Objectives. But first: What s in blood? Introduction. Overview: Erythrocytes. Erythrocytes, cont. 4/10/2016
|
|
- Logan Ramsey
- 5 years ago
- Views:
Transcription
1 Objectives Nutritional Deficiencies That May Cause Anemia 1. Discuss the role that various nutrients play in red blood cell formation. 2. List sources of nutrients involved in red blood cell formation. 3. Describe the clinical and laboratory features of anemias related to nutrient deficits. Lee Ellen Brunson-Sicilia, MHS, MLS(ASCP) CM Introduction Anemia Functionally defined as a decrease in the competence of blood to carry oxygen to tissues Decrease in the normal concentration of hemoglobin (Hgb) and/or erythrocytes (RBCs) One of the most common problems encountered in clinical medicine Is not a disease Cause must be identified for proper treatment But first: What s in blood? Overview: Erythrocytes Red blood cells (RBC) Produced in bone marrow Anucleate Biconcave disks 120-day life span Do not normally leave the vessel Primary Functions: Carry O 2 to tissues Carry CO 2 lungs (via hemoglobin) Erythrocytes, cont million/µl 1
2 Overview: Hemoglobin (Hgb) The iron-containing pigment of the red blood cells that functions to carry oxygen from the lungs to the tissue 33% of RBC volume 90% of dry RBC weight 1 Hgb = 4 heme rings + 4 globin chains + 4 iron atoms 1 hemoglobin carries 4 O 2 molecules Hgb Structure Where is Hgb made? How does anemia develop? Anemia develops if: The bone marrow RBC production is impaired. RBC loss or destruction exceeds the maximum capacity of the marrow RBC production. The bone marrow must increase production to meet demands of anemia. Marrow can compensate for decreased survival, to a point. Usual Diagnostic Criteria Decreased Hgb Hematocrit Packed RBC volume Tells what fraction of patient s whole blood is RBCs Decreased Hct 2
3 Interpretation of Abnormal Hgb Concentrations Screening for anemia High altitudes Cigarette smoking Males Newborns To correctly diagnose anemia the physician needs patient history, physical examination, symptoms, and laboratory test results. Insert Table 8-5 Signs and Symptoms of Anemia Insert Table 8-6 May range from slight fatigue or barely noticeable physiologic changes to life-threatening reactions Depends on: Rate of onset Severity of decreased production or blood loss Ability of body to adapt General Physical Findings Fatigue Lethargy Skin pallor Dyspnea Pale conjunctiva Hypotension Heart abnormalities Enlarged organs Adaptations to Anemia Increase in erythropoietin production Increase in oxygenated blood flow Cardiac output and circulation rate Blood flow to vital organs (heart and brain) Oxygen uptake Deepening the amount of inspiration Increase respiration rate Increase in oxygen utilization by tissue 3
4 Adaptations to Anemia Patients respond differently to similar changes in Hgb Severity of anemia Competency of the cardiovascular and respiratory systems O 2 requirements of the individual (physical and metabolic activity) Duration of the anemia Disease or condition that caused the anemia Presence and severity of coexisting disease Causes of Anemia Nutritional deficit Blood loss Bone marrow disorders Accelerated RBC destruction Stem cell arrest or damage Hereditary Nutrients Required for RBC Production Iron Vitamin B 12 Folate Iron in the body Iron Deficiency Iron is required by every cell in the body Generation of energy Cellular growth and proliferation Oxygen transport Total concentration is ~20mg/lb body weight Hgb makes up major fraction of body iron: 0.5mg iron/ml blood 4
5 Iron in the body, cont mL RBC destroyed each day 85% recycled to developing RBC in bone marrow Rest is stored in liver, GI tract and marrow Very limited mechanism for excretion Lose ~1 mg per day Daily intake requirement for iron is 1 mg Iron Balance Iron overload can result if body s capacity is exceeded Critical processes inhibited if iron is limited Iron Transport Transferrin (Tf) Plasma transport protein, made in the liver 2 homologous lobes Each lobe contains an iron-binding site for Fe 3+ Mediates iron exchange between RBC and the tissues Iron Storage Iron Storage Ferritin Short-term storage for iron Readily available for erythropoiesis Found in the bone marrow, liver, spleen Serum levels reflect tissue storage Caution: Ferritin increases in the presence of inflammation could mask anemia. Hemosiderin Long-term storage for iron; iron released slowly Bone marrow and liver primarily Yellow to brown refractile inclusions 5
6 Iron Absorption Foods Rich in Iron Iron homeostasis depends on balance of Absorption of iron Total body requirements 2 forms of dietary iron Heme iron (ferrous) animal sources Non-heme iron (ferric) vegetables Heme iron Beef or chicken liver Clams or mussels Oysters Non-heme iron Soybeans Lentils Pinto beans Garbanzo beans Tofu Enriched breakfast cereals Impact Iron Absorption Factors Affecting GI Iron Absorption Enhance Orange juice Vitamin C Pickles Soy Sauce Vinegar Alcohol Inhibit Tea Coffee Oregano Cow s milk Calcium Some medications Prevacid Prilosec Availability of iron Condition of GI tract Activity of bone marrow Tissue iron stores Oxygen content of blood Systemic inflammation or infection Hgb concentration in blood Lab Assessment of Iron Serum Iron iron in serum Serum Ferritin iron in storage Transferrin saturation % bound with iron Iron Deficiency Anemia (IDA) Most common nutritional deficiency in the world Prevalent in countries where Unfortified grain major part of diet Meat is scarce Hookworm infestation is common TIBC total iron binding capacity 6
