ROULEUX FORMATION
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ACANTHOCYTES ACANTOHOCYTES Spherical,spine thorn
like projection. Associated with low
conc Of ß lipoprotein Seen in liver disease
fatmalsbrorption,enzyme defeciencies.
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ECHINOCYTES ECHINOCYTES Cells look like a
burr,sharp,pointed irregular projections
Seen in liver diseases
Associated with impaired renal function n hemolytic anemia
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ECHINOCYTES CRENATED/BERRY Have serrated or
goose bump outline on the member of RBC.
Usually artifactual due to moisture on slide surface or blood smears.
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KNIZOCYTES A nondiscoid RBC
with two or more concavities of central pallor with Hb forming a bridge across the centre of the cells
Associated with hemolytic anemia.
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LEPTOCYTES Thin flat RBC,appear
hypochromic on fixed smears
Looks like codocytes but without the target appearance.
Associated with thalassemia,liver disease,iron defeciency anemia.
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OVALOCYTES elliptocytes or pencil
cells Oval,elliptical or
elongated Seen in iron def.
anemia- Liver diseases- Megaloblastic
disorders.
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DREPANOCYTES SICKLE CELLS Under reduced
oxygen tension CELLS become crescent / sickle shaped.
Caused by an inherited abnormality due to HbS.
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SPHEROCYTES Spherical,variable
size.Lack of central zone of pallor, stained red brown with wright’s stain
Have low surface to volume ratio which increases osmotic fragility.
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STOMATOCYTE RBC with mouth or
slot like zones of pallor.
Result from RBC Na pump defect seen in HEREDITARY stomatocytosis,AL, alcholism,liver disease,severe infections.
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CODOCYTES Target cells have
deeply stained centres n borders
Separated by a pale ring of central pallor
Appear target/gum drop shaped.
CAN BE AN ARTIFACT.
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DACROCYTES Elongated at one
end,forms tear drop or pear shaped cell.
Can’t come back to normal shape as the is stretched for long period.
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RBC AGGLUTINATION
Seen due to Ag-Ab binding
Seen in cold agglutination by M.pneumonia
RBC count low MCV high reading RECOVERY:Heat the
specimen at 37°c.
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RBC AGGLUTINATION
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ROULEUX FORMATION
RBCs line up on top of each other giving a stack of coin appearance.
Caused by increase in globulin content.
Seen in waldenstrom’s macroglobinemia.
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RBC INDICES HELP IN DIAGNOSTING TYPES OF ANAEMIA Mean corpuscular volume(MCV):volume of
single rbc in µm MCV=PCV per 100ml blood RBC Count million/cumm Mean corpuscular HAEMOGLOBIN:
(MCH):average amount of Hb in a single RBC in pg.
MCH=Hb in g%/RBC count.
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Mean corpuscular Hb concentration:amount of Hb expressed as % of volume of RBC.
MCHC=Hb in g% x100 PCV in 100ml of blood
COLOUR INDEX Hb in g%/RBC%
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MORPHOLOGICAL CLASSIFICATION
MICROCYTIC:small cell size
Normochromic:in chronic infections, malignant diseases.
Hypochromic:in chronic haemorrhage, plummer vinson syndrome,achlorhydria, ankylostomiasis.
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NORMOCTIC:normal cell size
Normochromic:in acute haemorrhage, hemolysis,hypoplasia of bone marrow.
Hypochromic: in defeciency of iron due to less intake,more loss or excessive demand.
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MACROCYTIC: Cell size more
Normochromic: in defeciency of haematopoietic factor like vit.B12,FOLIC ACID.
Hypochromic: in intense activity of bone marrow as in hemolytig anemia.
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HAEMOPOIESIS
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HAEMOPOIESISTHEORIES: Monophylectic:Different cells
arise from a single ancestral cell-PLURIPOTENT STEM CELL.75% cells in bone marrow are myeloid series;25% erythroid series
Polyphylectic:separate stem cells for each type of cell.
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MONOPHYLETIC THEORY
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PRINCIPLE INTERLEUKINS AND COLONY STIMULATING FACTORS IL-1:secretion of CSF,all blood cell
except lymphocytes IL-3:secretion of CSF,all blood cells
except lymphocytes IL-6:-do- IL-4:basophil production IL-5:EOSINOPHIL PRODUCTION G-CSF:production of neutrophils
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M-CSF:production of monocytes
GM-CSF:production of neutrophils monocytes,eosinophil,platelet,RBCs
ERYTHROPOIETIN:production of RBCs.
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ERYTHROPOIESIS DURING INTRAUTERINE LIFE:
Mesoblastic stage:upto 3 months of life RBCs are formed from mesoderm of yolk sac/area vasculosa
Hepatic stage:liver and spleen are sites of blood formation.
