Introduction To Hematology

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Hematopoiesis

Classification of Anemias
 Size  Progressive reduction
 Nucleus  First condenses, then
pyknotic finally
extruded

Hemoglobin synthesis Occurs in the cytoplasm


 Before Hb synthesis  Basophilic

 When Hb appears  Polychromatic

 When Hb synthesis  Eosinophilic

complete
 Results in the production of Neutrophils, Eosinophils,
Basophils & Monocytes.
 Stages: Myeloblast, Promyelocyte, Myelocyte,
Metamyelocyte, Band form, Polymorphonuclear
leucocyte.
 Is the process of platelet formation.
 Stages: Megakaryoblast, Promegakaryoblast,
Megakaryocyte, Platelets.
 Platelets are fragments of the cytoplasm of
Megakaryocytes.
 Normal platelet count: 150 – 450 x 109
 Size: Ranges from 6.7-7.7  : Ranges from 6.7-7.7 µm
µm  120 days
 Life span 120 days

 Red cell Indices


 82-100
MCV
 27-32 fL
MCH
 31-35
MCHC  11.5-14
RDW
MCV – Average volume of the RBC femtolitres.(fL)
MCH – Average content of Hemoglobin per RBC and is
expressed in picograms.
MCHC – Average concentration of hemoglobin in a
given volume of packed red cells and is expressed in
grams per deciliter.
RDW – is a quantitative measure of anisocytosis (%)
 Anemia is defined as a reduction of the total
circulating red cell mass below normal limits

 Decrease below normal of the Hemoglobin


concentration, Erythrocyte count or
Hematocrit.
 Functionally a decrease in the oxygen
carrying capacity of the blood which leads to
tissue hypoxia.
 Microcytic Hypochromic anemia.
 Normocytic Normochromic anemia.
 Macrocytic Normochromic anemia
ANEMIAS DUE TO IMPAIRED RED CELL
PRODUCTION

HEMOLYTIC ANEMIAS DUE TO INCREASED


RED CELL DESTRUCTION

ANEMIA DUE TO BLOOD LOSS


Nutritional anemias
 Iron Deficiency anemia
 Vit B12 & Folic acid deficiencies

Immune mediated injury to progenitors


 Aplasticanemia
 Pure Red Cell Aplasia
Primary Hematopoietic Neoplasms
 Acute Leukemia
 Myelodysplastic syndrome
 Myeloproliferative neoplasms

 Miscellaneous
Anemia of Chronic disease
Marrow suppression due to drugs
ANEMIAS DUE TO IMPAIRED RED CELL
PRODUCTION

HEMOLYTIC ANEMIAS DUE TO INCREASED


RED CELL DESTRUCTION

ANEMIA DUE TO BLOOD LOSS


 Intra corpuscular defect
 Hereditary Hemolytic anemias
 Red Cell enzyme deficiencies
 G6PD enzyme deficiency
 Pyruvate Kinase deficiency
 Red Cell Membrane Disorders
 Herediary Spherocytosis
 Hereditary Elliptocytosis
 Hemoglobin Abnormalities

 Thalassemia – Deficient Globin synthesis

 Sickle Cell Disease – Structurally abnormal


Hemoglobins

 AcquiredGenetic defects
 Paroxysmal Nocturnal Hemoglobinuria
 Extra corpuscular defects
 Immune hemolytic anemia
 Hypersplenism
ANEMIAS DUE TO IMPAIRED RED CELL
PRODUCTION

HEMOLYTIC ANEMIAS DUE TO INCREASED


RED CELL DESTRUCTION

ANEMIA DUE TO BLOOD LOSS


 Acute Blood loss – Trauma
 Chronic Blood loss – Bleeding from the GI or
Urinary Tract.
 Due to tissue Hypoxia
 Weakness, Malaise, Easy fatigability.
 Dyspnea on exertion
 Pallor
 Headache, Vertigo, Tinnitus and Lack of
concentration
 Palpitation, Tachycardia, Cardiac murmurs due to
compensatory increase in cardiac output
 Anemia is defined as the decrease below normal of
the hemoglobin concentration, erythrocyte count or
hematocrit.
 Classified morphologically and etiologically
 Symptoms are due to hypoxia and cardiac
compensation.
 Red Cell Indices
 Define and Classify Anemias
 Mention the morphological and etiological
classification of Anemias.

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