7 Causes of IDA Increased iron demands Growth spurts in infants and children Pregnancy and nursing Lack of iron intake Poor diet Conditions that diminish absorption Causes, cont. Blood loss Menorrhagia women of child-bearing age GI bleed men and post-menopausal women Ulcers Hiatal hernias Alcoholic gastritis Excessive aspirin ingestion Hemorrhoids Hookworm infestation Pathophysiology IDA develops in sequential stages Due to a negative iron balance: losing more iron than is absorbed Stages Iron depletion Iron deficient erythropoiesis Iron deficiency anemia (IDA) Pathophysiology Stage I Iron depletion Iron stores are exhausted: serum ferritin Serum iron and transferrin saturation in peripheral blood still normal. No anemia RBC morphology is normal. Iron absorption in gut. Pathophysiology Stage 2 Iron deficient erythropoiesis Ferritin and hemosiderin depleted Serum iron and serum ferritin, TIBC Transferrin saturation Hgb still normal RBCs may be slightly microcytic Pathophysiology Stage 3 IDA All lab tests for iron status become abnormal Microcytic, hypochromic anemia Represents advanced stage of severe iron deficiency 7
8 Clinical Features Onset is usually insidious Takes months to years (more rapid if blood loss) Symptoms appear as anemia develops Variety of other abnormalities appear Koilonychia - concavity of nails Glossitis inflammation of the tongue Muscle dysfunction Inability to regulate body temperature Gastritis Heart palpitations Koilonychia Glossitis Clinical Features Pica syndrome Unusual craving for ingesting unnatural items Phagophagia (ice-eating) Geophagia (dirt/clay-eating) Amylophagia (starch-eating) Infants: perform worse in mental and motor development Children: irritability, loss of memory, difficulties in learning Laboratory Features of IDA Peripheral blood Microcytic (small): MCV Hypochromic (pale): MCHC Variation in RBC size (anisocytosis) Variation in RBC shape (poikilocytosis) Target cells, elliptocytes, teardrop cells Decreased PLT count Microcytic, hypochromic anemia of iron deficiency. Compare size of RBCs to nucleus of small lymphocyte in center. Laboratory Features Bone marrow Mild to moderate erythroid hyperplasia Ineffective erythropoiesis Erythroblasts poorly hemoglobinized Iron stores Depleted serum ferritin Absent hemosiderin in tissues 8
9 Therapy Treat underlying disorder Administer iron Oral administration Parenteral administration Observe for response Defined as an of 1 gm/hemoglobin in 1 month Retic response begins about the 3 rd day Hgb normal within 6-10 weeks B 12 and Folate Deficiencies B 12 and folate in the body Both required for DNA synthesis and cell maturation Deficiency in either will affect all blood cell lines: RBCs, WBCs and PLTs. Deficiencies cause megaloblastic anemia Vitamin B 12 Also called cobalamin Required for neurologic function Present in most foods of animal origin ~3-5 μg/day is needed for normal functions Only 70% taken in is absorbed in GI tract Half stored in liver, rest is in heart and kidneys Organ stores last 3-5 years B 12 Absorption Released from food by peptic digestion at a low ph in the stomach Binds to intrinsic factor (IF) from parietal cells that line the GI tract IF-B 12 complex resists digestion, is taken to mucosal cells in lower small intestine. Vitamin B 12 is taken to tissues via bloodstream, bound to transcobalamin. 9
10 Clams Beef liver Fortified breakfast cereals Trout Salmon Tuna Foods Rich in B 12 Vitamin B 12 Deficiency: Pernicious Anemia Most common cause of B12 deficiency Caused by absence of IF secondary to immune destruction of gastric mucosa Vitamin B 12 can not be absorbed Disease of older adults: > 40 years of age Autoimmune disease Most common in persons of Scandinavian and northern European ancestry Other Causes of B 12 Malabsorption Gastrectomy or intestinal resection Diseases that prevent binding of IF-B 12 complex in the ileum: Crohn s disease, Celiac disease Bacterial overgrowth Tapeworm infestation Certain medications Prevacid, Prilosec Pepcid, Zantac Metformin Other Causes of Vitamin B 12 Deficiency Nutritional deficiency Rare in the U.S. Vegetarians Pregnant women Other causes Transcobalamin deficiency Nitrous oxide abuse Defective IF receptors in ileum Zollinger-Ellison syndrome Folate Folate is a B-vitamin that is naturally present in many foods. A form of folate, called folic acid, is used in dietary supplements and fortified foods. 1998: FDA requires food companies to add folic acid to grain products sold in the U.S. Recommended daily intake: Adults ~400μg Liver stores: 3-6 month supply Folate Absorption Takes place throughout the small intestine Most absorption takes place in upper portion of small intestine (proximal jejunum). Crosses into bloodstream and is transported throughout the body 10
11 Beef liver Spinach Black-eyed peas Fortified cereals White rice Asparagus Enriched pastas Brussels sprouts Foods Rich in Folate* *NOTE: Folate is destroyed by heat. Folate Importance Embryogenesis Neural tube defects: Spina bifida Cleft palate Anencephaly Growth Pregnancy Lactation Causes of folate deficiency Inadequate diet Most often seen in poor and elderly Alcoholics Increased requirement Hemolytic anemias Myeloproliferative disorders Metastatic cancers Pregnancy Causes of folic acid deficiency Malabsorption Intestinal diseases affecting the upper small intestine: Crohn s disease, Celiac disease Overgrowth of bacteria Drug inhibition Oral contraceptives Long-term anticoagulant drugs Anti-epileptics: Dilantin, Carbatrol, Depacon Megaloblastic: Clinical Findings Onset is insidious Anemic symptoms Other symptoms Digestive tract Genitourinary tract Lemon yellow skin Neurological disturbances Megaloblastic: Clinical Findings Vitamin B 12 deficiency only Neurological disturbances Tingling, numbness, weakness of the extremities Abnormal gait Loss of memory, depression, irritability; megaloblastic madness 11
