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Major function of blood

transport nutrients and aid in removal of wastes.

Elements of blood

55% plasma 45% RBC, WBC & platelets

Avg supply of blood in adult

5-6 liters or 1.5 gallons

pH of blood


Life span of RBC

120 days

Filters out worn RBCs

spleen & liver - also save iron for new RBCs


component of RBC transports O2

WBC > 11,000

sign of infection



Phases of blood coagulation

1. platelets & plasma protiens clump- thromboplastin formed
2. prothrombin converted to thrombin in presence of calcium
3. thrombin & fibrinogen form fibrin w/ calcium fibrin clot forms
4. clot is removed thru fibrinolysis

Type A blood

has A antigens and anti B antibodies

Type B blood

has B antigens and anti A antibodies

Type AB Blood

has A&B antigens and NO antibodies

Type O blood

has NO antigens but both A&B anti-bodies

Blood forming organs

lymph nodes, bone marrow, spleen & liver

Where is bone marrow?

center of long bones and in the spongy part of other bones

Where is the spleen?

ULQ of abd

What does the spleen do?

produces lymphocytes, plasma cells & antibodies, filters MO's and removes old blood cells from body

Where is the liver?

URQ of abd

What does liver do in regards to blood formation?

blood forming intrauterine, produces thrombin & fibrinogen for clotting.


decrease in red blood cells leads to anemia

Anemia description

low or decreased RBC volume; any decrease in O2 carrying ability of the RBC. 400 types. 3 common

Anemia Symptoms

low erythrocyte count, headace, fatigue, pallor & shortness of breath.


conditino of increased RBC's

Erthrocytosis Symptoms

high RBC count, reddened skin tones, bloodshot eyes, increased blood volume & pressure and an increase in workload of the heart.


decrease in WBC count

Neurtopenia & lymphonpenia

neurtophil & lumphocyte decreases. Can be associated with chronic infection.


increase in WBCs. Normal repsonse to acute infection.


"white blood" Leukoctyosis related to a tumor WBC count is EXTREME.


decrease in platelets leading to coagulation problem


small hemorrhages in the skin


large areas of bruising or hemorrhage



S/S of Thrombocytopenia

petechiae, ecchymosies, epitaxis, bleeding lesions in the mouth, gums & mucous membranes


increase in plateles. uncommon and usually no serious side effects

Anemia Et

due to low number or RBCs or decrease in hemoglobin in RBCs.. Acute hemorrhage or chronic bleeding, diseases of blood forming organs, abnormal cell formation, dietary definciencies.

S/S of Anemia

Pallor, weakness, fatigue, dyspnea, tachycardia, tachypnea, headache, irritability & syncope



Anemia DX

simple case: history, PE, hemoglobin levels, hematocrit, iron, folic acid & B12 levels. Examination of size & shape of RBC

Anemia Prev

healthy diet high in iron & Bcomplex vitamins. some are not preventable.

Iron Deficency Anemia

insufficient iron for body to produce hemoglobin w/in RBC

Iron Def Anemia ET

loss of iron, inadequate intake of iron, bleeding hemorrhoids, GI bleed & heavy &/or prolonged menses.

Iron Def Anemia Symptoms

pallor, weakness, fatigue, dyspnea, tachycardia, tachypnea

Iron Def Anemia Dx

History, P/E, blood tests shwoing low levels of hemoglobin, iron or both. Also may look for blood in urine & stool. Gastroscopy & colonoscopy.

Iron Def Anemia Tmt

reslove bleeding problem, increase dietary intake of iron - fruits, green veg, lean meat, whole grains

Iron Def Anemia Prev

eating healthy diet high in iron. Seek med help at first sign of excessive bleeding.

Folic Acid Anemia

Definicy in folic acid - beeded for maturation of RBC. Folic Acid is a B complex vitamin

Folic Acid Anemia ET

poor diet, overcooking veg, alcoholism during time of high need as in infancy & pregnancy

Folic Acid Anemia Symptoms

fatigue, weight loss, abd pain, black or bloody stools, chest pain.

Folic Acid Anemia Dx

blood tests. CBC show abnormally large RBC. Blood folate level is low. Bone marrow (rarely needed) biopsy will show large red cell size.

Folic Acid Anemia TMT

increase dietary intake of folic acid: green leafy veg, mushrooms, lima beans & kidney beans.

Folic Acid Anemaia Prev

diet high in folic acid

Vitamin B12 Deficiency Anemia AKA

AKA Pernicous Anemia

Pernicous Anemia Descrp

usually older folks. Autoimmune disease blocks production of intrinsic factor needed for B12 absorption.

Causes of inability to absorb B12

removal of small intestine, disease of small intestine (Crohn's), diet deficint in B12, loss or lack of intrinsic factor.

Pernicous Anemia S/S

pallor, fatigue, weakness, confusion, depression numbness in hands & feet.

Pernicous Anemia DX

Thorough history & physical, CBC, tesing for B12, gastroscopy.

Pernicous Anemia TMT

Absorption & diet def: oral vitamins or injectable B12 or diet high in B12. No intrinsic factor: B12 injections for life

Pernicous Anemia Prev

diet high in vit B12, otherwise not preventable.