Myeloid stage:from middle of foetal life,RBC formation occurs in bone marrow.
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MESOBLASTIC STAGE
MESOBLASTIC STAGE:
Upto 3 months in i.u life,RBCs are formed from mesoderm of yolk sac
INTRSVASCULAR
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HEPATIC STAGE After 3 months of
foetal life,liver n spleen are the site of bloob formation.
RBCs develop from the mesenchyme b/w bloodvessels and tissue cells.
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MYELOID STAGE From the middle
of foetal life,RBC forms in bone marrow.
EXTRAVASCULAR
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IN CHILDREN: In all bones with red marrow Liver Spleen
IN ADULTS: After 18-20 years,from red bone marrow Liver n spleen,if bone marrow is destroyed.
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BLOOD CELLS IN BONE MARROW
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STAGES OF ERYTHROPOIESIS
HEMOCYTOBLAST:19-23 m PROERYTHROBLAST:15-20 m EARLY NORMOBLAST:14-16 m INTERMEDIATE NORMOBLAST:10-14 m LATE NORMOBLAST: early n late type RETICULOCYTE:7-8 m ERYTHROCYTE:7.2-7.4 m
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ERYTHROBLAST
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PRECURSORS OF RBCs
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REGULATION OF ERYTHROPOIESIS
GENERAL FACTORS:Hypoxia Effect mediated by ERYTHROPOIETIN Erythropoietin:glycoprotein,74% protein
26% carbohydrates,contains 165 aa. Sources:kidney,liver,tissue macrophage Inactivated;in liver,kidney Excretion:urine
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SPECIAL MATURATION FACTORS Diet Castle’s intrinsic factor Extrinsic factors:vit.B12,FOLIC ACID I.F+E.F=Haematinic principle i.e
heips in maturation of proerythroblasts to mature RBCs.
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RETICULOCYTE COUNT
NORMAL VALUE: Adults(0.2-2%)
Infants:(2-6) Clinical significance: To assess erythroid
activity of bone marrow.
Assessing treatment and prognosis of anemia
INCREASE IN Infants High altitude After haemorrhage Chr. Hemolytic
anemia Disorders of spleen Disorders of bone
marrow
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ERYTHROCYTE SEDIMENTATION RATE
PHASES:• Phase of rouleax formation:10 minutes• Phase of settling:40 minutes• Phase of packing:10 minutes METHODS: Westergren Wintrobe Micro ESR
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NORNAL VALUES OF ESR
WESTERGREN: Males:3-5mm 1st hour Females:4-7mm 1st hour
WINTROBES: Males:2-8mm 1st hour Females:4-10mm 1st hour
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PHYSIOLOGICAL VARIATIONS IN ESR
AGE SEX HIGH ALTITUDE PREGNANCY
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VARIATIONS IN ESR INCREASE IN All acute infections Inflammation Malignancies SLE,Vasculitis Anemias Bone diseases Lung disease
DECREASES IN Afibrinogemia Polycythemia
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ESR AND PCV BLOOD SAMPLES
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PACKED CELL VOLUME
It is the ratio of RBCs to that of whole blood expressed as%
METHODS: Macromethod using wintrobe tube Microhematocrit Electronic method
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FORMULA:Height of RBCs packed (mm)
Height of rbc+plsma
NORMAL VALUES: Females:44% Males:42%
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ANTICOAGULATED BLOOD SAMPLE AFTER
CENTRIFUGATION
![Page 96: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/96.jpg)
COMPONENTS OF BLOOD
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RBC COUNT RBC PIPETTE BLOOD
WITHDRAWN UPTO MARK 0.5
DILUTENT:HAYEM’S FLUID
DILUTION FACTOR : 200 TIMES.
![Page 99: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/99.jpg)
RBC COUTING CHAMBERS
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HAEMOGLOBIN
The red oxygen carrying pigment in the RBCs of vertebrates
STRUCTURE: Haem:Fe containing porphyrin Iron:in ferrous form Globin:protein consist of two α
chains and two β chains MOLECULAR WEIGHT=68,000
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HAEMOGLOBIN
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STRUCTURE OF HAEMOGLOBIN
SHOWING TWO ALPHA AND TWO BETA CHAINS.
HEAME GROUPS IN RED
IRON ATOMS IN PURPLE.
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BINDING OF OXYGEN TO Hb
OXYGEN BINDS TO THE IRON ATOM DIRECTLY BELOW THE PLANE OF HEME GROUP.
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SOME IMPORTANT DEFINITIONS
OXY Hb:combination of Hb with oxygen CARBAMINO Hb: HbNH COOH REDUCED Hb:oxygen removed from Hb CARBOXY Hb:CO+Hb METHAEMOGLOBIN:Hb exposedto
various drugs,the ferrous is oxidised to ferric form.