12 Megaloblastic Anemia 95% of megaloblastic anemias Deficiency of folic acid ( intake) Deficiency of vitamin B 12 ( intrinsic factor) Megaloblastic Anemia Very large RBCs and precursors in marrow: megaloblasts Very large RBCs in peripheral blood ( MCV) Nuclear maturation defect Anemia Due to ineffective hematopoiesis (not Hgb defect) Disrupted DNA development Delayed nuclear maturation prevents cell division Megaloblastic: Lab Findings Peripheral blood Macrocytic, normochromic anemia Affects all 3 cell lines: RBC, WBC, PLT Megaloblastic: Lab Findings Distinguishing features on blood smear Oval macrocytes Howell-Jolly Bodies Hypersegmented neutrophils > 5 lobes Can be seen in the absence of macrocytosis Sensitive and specific for megaloblastic anemia Anisocytosis and poikilocytosis Reticulocytopenia 12
13 Megaloblastic: Lab Findings FIGURE 12-4 Basophilic and orthochromatic megaloblasts in the bone marrow from a patient with pernicious anemia. Note the large size of the cells, the open chromatin network in the nuclei, and the presence of Howell-Jolly bodies in the orthochromatic megaloblasts. There is also a large band neutrophil and segmented neutrophil with five nuclear lobes. Bone marrow Hypercellular ½ of RBC precursors show megaloblastic changes Megaloblastic: Lab Findings Vitamin B 12 levels Serum folate Intermediates in folate and vitamin B 12 metabolism Methylmalonic acid (MMA) Normal in folate def. in vitamin B 12 def. Homocysteine levels in both vitamin B 12 and folate def. Megaloblastic: Lab Findings Ineffective erythropoiesis results in hemolysis in the marrow, causing increases in: Serum iron Indirect bilirubin Urobilinogen Lactate dehydrogenase Therapy First determine which deficiency exists Vitamin B 12 or Folate Oral supplements if malabsorption is not cause IM injections B 12 : sublingual tablets or intranasal gels Therapy, cont. Specific therapy Marrow responds rapidly to correct treatment Retic response after 4 th day Hgb rises ~2-3 g/dl every 2 weeks WBC abnormalities disappear more slowly days Reverse peripheral neuropathy of vitamin B 12 deficiency PA lifelong therapy 13
14 References McKenzie, Shirlyn B., Clinical Laboratory Hematology, 3 rd ed. Pearson, Greer, John P., et al. Wintrobe s Clinical Hematology, 12 th ed. Lippincott Williams & Wilkins, National Institutes of Health, Office of Dietary Supplements website: 14
Objectives. But first: What s in blood? Introduction. Overview: Erythrocytes. Erythrocytes, cont. 4/21/2016
Objectives Nutritional Deficiencies That May Cause Anemia Lee Ellen Brunson-Sicilia, MHS, MLS(ASCP) CM 1. Discuss the role that various nutrients play in red blood cell formation. 2. List sources of nutrients
More informationDefinition Aetiology
Definition Anaemia is a fall in haemoglobin below the reference ranges for age and sex (adult female
More informationHematopoiesis, The hematopoietic machinery requires a constant supply iron, vitamin B 12, and folic acid.
Hematopoiesis, 200 billion new blood cells per day The hematopoietic machinery requires a constant supply iron, vitamin B 12, and folic acid. hematopoietic growth factors, proteins that regulate the proliferation
More informationNUTRITIONAL CARE IN ANEMIA
االله الرحمن الرحيم بسم NUTRITIONAL CARE IN ANEMIA Nutrition Departement Faculty of Medicine University of North Sumatera Definition Deficit of circulating RBC associated with diminished oxygen-carrying
More informationFaculty of Medicine Dr. Tariq Aladily
Iron deficiency anemia The most common anemia worldwide Only 10% of ingested iron is absorbed Most dietary iron occurs in meat products Absorbed in duodenum Hepcidin By inhibiting ferroportin, hepcidin
More informationL4-Iron Deficiency Anemia (IDA) & Biochemical Investigations
L4-Iron Deficiency Anemia (IDA) & Biochemical Investigations 1 st Year-College of Medicine Hematology Module-Biochemistry Semester II Dr. Basil OM Saleh Objectives Identify stages in development of IDA
More informationI. Definitions. V. Evaluation A. History B. Physical Exam C. Laboratory evaluation D. Bone marrow examination E. Specialty referrals
I. Definitions II. III. Red blood cell life cycle Iron metabolism IV. Causes of anemia A. Kinetic approach 1. decreased production 2. increased destruction 3. blood loss B. Morphologic approach 1. normocytic
More informationMicrocytic Hypochromic Anemia An Approach to Diagnosis
Microcytic Hypochromic Anemia An Approach to Diagnosis Decreased hemoglobin synthesis gives rise to microcytic hypochromic anemias. Hypochromic anemias are characterized by normal cellular proliferation
More informationDrugs Used in Anemia
Drugs Used in Anemia Drugs of Anemia Anemia is defined as a below-normal plasma hemoglobin concentration resulting from: a decreased number of circulating red blood cells or an abnormally low total hemoglobin
More informationDOWNLOAD PDF MACROCYTOSIS AND MACROCYTIC ANAEMIA
Chapter 1 : Macrocytic Anemia- Causes, Symptoms Treatment Macrocytosis is a term used to describe red blood cells that are larger than normal. Anemia is when you have low numbers of properly functioning
More informationLEC 6 Megaloblastic Aneamia
LEC 6 Megaloblastic Aneamia Megaloblastosis is a generalized disorder involving most rapidly growing cells, such as gastrointestinal and uterine cervical mucosal cells. The etiology of megaloblastosis
More information* imagine if the Hb is free ( e.g. hemolysis ) in the plasma what happens?