Hemolytic Anemia

Anemia characterized by increased RBC destruction

Hemolytic Anemia ET

Anemia related to antigen-antibody reaction, auto immune leading to destruction of one's own RBC, exposure to benzene, asprin, penicilin & bacterial toxins

Hemolytic S/S

pallor, weakness, fatigue, tachycardia (can lead to heart failure)

Hemolytic Anemia DX

History, P/E, blood tests. CBC will reveal anemia. Blood smear will show increase # of immature & fragmented RBC.

Hemolytic Anemia TMT

total exchange of blood; steroids & splenectomy

Hemolytic Anemia Prev

genetic = not preventable. Acquired can be avoided by proper blood screening for transfusions.

Sickle Cell Anemia

Hereditary in African Americans & Mediteraninans.Carried by mother, both sexes can get it, predominatly males

Sickle Cell Anemia S/S

Swelling joints, pain etc

Sickle Cell Anemia TMT

No tmt or cure. Symptoms & complicatins can be prevented or delayed with tmt.

2ndary Polycythemia (Erythrocytosis)

differs from primary in that only RBCs increase

2ndary Polycythemia ET

protective mech of body for increased O2 requirements. Highly trained athletes, high altitude living, smoking.

2ndary Polycythemia S/S

heaches, weakness, fatigue, lightheadedness, shortness of breath. If due to disease of lungs, reddened face & blue during exercise or exertion.

2ndary Polycythemia DX

History, P/E, blood testing. ABG (arterial blood gasses) test can show low O2 levels as well as normal or low ertythropoietin levels. Xray & CT rule out liver, kidney & spleen issues or tumors.

Secondary Polycythemia TMT

Address causes. Lungs: stop smoking.

Secondary Polycythemia Prev

some cases can be prevented by stopping causative factor or by not doing things that deprive the body of O2. Living at high altitude or smoking can be avoided.

Common symptom of WBC disorders

Compromised immune response


Infections aka "kissing disease" or "mono". Affects children & young adults. Somewhat contagious & illness can lasts for several weeks.

Mononucleosis ET

Caused by EBV (Epstein Barr virus). Many people are carriers or exposed and never develop disease. spread by direct contact with saliva, sharing utensils, drinking straws, kissing.

Mononucleosis Symptoms

Begin 4-7 days after infection. Fatigue, sore throat, fever, swollen lymph glands & splenomegaly.

Mononucleosis DX

hstory, P/E & WBC count showing marked elevation in monocytes.

Mononucleosis TMT

symptomatic only. rest, analgesics, throat gargles w/out complications symptoms are resolved in 3-4 weeks. No sports activities for 1 month following to avoid spleen injury.

Mononucleosis Prev

Frequent hand washing, covering mouth and nose when sneezing or coughing, not sharing drinks or eating utensils.


Malignant neoplasm of teh blood forming organs. Abnormally high production of immature leukocytes that function abnormally and cause decrease in prod. of RBC and platelets.

Acute Leukemia

commonly affects children, progresses rapidly and can be fatal.

Chronic Leukemia

occurs more often in older adults, often asymptomatic & may not cause death.

Myelogenous Leukemia

Leukemia affecting the bone marrow

Lymphocytic Leukemia

Leukemia affecting the lymph nodes

Leukemia ET

cause is unknown

Leukemia Symptoms

Fatigue, headache, sore throat, dyspnea, bleeding of mucus membranes of the mouth & GI sys, bone & joint pain. Enlargement of lymph nodes, liver & spleen. Bleeding disorders & anemia common due to erythrocytopenia & thrombocytopenia.

Leukemia DX

clinical history & blood studies. Bone marrow biopsy most definitive to confirm Dx

Leukemia TMT

aggressive chemo. When in remission, bone marrow transplant. Pain for megaly of spleen, lymph nodes & liver treated w/ analgesics. Complete remission abt 50%.

Leukemia Prevention

No known way to prevent, although avoiding toxic chems, smoking & radiation may prevent some forms.


aka thrombocytopenia purpura. Decrease in platelets leading to inability to clot normally.

Thrombocytopenia ET

inadequate or abnormal platelet production or destruction. In destruction, platlet life may be only hours instead of days.

Idiopathic Thrombocytopenia

Thrombocytopenia purpura

Thrombocytopenia Symptoms

Abnormal bleeding in the skin, mucous membranes & internal organs. Petechiae & ecchymoses. GI hemorrhages, frequent epitaxis & hematuria

Thrombocytopenia Dx

clinical history, platlet count & bleeding time.

Thrombocytopenia Tmt

Avoiding tissue trauma, admin of vitamin K to improve clotting, transfussion of platelets. Persistant leads to splenectomy.

Thrombocytopenia Prevention

Most cases not preventable. Certain ones are: avoid meds that decrease platelet stickiness (asprin & ibuprophen). Avoid heavy drinking (slows platelet production)


Hereditary hemolytic anemia primarly of Mediterranean folks. RBCs are fragile, thin & form defective hemoglobin. RBCs do not functino normally & lead to sys of anemia.

Cooley's Anemia

Thalassemia Major. Most severe form of disease and presents in childhood

Von Willebrand's Disease

Hereditary, congenital bleeding disorder caused by deficiency in clotting factor and platelet function. Males & females.


Von willebrand's Disease

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