Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

BT 633- Human Biology & Diseases

Blood Patho-Physiology
Dr Piruthivi Sukumar MBBS MMST PhD
Assistant Professor
Room No:303 (Old Wing)
Dept of Biotechnology
p.sukumar@iitg.ernet.in
2232 (O)
881 103 9291(M)

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Blood
Hemostasis

Hemostasis means prevention of blood loss

Hemostasis is the process of forming clots in the walls of damaged blood vessels and
preventing blood loss, while maintaining blood in a fluid state within the vascular system

Stages/Events
1. Vascular spasm
2. Formation of platelet plug
3. Blood coagulation

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Vascular Spasm

Reduces flow of blood from injured vessel.

Causes:
1- Neural reflex
2- Release of vasoconstrictors (Thromboxane A2 and serotonin) from platelets

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Platelet Plug Formation

Stages
Platelet adherence
Platelet activation
Platelet aggregation

Platelets attach to exposed collagen with the presence
of von Willebrand factor (vWF) and Glycoprotein

Adhesion of platelets causes release of chemical
mediators (ADP, Thromboxane A2)

ADP attracts more platelets

Thromboxane A2 (powerful vasoconstrictor)
promotes aggregation & more ADP

Formation of platelet plug

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Blood Coagulation

Involves a cascade of reactions - clotting factors are activated

They are plasma proteins synthesized by liver
Vitamin K needed for - factor II, VII, IX and X synthesis
In the plasma - inactive form
When activated they act as proteolytic enzymes which activate other inactive enzymes
Several of these steps require Ca++ and platelet phospholipid.

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Clotting Factors

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Blood Clotting
Factor X can be activated by reactions in
either of 2

Intrinsic system
Factor XII is activated
in vitro - by exposing blood to foreign
surface (glass test tube)
In vivo - when blood is exposed to
collagen

Extrinsic system
Requires contact with tissue factors
external to blood
Trauma to the vascular wall and
surrounding tissues.
Triggered by release of tissue factor
(thromboplastin from damaged tissue),
that activates factor VII

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Clotting Disorders
Hemophilia
Hemophilia is an inherited bleeding, or coagulation, disorder. Children with hemophilia lack the
ability to stop bleeding because of the low levels, or complete absence, of specific proteins,
called "factors," in their blood that are necessary for clotting
Three Types:
Hemophilia A-- lack of factor VIII
Hemophilia B--deficiency of factor IX.
Hemophilia C-- lack of factor XI.
Thrombosis
Thrombosis occurs when clots obstruct blood vessels
Venous thrombosis causes- disease or injury to the veins in the legs, immobility for any reason
Fracture,certain medications,obesity,inherited disorders or inherited predisposition
Arterial thrombosis stroke, heart attack

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Anemia
fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood
Classification
1.) Decreased production vs RBC loss (increased destruction or bleeding)
2.) RBC Size:
Macrocytic vs. microcytic vs. normocytic
3.) Hemoglobin Content:
Hypochromic vs. normochromic
4.) Shape: Normal or abnormal

Polycythemia

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Anemia
Causes:
Excessive blood loss or hemorrhage
Hemophilia
Vitamin K deficiency
Trauma
Deficient or defect in production of red cells/Hemoglobin
Iron Deficiency
Aplastic anemia
Excessive red cell destruction
Haemolytic Anemia hereditary/acquired

Management

Department of Biotechnology

INDIAN INSTITUTE OF TECHNOLOGY Guwahati

Next Class..

Blood Disorders & Blood Gas Transport