In this lecture we will talk about Some characteristics of RBC. Erythrpoiesis : * During fetal & adult life. * its regulation. RBCs : - Appear under the microscope as circular,unnucleated and biconcave
More informationNUTRITIONAL ANEMIAS K Y L I E P E T E R S O N & E M I L Y S T E W A R T S A O R I S A K I T A & M A R J O R I E M I L L E R
NUTRITIONAL ANEMIAS K Y L I E P E T E R S O N & E M I L Y S T E W A R T S A O R I S A K I T A & M A R J O R I E M I L L E R ANEMIA Anemia: a deficiency in the size/number of RBC or the amount of hemoglobin
More informationINTERELATIONSHIP BETWEEN IDA AND VITAMIN D DEFICIENCY IS NOW ESTABLISHED
INTERELATIONSHIP BETWEEN IDA AND VITAMIN D DEFICIENCY IS NOW ESTABLISHED Rationale for Combining Iron & Vit-D Vit D deficiency and Iron deficiency Anaemia the two most menacing disorders - are inter-related
More informationGeneral Characterisctics
Anemia General Characterisctics Definition: anemia is a decrease in red blood cells. Happens due to underproduction, increased destruction or loss of red cells. Diagnosis of anemia: Hgb < 135 (men) Hgb
More informationIron deficiency anemia:
بسم هللا الرمحن الرحمي Before we start: Dr. Malik suggested for the third immunity lecture to be a continuation for the hematology pharmacology. And he will discuss the drugs for treating leukemia and
More informationZahraa Muneer. Enas Ajarma. Saleem
2 Zahraa Muneer Enas Ajarma Saleem Blood parameters: 1. RBCs count 2. Haematocrit 3. Haemoglobin content In new-born babies all three parameters of blood are higher than in normal adults. This happens
More informationKehkashan Zehra Hossain. Registered Clinical Dietitian Head of the Department SIUT
Kehkashan Zehra Hossain Registered Clinical Dietitian Head of the Department SIUT Definition Anemia is the deficiency in the size or number of red blood cells or the amount of hemoglobin they contain Krause
More informationIntroduction and Approach to Anemia
2 nd lecture in Hematology by Dr.Alaa Fadhil Alwan Introduction and Approach to Anemia Anemia is defined clinically as a blood hemoglobin or hematocrit value that is below the appropriate reference range
More informationEating to Prevent Iron Deficiency Anemia
Eating to Prevent Iron Deficiency Anemia What is anemia? Anemia is a blood disorder. Anemia is when your body doesn t have enough healthy red blood cells. Anemia can be life threatening. Your blood carries
More informationHematology Unit Lab 1 Review Material
Hematology Unit Lab 1 Review Material - 2018 Objectives Laboratory instructors: 1. Assist students during lab session Students: 1. Review the introductory material 2. Study the case histories provided
More informationRama Nada. -Ensherah Mokheemer. 1 P a g e
- 3 - Rama Nada -Ensherah Mokheemer - 1 P a g e Don t forget to refer to page index wherever you see * Quick revision: In the previous lecture we said that: - your body contains 4-5g of iron (4g in females
More informationYEAR III Pharm.D Dr. V. Chitra
YEAR III Pharm.D Dr. V. Chitra Anemia can be defined as a reduction in the hemoglobin,hematocrit or red cell number. In physiologic terms an anemia is any disorder in which the patient suffers from tissue
More informationChapter 2. ERYTHROPOIESIS and ANEMIA
Chapter 2 ERYTHROPOIESIS and ANEMIA Red Cell Production The Production of red cells, known as erythropoiesis, is a developmental system fundamentally under genetic control but modulated and regulated by
More informationRed cell disorder. Dr. Ahmed Hasan
Red cell disorder Dr. Ahmed Hasan Things to be learned in this lecture Definition and clinical feature of anemia. Classification of anemia. Know some details of microcytic anemia Question of the lecture:
More informationAssessing Iron Deficiency in Adults. Chris Theberge. Iron (Fe) deficiency remains as one of the major global public health problems for
Assessing Iron Deficiency in Adults Chris Theberge Iron (Fe) deficiency remains as one of the major global public health problems for two reasons. It affects about one fourth of the world s population
More informationDo you have Iron Deficient Anemia?
Do you have Iron Deficient Anemia? Do you ever just have this overwhelming feeling all day, every day, that you have no energy?! Ever just sat there thinking, I eat well and healthily, I exercise, I take
More informationJosie Grace C. Castillo, M.D.