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NORMAL VALUES
AT BIRTH:23g% AT THE END OF 3 MONTHS:
10.5g% AFTER 3 MONTHS: 12.5% ADULTS: Males:14-18g% :Females:12-15.5g%
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FUNCTIONS OF HAEMOGLOBIN
Transport of oxygen from lungs to tissues
Transport of carbondioxide from tissues to lungs
Acid base buffer.
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OXY AND DEOXY Hb
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TRANSPORT OF CO2 AND BOHR EFFECT
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SYNTHESIS OF HAEMOGLOBIN
Takes place in developing RBCs
REQUIRES: Proteins Minerals: Fe,Cu,Co,Ca Role of vitamins:B12,folic acid.
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FATE OF HAEMOGLOBIN
OLD RBCs are destroyed in tissue macrophages The system includes:
Kuppfer cells in liver Alveolar macrophages in lungs Osteoclasts in the bone Microglia in the brain Lymph nodes,spleen,Littoral cells
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VARIETIES OF HAEMOGLOBIN
Hb A1C: Glycosylated Hb HbA :Adult Hb HbF: Foetal Hb HbS:Sickle shaped RBCs
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GLYCOSYLATED HAEMOGLOBIN RED-Haemoglobin GREEN-GLUCOSE
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LEVEL OF HbA1C
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GLYCOSYLATED HAEMOGLOBIN
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HbA1C IN WELL N POORLY CONTROLLED DIABETES
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HbA1c levels by coincidence nearly equate to glucose levels. So an HbA1c level of 10% means the average glucose level for the previous 10 weeks was 13mmol/l.
But at lower levels there is even less difference, so an HbA1c of 7% means the average glucose level was 8mmols/l
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SICKLE SHAPED RBC
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SICKLE CELL(EM)
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SICKLE CELLS IN BLOOD VESSEL
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HAEMOGLOBIN ESTIMATION
VARIOUS METHODS ARE: Sahli’s method Cyanomet Hb method Oxy Hb method Haldane’s method Wu’s method CuSO FALLING DROP METHHOD
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Tallquist method Electronic counter method
Direct reading haemoglobinometer
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ELECTRONIC Hb METER
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LEUCOCYTES GRANULOCYTES: Neutrophils:50-70% Eosinophils:1-4% Basophils:<1%
AGANULOCYTES: Lymphocytes:20-405 Monocytes:2-8%
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NEUTROPHIL WITH BARR BODY
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LEUCOPENIA TLC below 4000/cumm CAUSES: Starvation Typhoid fever VIRAL or PROTOZOAL infections Bone marrow depression
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LEUCOCYTOSIS TLC above 11,000/cumm CAUSES: Newborns Exercise Pregnancy,lactation,menstruation Steroids Any pyogenic infection
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NEUTROPHILS SIZE: 10-14 m NUCLEUS:purple,multilobed CYTOPLASM:slightly blue in colour
GRANULES:fine pinpoint Neutrophilic in nature Contains proteins,lipids,nucleic acid
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NEUTROPHIL
![Page 131: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/131.jpg)
NEUTROPHIL WITH BARR BODY
![Page 132: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/132.jpg)
GRANULES OF NEUTROPHILS PRIMARY: Lysozymes ,cationic proteins Acid hydrolases,Elastases SECONDARY: Lysozymes,alkaline phosphatase Collegenases,Lactoferrin TERTIARY:Gelatinase,Cathepsin
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VARIATIONS IN THE COUNT NEUTROPHILIA:• Acute infections• Burns,acute
heamorrhage,hemolysis,truma,surgery.
• Tissue necrosis
NEUTROPENIA Bone marrow
depression Typhoid fever Viral influenza Severe
overwhelming infections.
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EOSINOPHILS SIZE: 10-14 m NUCLEUS:purple
colour,bilobed(85%) and trilobed(15%)
CYTOPLASM:acidophilic,granular GRANULES:coarse,stain bright red :contain histamine,lysozyme,ECF-A.
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EOSINOPHIL
![Page 136: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/136.jpg)
EOSINOPHIL IN PBF
![Page 137: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/137.jpg)
VARIATIONS IN COUNT
EOSINOPHILIA Allergic conditions Parasitic infections EOSINOPENIA Acute stressful conditions ACTH treatment
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BASOPHILS SIZE:10-14 m NUCLEUS: as in eosinophils CYTOPLASM:Basophilic,granular GRANULES:coarse,stains purple/blue Plenty in number Overcrowd the nucleus Contains histamine n heparin.
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BASOPHIL
![Page 140: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/140.jpg)
BASOPHIL IN PBF
![Page 141: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/141.jpg)
VARIATIONS IN COUNT
BASOPHILIA: Chicken pox Smallpox TB Influenza
BASOPENIA: Drug induced
reactions After
glucocorticoid administration.
