Hematologic System
Chapter 11
Components of Blood
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Plasma (liquid protein): carries antibodies and nutrients
to tissues and carries waste away
Cells
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Erythrocytes: carry oxygen to the tissues and removes
carbon dioxide
Leukocytes: manage the inflammatory and immune
responses
Thrombocytes: control clotting
(Made in the Bone Marrow)
List off the components of blood to your neighbor.
Pathophysiologic Changes
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Erythropoiesis (formation of red blood cells)
Hypoxia stimulates RBC production:
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Lack of oxygen in the tissues (hypoxia) releases a hormone that is
stored in the kidneys and the liver, called erythropoietin.
Erythropoietin stimulates the bone marrow to convert some of the
stem cells stored there to red blood cells. (This conversion requires
Vitamin B12, Folic Acid, Copper, cobalt, and Iron.
From lecture by Suanne Petroff, RNCS, FNP, CNN http://www.hdcn.com/symp/05anna/02/pet1/pet1.htm
From lecture by Suanne Petroff, RNCS, FNP, CNN http://www.hdcn.com/symp/05anna/02/pet1/pet1.htm
From lecture by Suanne Petroff, RNCS, FNP, CNN http://www.hdcn.com/symp/05anna/02/pet1/pet1.htm
Pathophysiologic Changes
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Hemoglobin
It is the major component of the red blood cell.
 It consists of an iron-containing molecule (heme) bound to
a protein called globulin.
 It is the heme component that binds to oxygen.
 The oxygen molecule is released to the tissue, and
carbon dioxide and hydrogen are picked up from the
tissue and transported by the hemoglobin to the lungs.
 In the lungs, the CO2 and H+ are released to the
environment.

http://www.youtube.com/watch?v=_ZV5140
OykE&feature=player_embedded
Disorders: Folic Acid Deficiency
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A type of megaloblastic anemia
Causes of this type of anemia are:
 Alcohol abuse
 Diet with low folic acid intake (less than 50 mcg/day)
 Conditions where high quantities of folic acid are
needed (pregnancy; rapid growth during infancy,
childhood, and adolescence; cancer)
 Impaired absorption of folic acid.
Disorders: Folic Acid Deficiency
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Signs and Symptoms
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Fatigue
Shortness of breath
Pallor
Weakness
Glossitis
Irritability and forgetfulness
Prevention/Treatment
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Diet rich in folic acid
Supplementation
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Age 14 and older: 400 mcg/day
Disorders: Pernicious Anemia (Vitamin B12
Deficiency Anemia)
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A type of megaloblastic anemia
Caused by a malabsorption or a dietary deficiency of Vitamin
B12
Signs and Symptoms:
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Weakness
Pallor
Sore tongue
Numbness and tingling in the extremities
More severe Neurologic symptoms:
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Weakness in the extremities, Lack of coordination, ataxia, double or
blurred vision, delirium
Prevention/Treatment:
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Injections of Vitamin B12
QW: Describe Folic Acid deficiency and Vitamin
B12 deficiency.
Disorders: Iron Deficiency Anemia
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A type of microcytic anemia
The most common anemia in the US
Caused by a problem in the quantity/quality of
hemoglobin
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Blood loss due to heavy menses, gastro-intestinal bleed,
hemorrhage,
Inadequate dietary intake of iron (< 1-2mg/day)
Malabsorption
Pregnancy
Disorders: Iron Deficiency Anemia
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Signs and Symptoms
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Initially, asymptomatic
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Extreme Fatigue
Pallor
Shortness of breath
Dizziness
Headache
Inability to concentrate and irritability
Sore tongue
Cracks in the sides of the mouth
Brittle nails
Unusual cravings for non-nutritive substances (pica) such
as ice, dirt, paint, starch)
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Disorders: Iron Deficiency Anemia
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Prevention/Treatment
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Diet with Iron-rich foods (meat, egg yolks, beans)
Eat iron-rich foods along with Vitamin C-rich foods (tomatoes,
broccoli)
Take iron supplements if needed (remember too much iron
is toxic!)
Disorders: Thrombocytopenia
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Deficiency in circulating platelets.
Causes of Thrombocytopenia:
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Blood loss
Bone marrow suppression, as in
leukemia, aplastic anemia, drug
toxicity
Platelet destruction (cirrhosis, severe
infection)
Sequestration in the spleen
Signs and Symptoms:
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Petechia, bleeding into the mucous
membrane, other spontaneous bleeds
Malaise, fatigue, general weakness
Disorders: Sickle Cell Anemia
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Congenital hemolytic anemia
Cause: mutation of hemoglobin S gene seen in those of
African, Mediterranean, or East Indian ancestry which
causes the red blood cells to sickle when there is hypoxia
(due to infection, exposure to cold, high altitude,
overexertion). This sickling produces hemolysis and tissue
infarctions.
Signs and Symptoms of a sickling crisis:
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Severe pain
Jaundice
Prevention/Treatment
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Hydration
Oxygen
Pain medication
Blood transfusion