Josie Grace C. Castillo, M.D. 2 types of nutrients Macronutrients Carbohydrate Fats Protein Micronutrients Vitamins Minerals 1 Occur when the quantity or quality of food is not sufficient to meet a persons
More informationNutritional anaemia. Dr J Potgieter Dept of Haematology NHLS - TAD
Nutritional anaemia Dr J Potgieter Dept of Haematology NHLS - TAD Classification of anaemia Microcytic, hypochromic MCV < 80fl MCH > 27pg Iron deficiency Anaemia of chronic disease Thalassaemia Lead poisoning
More informationChapter 28. Media Directory. Hematopoiesis. Regulation of Hematopoiesis. Erythropoietin. Drugs for Hematopoietic Disorders
Chapter 28 Drugs for Hematopoietic Disorders Slide 35 Media Directory Epoetin Alfa Animation Upper Saddle River, New Jersey 07458 All rights reserved. Hematopoiesis Figure 28.1 Hematopoiesis Process of
More informationDr. Hasan Fahmawi, MRCP (London), FRCP(Edin) Consultant Physician ANAEMIA
Dr. Hasan Fahmawi, MRCP (London), FRCP(Edin) Consultant Physician ANAEMIA Definition Anaemia refers to a state in which haemoglobin in the blood is below the reference range appropriate for age and
More informationFolic Acid and vitamin B12
Folic Acid and vitamin B12 ILOs: by the end of this lecture, you will be able to: 1. Understand that vitamins are crucial nutrients that are important to health. 2. Know that folic acid and vitamin B12
More informationTypes of Anaemias and their Management. S. Moncrieffe, Pharm.D., MPH, Dip.Ed., RPh. PSJ CE Mandeville Hotel April 27, 2014
Types of Anaemias and their Management S. Moncrieffe, Pharm.D., MPH, Dip.Ed., RPh. PSJ CE Mandeville Hotel April 27, 2014 Objectives At the end of the presentations participants should be able to: 1. Define
More informationHAEMATOLOGICAL EVALUATION OF ANEMIA. Sitalakshmi S Professor and Head Department of Clinical Pathology St John s medical College, Bangalore
HAEMATOLOGICAL EVALUATION OF ANEMIA Sitalakshmi S Professor and Head Department of Clinical Pathology St John s medical College, Bangalore Learning Objectives Laboratory tests for the evaluation of anemia
More informationAround million aged erythrocytes/hour are broken down.
Anemia Degradation ofheme Around 100 200 million aged erythrocytes/hour are broken down. The degradation process starts in reticuloendothelial cells in the spleen, liver, and bone marrow. [1] The tetrapyrrole
More informationPATHOLOGY OF THE HEMATOLYMPHOID SYSTEM 1 AND 2 -INTRODUCTION TO ANEMIA - ANEMIA OF DECREASED PRODUCTION.
PATHOLOGY OF THE HEMATOLYMPHOID SYSTEM 1 AND 2 -INTRODUCTION TO ANEMIA - ANEMIA OF DECREASED PRODUCTION. 1 ANEMIA Anemia is defined as decrease in the RBC mass, it usually is reflected by decrease in hemoglobin
More informationAnemia 1: Fourth year Medical Students/ October/21/ 2015/ Abdallah Abbadi.MD.FRCP Professor
Anemia 1: Fourth year Medical Students/ October/21/ 2015/ Abdallah Abbadi.MD.FRCP Professor Email: abdalla.awidi@gmail.com Main Hematological diseases A- Benign Hematology 1- Anemias 2- Bleeding disorders
More informationIntroduction and II. Blood Cells A. Introduction
Chapter 14: Blood 1. Blood is three to four times more viscous than water. Introduction and II. Blood Cells A. Introduction 2. Most blood cells form in red bone marrow. 3. Types of blood cells are red
More informationMoath Darwish. Waseem Alhaj. Tareq Adely
4 Moath Darwish Waseem Alhaj Tareq Adely Please refer to the slides for pictures. Iron deficiency anemia 1. Iron absorption and regulation a. only 10% of ingested iron are absorbed b. absorption of iron
More informationBlood. Biol 105 Lecture 14 Chapter 11
Blood Biol 105 Lecture 14 Chapter 11 Outline I. Overview of blood II. Functions of blood III. Composition of blood IV. Composition of plasma V. Composition of formed elements VI. Platelets VII. White blood
More information4/5/17. Blood. Blood. Outline. Blood: An Overview. Functions of Blood
Outline Blood Biol 105 Chapter 11 I. Overview of blood II. Functions of blood III. Composition of blood IV. Composition of plasma V. Composition of formed elements VI. Platelets VII. White blood cells
More informationClassification of Anaemia
Classification of Anaemia Dr Roger Pool Department of Haematology NHLS & University of Pretoria MEASUREMENT OF HAEMATOCRIT The haematocrit ratio (Hct) is the proportion of blood made up of cells - mainly
More informationChapter 13. Trace Minerals
Chapter 13 Trace Minerals Minerals in the Human Body The Trace Minerals--An Overview Needed in very small quantities in the body. Perform many essential functions important to health. Toxic levels can
More informationLec.2 Medical Physiology Blood Physiology Z.H.Kamil
Destruction of Red Blood Cells When red blood cells are delivered from the bone marrow into the circulatory system, they normally circulate an average of 120 days before being destroyed. Even though mature
More information3.1.1 Water Soluble Vitamins
3.1.1 Water Soluble Vitamins Overview of Vitamins essential for good health organic molecules individual units regulate body processes micronutrients solubility fat or water Water Soluble Vitamins B-complex;
More informationSusan Stegman, MD Medical Director AXA Equitable Life May 3, 2016
Susan Stegman, MD Medical Director AXA Equitable Life May 3, 2016 Underwriting impact Anemia overview Classification of anemia Specific anemia topics Iron deficiency anemia Thalassemia Megaloblastic anemia
More informationTHE UNIVERSITY OF JORDAN FACULTY OF MEDICINE DEPARTMENT OF PATHOLOGY
THE UNIVERSITY OF JORDAN FACULTY OF MEDICINE DEPARTMENT OF PATHOLOGY INTRODUCTION TO ANEMIA Third year medical students First semester 2018/2019 Dr. RBC DISORDERS Lecturer: Dr. Tariq Al-Adaily Email: TNALADILY@ju.edu.jo
More informationTHE KENYA POLYTECHNIC UNIVERSITY COLLEGE
THE KENYA POLYTECHNIC UNIVERSITY COLLEGE SCHOOL OF HEALTH SCIENCES AND TECHNOLOGY DEPARTMENT OF BIOMEDICAL LABORATORY SCIENCES AND TECHNOLOGY DIPLOMA IN MEDICAL LABORATORY SCIENCE END OF YEAR 1 EXAMINATION
More informationVITAMIN BASICS VITAMIN WHAT IT DOES TOO LITTLE TOO MUCH SOURCES. Night blindness Total blindness Reduced resistance to infection Can lead to death
VITAMIN BASICS VITAMIN WHAT IT DOES TOO LITTLE TOO MUCH SOURCES Fat-Soluble Vitamin A Maintains vision Maintains epithelial tissues (skin) Develops immune cells Bone growth Night blindness Total blindness
More informationORIGINAL ARTICLE CLINICO PATHOLOGICAL REVIEW OF MEGALOBLASTIC ANAEMIA IN CHILDREN- A 7 YEAR PAEDIATRIC HOSPITAL EXPERIENCE
CLINICO PATHOLOGICAL REVIEW OF MEGALOBLASTIC ANAEMIA IN CHILDREN- A 7 YEAR PAEDIATRIC HOSPITAL EXPERIENCE M.Ramani 1, D.Ranganath 2,O.H.RadhikaKrishna 3, K.Geetha 4, M.Keerthika 5, PujaDeshmukh 6, S.P.Krupani7,
More informationHEMATOPOIESIS. HEMATOLOGY Introduction. Study of blood & its components Window of rest of body. Introduction
HEMATOLOGY/ HEMATOPOIESIS Introduction HEMATOLOGY Introduction Study of blood & its components Window of rest of body 1 BLOOD Raison d etre Delivery of nutrients Oxygen Food Vitamins Removal of wastes
More informationAnatomy and Physiology
Anatomy and Physiology For The First Class 2 nd Semester Erythrocytes = Red Blood Cells (RBC) Erythrocytes = Red Blood Cells Red blood cells are biconcave discs, they have no nucleus and cytoplasmic organelles.
