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55%
plasma
45%
cells
Hemopoiesis
Remember
Under special abnormal conditions
in post-natal life ( e.g. B.M. failure )
#.
( extra-medullary Hemopoiesis)
#. Fatty marrow(Long bones) may
reverse to hemopoiesis leading to
expansion of hemopoiesis down the long
bones ( B. M. expansion )
L/Group12
--?Q5.How
Hemopoietic stem Cells (HSC) (CD34+ CD38-)
Pluri-potent SC in bone marrow
Myeloid SC
Lymphoid SC
RBC
Other WBC
LYMPHOCYTES
PLATELET
-Pro
normoblast
Early
normoblast
Intermediate
Myeloblast
-Mono
blast
normoblast
Late
normoblast
Reticulo
cyte
RBC
Pro
-mono
cyte
-Mono
cyte
Pro-myelocyte
Myelocyte
-Mega
-Karyo
blast
-Mega
-karyo
cyte
Meta-myelocyte
Band
Granulocytes
Platelet
Pls refer to
haemostasis
Pro-normoblast
Why
Cytoplasm of pronormoblast
stains
?deep blue basophilic
Early normobl.
Interm normobl
Late normobl.
S.
142 m
13 2 m
112 m
N/C
3/1
1/1
1/3 or less
C.
still basophilic
start of
Hb. synthesis
increasing
Hb--ization
N.Ch. Condensed
forming
coalescent clumps
(basophilic)
more clumped
(polychromatic)
L/Group12
N. is smaller,
darker
& eccentric
(orthochromic)
Reticulocytes
C Routine stain
S.: diam. 8 1 m
No nucleus
supra-vital stains
e.g. new methylene blue stain
Normal
Reticulocyte Count
Fully- hemoglobinized,
biconcave , flexible &
squeezable hard-working
mature cells
Life-span 1207 days
##Diameter
~71 m
##Volume (MCV) 8610 fl
Hb (MCH) 302 pg
Stains deep at periphery &
pale in the center.
This area of central pallor is
~ one third of diameter.
fl (femtolitre) =10-15 L
pg (picogram)=10-12 g
L/Group12
Normal
RBC
Normocytic
Normochromic
Cell
##IMP
15 m
N/C 5/1
C: pale blue
N chromatin: fine
<5% of normal marrow
Usually larger
N/C 4/1or less
N chrom.: denser
Gr. Specific (neutrophil,
eosinophil or basophil)
N chrom.: thick strands
L/Group12
Myeloblast
Ni Gr.
C.
N
+ 1-5
Promyelocyte
+ +
1-3
Myelocyte
1ry
- +
2ry
Cell
##IMP
N: Kidney-shaped
or indented
N.Chr.: more condensed
Smaller
N. U-shaped
N.Chr.: coarse & clumped
N Neutroph - (2 to 4 seg.)
Eosino- & Basoph - bi- lobed
Gr Eosinoph - (orange)
Basoph (deep blue)
L/Group12
Meta-myelocyte
Band form
Segmented
Monocyte
##The largest WBC in the normal PBS
##predominant cell Neutrophil
C. ground-glass &voluminous with vacuoles
fine azuro-philic granules
N. folded with thready chromatin
Turns into macro-phage in tissues
L/Group12
L/Group12
largely in
L/Group12
liver.
Remember
B.M.donor
r injected in patient [B.M.
recipient]
CBC
Peripheral
Blood smear
(PBS)
Q7.Routine
Diagnostic Tools
in
Hematology
bone marrow
aspiration
bone marrow
trephine biopsy
L/Group12
CBC
L/Group12
fl (femtolitre) = 10-15 L
L/Group12
pg (picogram) =1 0-12 g
L/Group12
Bone Marrow
Trephine Biopsy
L/Group12
##Absolute
count
L/Group12
L/Group12
L/Group12
Anemia (s)
Reduction in Hb.Conc.
Red Cell count
below normal
for age and sex
Is a Hb conc. of 12 g/dL anemia?
Hb
(g/dL)
Male
13-17
(152)
Female
12-15
(13.5 1.5)
L/Group12
Anemias
di-phospho- 2,3
glycerate
O2
DPG 2,3
Anemia
HYPOXIA
Re-distribution
Delivery
COMPENSATORY
MECHANISMS
.C.O
cardiac
output
Plasma
PATHOPHYSIOLOGY
OF ANEMAIS
For specific
features
Pls, refer to different
types
of anemia in text
Gastro-intestinal
System
General
Cardio-Respiratory
System
Genito-urinary
System
Anemias
ETIOLOGIC
Classification
ACUTE
normocytic normochromic
CHRONICrefer to IDA
microcytic hypochromic
Hemorrhagic
anemia (s)
II
Dys-hemopoietic
Anemia (s)
Deficiency
Non
deficiency
III
Hemolytic
anemia (s)
Abnormalities of
RC
L/Group12
Abnormalities of
RC
environment
Anemias
MORPHOLOGIC
Classification
I
Normocytic
Normochromic
II
Microcytic
Hypochromic
anemia (s)
IDA
Thalassemi
as
1/3 ACD
anemia (s)
2/3 ACD
III
Macrocytic
anemia (s)
Megaloblastic
L/Group12