![Page 142: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/142.jpg)
LYMPHOCYTES SIZE: Large-10 to14 m; small-7to10 m NUCLEUS:single,very big,purple :round or indented :central in position nuclear chromatin
coarse,lumpy CYTOPLASM:pale blue,scanty.
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LYMPHOCYTE
![Page 144: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/144.jpg)
LYMPHOCYTE IN PBF
![Page 145: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/145.jpg)
VARIATIONS IN COUNT
LYMPHOCYTOSIS:
In children Chronic infections
eg.TB Leukemia Viral influenza.
LYMPHOPENIA Hypoplastic
bone marrow AIDS
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MONOCYTES SIZE:10-18 mNUCLEUS: Pale staining Single,round/kidney sheped Eccentric in position Nuclear chromatin finely reticular. CYTOPLASM:pale blue n clear GRANULES: fine purple dust like granules.
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MONOCYTE
![Page 148: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/148.jpg)
MONOCYTE IN PBF
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VARIATIONS IN THE COUNT
MONOCYTOSIS: TB Syphilis Leukemias
MONOCYTOPENIA: Hypoplastic bone marrow.
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STAGES OF GRANULOPOIESIS
PRIMITIVE WBC:18-23 m MYELIBLAST:16-20 m MYELOBLAST A/PREMYELOCYTE:14-18 MYELOCYTE B:12-16 m MYELOCYTE C/METEMYELOCYTE:10-
14 MATURE WBCs
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SENILE LEUCOCYTES
CHARACTERIZED BY: Loss of mobility Nucleus seen lying free Nuclear lobulations increases Poorly stained granules Cell break up readily while making
blood smear.
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TOTAL LEUCOCYTE COUNT
THE ENTIRE KIT REQUIRED FOR
WBC COUNT RBC COUNT PLATELET
COUNT.
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PIPETTE SHOWING TOTAL WBC
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METHOD OF COLLECTION OF BLOOD
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COLLECTION OF BLOOD SAMPLE
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WBC PIPETTE GET A FINGER
PRICK DONE WITHDRAW
BLOOD UPTO MARK 0.5
WIPE THE EXCESS BLOOD ON OUTER PORTION OF PIPETTE.
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AREA FOCUSSED -BULB
MIXING THE BLOOD WITH TURK’S FLUID
DILUTION:20 TIMES
KEEP IN FOR 2-3 MINUTES.
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DISCARD FEW DROPS BEFORE CHARGING .
![Page 160: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/160.jpg)
CHARGING THE CHAMBER
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NEUBAUER CHAMBER
![Page 162: BLOOD](https://reader030.vdocuments.mx/reader030/viewer/2022013102/5473e89eb4af9f8c408b466d/html5/thumbnails/162.jpg)
SHOWING DEPTH OF 0.1mm
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FIELDS FOR WBC N RBC COUNTS
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HOW TO PREPARE A BLOOD SMEAR?
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STAINNING APPARATUS
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MICROSCOPE TO VISUALIZE SMEAR
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ERRORS IN SMEAR PREPRATION SHOWING FEATHER EDGE
THIN IDEAL THICK
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BLOOD AS A CULTURE MEDIA
Blood is classified as: SPECIAL MEDIA/ENRICHED MEDIA INDICATER MEDIA:Blood agar
mediun is an enriched media but certain bacteria lyses red bllod cells showing clear zone around the colonies.Thus its in indicater media as well.
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COMMONLY ISOLATED PATHOGENS FROM BLOOD
CULTURE Hemolytic Streptococci Staphylococci-pathogenic n
saprophytic Colliform bacilli Hemophilus influenza Enterococci Pseudomonas sp. Bacteroides sp. Salmonella sp.
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MALARIAL PARASITE INVADING ERYTHROCYTES
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TRYPANOSOME PARASITE WITH MAMMALIAN RBCs
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CAUTION! BLOOD AS AN
OCCUPATIONAL HAZARD.
SOURCE OF DISEASES LIKE HBV AND HIV (BE HIGHLY ALERT)
PRACTICE UNIVERSAL PRECAUTIONS
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VARIOUS BLOOD TESTS
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CONCLUSION
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A MESSAGE-DONATE BLOOD-
SAVE LIFE
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REFERENCES
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REFERENCES Hofferband,Lewis,Post Graduate in
HAEMATOLOGY,4th edition A.K Jain,Text book of Physiology,Vol.1 Hasrh Mohan,Text Book of Practical
Pathology. C.L Ghai,A text book of Practical
Physiology,5th edition Gyton,Medical Physiology
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Victor,Colour atlas of Histology REFERENCES FROM NET:GOOGLE
IMAGES CONCERNING BLOOD N ITS COMPONENTS.
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THANK YOU