More informationTopics of this lecture : RBC. Structural characteristics Hemoglobin Erythropoiesis Erythrocytes destruction
Topics of this lecture : RBC Structural characteristics Hemoglobin Erythropoiesis Erythrocytes destruction Structural characteristics Its small size and biconcave shape provides more surface area than
More informationnamib la UnIVERSITY OF SCIEnCE AnD TECHnOLOGY FACULTY OF HEALTH AND APPLIED SCIENCES DEPARTMENT OF HEALTH SCIENCES
namib la UnIVERSITY OF SCIEnCE AnD TECHnOLOGY FACULTY OF HEALTH AND APPLIED SCIENCES DEPARTMENT OF HEALTH SCIENCES QUALIFICATION: BACHELOR OF BIOMEDICAL SCIENCES QUALIFICATION CODE: SOBBMS LEVEL: 6 COURSE
More informationBONE MARROW PERIPHERAL BLOOD Erythrocyte
None Disclaimer Objectives Define anemia Classify anemia according to pathogenesis & clinical significance Understand Red cell indices Relate the red cell indices with type of anemia Interpret CBC to approach
More informationNUTRITIONAL ANEMIA. IAP UG Teaching slides
NUTRITIONAL ANEMIA 1 DEFINITION Anemia is defined as a condition where the hemoglobin conc. or hematocrit of an individual is lower than the level considered normal for the person s age and sex group.
More informationIron for Your Health
Iron for Your Health Why do we need iron? Iron is an important mineral for health. Iron carries oxygen throughout the body. Most of the iron in the body is found in muscles, where it helps to store oxygen
More informationYear 2003 Paper two: Questions supplied by Tricia
QUESTION 65 A 36-year-old man presents in a post-ictal state after an observed generalised seizure. Full blood investigation shows: haemoglobin 0 g/l [128-175] mean corpuscular volume (MCV) 106 fl [80-7]
More informationAnemia defined. Challenging Case Studies in Laboratory Diagnosis: A focus on anemia
Challenging Case Studies in Laboratory Diagnosis: A focus on anemia Margaret A. Fitzgerald, DNP, FNP-BC BC, NP-C, FAANP, CSP President, Fitzgerald Health Education Associates, Inc., North Andover, MA Family
More informationTHE PHYSIOLOGY OF BLOOD
2 THE PHYSIOLOGY OF BLOOD Objectives 1. ERYTHROCYTES 2. ERYTHROCYTE AGGLUTINOGENES, 3. PLASMA AGGLUTININS 4. TRANSFUSION 5. Practical tasks ERYTHROCYTE COUNT BLOOD GROUPING RH FACTOR CROSSMATCHING TEST
More informationEDUCATIONAL COMMENTARY MORPHOLOGIC CHANGES IN PERIPHERAL BLOOD CELLS
EDUCATIONAL COMMENTARY MORPHOLOGIC CHANGES IN PERIPHERAL BLOOD CELLS Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE
More informationFunctions of Blood. 1. Transportation 2. Protection against invasion 3. Blood clotting 4. Regulation. Blood: Functions Blood clotting
Outline Blood Biol 105 Lecture Packet 13 Chapter 11 I. Overview of blood II. Functions of blood III. Composition of blood IV. Composition of plasma V. Composition of formed elements VI. Platelets VII.
More informationLECTURE-4 VITAMINS DR PAWAN TOSHNIWAL ASSISTANT PROFESSOR BIOCHEMISTRY ZYDUS MEDICAL COLLEGE AND HOSPITAL, DAHOD, GUJARAT DATE
LECTURE-4 VITAMINS DR PAWAN TOSHNIWAL ASSISTANT PROFESSOR BIOCHEMISTRY ZYDUS MEDICAL COLLEGE AND HOSPITAL, DAHOD, GUJARAT DATE-20-12-2018 VITAMIN B 12 VITAMIN B-12 COBALAMIN (COBALT ATOM IN CORRIN RING)
More informationApproach to the child with anemia. Nittaya Wisanuyothin,MD. Pediatrics Department, Maharat Nakhonratchasima Hospital
Approach to the child with anemia Nittaya Wisanuyothin,MD. Pediatrics Department, Maharat Nakhonratchasima Hospital Definition of anemia Hb< 2 SD or P2.5 below the mean for a healthy of the same gender
More informationFOCUS ON IRON-DEFICIENCY ANEMIA AND ITS TREATMENT
FOCUS ON IRON-DEFICIENCY ANEMIA AND ITS TREATMENT What you need to know 8846 In Vivo Takeda Feraheme Flip Chart-v3.indd 1 13-01-16 9:37 AM BLOOD AND ITS IMPORTANCE IN YOUR BODY Blood circulates throughout
More informationBCH 471 Experiment (7) HEMOGIOBIN AND ANEMIA, ERYTHROCYTE SEDIMENTATION RATE (ESR) AND HEMATOCRIT (HCT)
BCH 471 Experiment (7) HEMOGIOBIN AND ANEMIA, ERYTHROCYTE SEDIMENTATION RATE (ESR) AND HEMATOCRIT (HCT) OBJECTIVES 1) Quantitative determination of hemoglobin in a blood sample. 2) Determination of erythrocyte
More informationFolic Acid. Ameer Saadallah Al-Zacko Ahmad Ausama Al-Kazzaz Ahmad Maan Al-Hajar
Folic Acid Ameer Saadallah Al-Zacko Ahmad Ausama Al-Kazzaz Ahmad Maan Al-Hajar Now with Ahmad Maan Al-Hajar Folic acid Folic acid is a water soluble Vitamin which has many forms include folate, vitamin
More informationBiol Chapter 17 Cardiovascular & Blood
Collin County Community College Biol. 2402 Chapter 17 Cardiovascular & Blood 1 CVS and Public Health 2 1 CVS and Public Health 3 Cardio Vascular System 4 2 Cardio Vascular System: BLOOD Functions of Blood
More informationTHE CLASSIFICATION OF ANEMIA*
THE CLASSIFICATION OF ANEMIA* RUSSELL L. HADEN, M.D. SUMMARY A laboratory and clinical classification of anemia has been outlined. The results of the blood study have been correlated with the clinical
More informationInterpreting the CBC. Robert Miller PA Assistant Professor of Clinical Pediatrics and Family Medicine USC Keck School of Medicine Retired
Interpreting the CBC Robert Miller PA Assistant Professor of Clinical Pediatrics and Family Medicine USC Keck School of Medicine Retired The CBC 3 Cell Lines RBCs WBCs Platelets Assess general health Make
More informationAnemia 1: Fourth year Medical Students/ Feb/22/ Abdallah Awidi Abbadi.MD.FRCP.FRCPath Professor
Anemia 1: Fourth year Medical Students/ Feb/22/ 2018 Abdallah Awidi Abbadi.MD.FRCP.FRCPath Professor Email: abdalla.awidi@gmail.com Kidney EPO O2 Sensor Blood vessel Definition: Anemia is operationally
More informationMinerals in the Human Body
Trace Minerals Minerals in the Human Body The Trace Minerals--An Overview Needed in very small quantities in the body. Perform many essential functions important to health. Toxic levels can easily be reached
More informationPhysiological Role: B-vitamins are coenzymes of many enzymes systems of body metabolism. Thiamine {B 1 }
Food Constituents [continued] Micronutrients B-Vitamins The B group of vitamin {water soluble} includes: Thiamine: vitamin B 1, ant beriberi vitamin. Riboflavin: vitamin B 2. Niacin: nicotinic acid, PP
More informationBLOOD. Dr. Vedat Evren
BLOOD Dr. Vedat Evren Blood Liquid suspension of formed elements Blood = Blood cells + plasma Plasma = Coagulation factors + serum Cells = Erythrocytes + Leukocytes + Thrombocytes 8 % of the total body
More informationThe Six Essential Nutrient Groups:
The Six Essential Nutrient Groups: Water: Water transports other nutrients to cells, carries wastes away, aids digestion and more. It makes up more than half your weight. SOURCES: water; juices and
More informationCH 11 Blood OUTLINE: Functions of Blood Composition of Blood Blood Cell Disorders Blood Types Blood Clotting Functions of Blood Transportation
1 CH 11 Blood OUTLINE: Functions of Blood Composition of Blood Blood Cell Disorders Blood Types Functions of Blood Transportation Protection Regulation ph Temperature Composition of Blood Plasma: liquid
More informationAnemia In the Insurance Applicant What do the numbers mean?
Anemia In the Insurance Applicant What do the numbers mean? Lisa Duckett, M.D. Vice President and Medical Director September 12, 2017 Goals of the presentation Develop a consistent way to analyze Complete
More informationNutritional Megaloblastic Anemias DR. NABIL BASHIR HLS, 2018
Nutritional Megaloblastic Anemias DR. NABIL BASHIR HLS, 2018 Definition: Macrocytic Anemia MCV>100fL Impaired DNA formation due to lack of: B12 or folate in ultimately active form use of antimetabolite
More informationHypochromic Anaemias
Hypochromic Anaemias Dr Mere Kende MBBS, MMED (Path), MAACB, MACTM, MACRRM LECTURER-SMHS Anaemia LOW HEMOGLOBIN Anaemia Definition: Hb
More informationEDUCATIONAL COMMENTARY BLOOD CELL IDENTIFICATION
EDUCATIONAL COMMENTARY BLOOD CELL IDENTIFICATION Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click
More informationClinician Blood Panel Results
Page 1 of 8 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
More informationAgenda. Components of blood. Blood is Fluid Connective Tissue. Blood: General functions
Agenda Chapter 19: Blood Major functions Major Components Structure of RBCs and WBCs ABO Blood Types, and Rh Factor Lab 34.1 and Blood Typing Blood: General functions Transport of dissolved gases, nutrients,
More informationTopic owner: Mollie Grow MD MPH, updated June 2018
Iron deficiency Anemia UW Pediatrics Outpatient Clinical Guidelines Sources: AAP Clinical Report Diagnosis and Prevention of Iron Deficiency and Iron- Deficiency Anemia in Infants and Young Children (0
More informationA. Blood is considered connective tissue. RBC. A. Blood volume and composition 1. Volume varies - average adult has 5 liters
A. Blood is considered connective tissue. RBC A. Blood volume and composition 1. Volume varies - average adult has 5 liters 2. 45% cells by volume called hematocrit (HCT) a. red blood cells (RBC) mostly
More informationNutrition and Health. Micronutrients - Vitamins
Nutrition and Health Micronutrients - Vitamins Topics Vitamins Water-soluble vitamins vitamin B vitamin C Fat-soluble vitamins vitamin A vitamin D vitamin E vitamin K 2 VITAMINS 3 Vitamins Vitamins are
More informationLife of a RBC. 1) Kidney detects O2 levels 2) Kidney secretes Erythropoietin 3) Erythropoietin à stem cells will begin to differentiate
Life of a RBC 1) Kidney detects O2 levels 2) Kidney secretes Erythropoietin 3) Erythropoietin à stem cells will begin to differentiate 4) Cell collects Hgb, loses nucleus, becomes smaller 5) Cell becomes
More informationNutrition JMRSO 2017 FOOD SCIENCE
Nutrition JMRSO 2017 FOOD SCIENCE What is nutrition? Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction,
More informationAnemia. F r e q u e n t l y A s k e d Q u e s t i o n s
Anemia Q: What is anemia? A: Anemia (uh-nee-me-uh) occurs when you have less than the normal number of red blood cells in your blood or when the red blood cells in your blood don t have enough hemoglobin
More informationLECTURE-3 VITAMINS DR PAWAN TOSHNIWAL ASSISTANT PROFESSOR BIOCHEMISTRY ZYDUS MEDICAL COLLEGE AND HOSPITAL, DAHOD, GUJARAT DATE
LECTURE-3 VITAMINS DR PAWAN TOSHNIWAL ASSISTANT PROFESSOR BIOCHEMISTRY ZYDUS MEDICAL COLLEGE AND HOSPITAL, DAHOD, GUJARAT DATE-20-12-2018 FOLATE or FOLIC ACID FOLATE Other names Folic acid Folacin Pteroylglutamic
More informationEating Right While Pregnant
Eating Right While Pregnant Healthy eating in pregnancy, and enough of it, is very important for your baby to grow and develop. You should consume 200 to 300 more calories than you did before you became
More informationEverything You Need to Know about Vitamins and Minerals
Everything You Need to Know about Vitamins and Minerals A Beta-Carotene Thiamine (B 1 ) Riboflavin (B 2 ) Vitamin A is needed for new cell growth. Helps fight infection. Essential for healthy skin, good
More informationCalifornia Association for Medical Laboratory Technology
California Association for Medical Laboratory Technology Megaloblastic Anemia Distance Learning Program Course # DL by Helen M. Sowers, M.A., CLS, Dept of Biological Science (retired) California State
More informationHemoglobin. Each alpha subunit has 141 amino acids, and each beta subunit has 146 amino acids.
In the previous lecture we talked about erythropoiesis and its regulation by many vitamins like vitamin B12 and folic acid, proteins, iron and trace elements copper and cobalt. Also we talked about pernicious
More informationOther labs 4/24/2012. N 24: Pediatric Hematological Alterations & Cancer Intro. Cabrillo College ADN Program C. Madsen RN, MSN 1.
Evaluation of CBC Evaluate type of WBCs Reticulocyte count RBC size, shape, color MCV: size RBC color (hypo or normo chromic) Mean corpuscular hemoglobin concentration (MCHC) Mean corpuscular hemoglobin
More informationIron Deficiency in Athletes. Dr Dan Bates (B.Med, BSc(HONS) Sports Medicine Registrar
Iron Deficiency in Athletes Dr Dan Bates (B.Med, BSc(HONS) Sports Medicine Registrar Stages of Iron deficiency Iron Storage depletion Depletion suggested by Decrease in ferritin Functional Iron depletion
More informationAnaemia in Pregnancy
Anaemia in Pregnancy Definition :anaemia is a pathological condition in which the oxygen-carrying capacity of red blood cells is insufficient to meet the body needs. The WHO : haemoglobin concentration
More informationNutrition for Health. Nutrients. Before You Read
CHAPTER 10 LESSON 2 Nutrition for Health Nutrients BIG Idea Each nutrient in your diet plays a unique and essential role in keeping you healthy. Before You Read Sometimes figuring out what to eat can be
More informationBlood Composi2on 17 A. Blood Composi2on 3/23/15. : a fluid connec2ve 2ssue composed of. Blood
Blood Composi2on 17 A Blood : a fluid connec2ve 2ssue composed of Plasma Formed elements Erythrocytes (red blood cells, or RBCs) Leukocytes (white blood cells, or WBCs) Platelets Blood Composi2on Percent
More informationBlood Composi2on 17 A. Blood Composi2on. Func2ons of Blood 3/23/15. Physical Characteris2cs and Volume. : a fluid connec2ve 2ssue composed of.
Blood Composi2on 17 A Blood : a fluid connec2ve 2ssue composed of Plasma Formed elements (red blood cells, or RBCs) Leukocytes (white blood cells, or WBCs) Platelets Blood Composi2on Percent of blood volume
More informationApproach to a pale child
Approach to a pale child Dr. Dafalla Ahmed Babiker Jazan university objectives Definition of anemia Classification and causes Important points in history and physical examination Investigations. Definition
More information