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HEMATOLOGY Introduction. Investigation of blood
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HEMATOLOGY Introduction Study of blood & its segments Window of rest of body

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BLOOD Raison d\'etre Delivery of supplements Oxygen Food Vitamins Removal of squanders Carbon dioxide Nitrogenous squanders Cellular poisons Repair of its course Protection as opposed to attacking microorganisms Multiple phone & acellular components

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HEMATOLOGY Divisions Red Blood Cells/Oxygen & CO 2 transport White Blood Cells/Protection versus microorganisms Coagulation/platelets/Maintenance of vascular honesty

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HEMATOLOGY Hematopoiesis In people, happens in bone marrow solely All phone components got from pluripotent undifferentiated organism (PPSC) PPSC holds capacity to both recreate itself and separate Types of separation controlled by the impact of different cytokines

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HEMATOPOIESIS Committed Stem Cells

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RED BLOOD CELLS Introduction Normal - Anucleate, exceedingly adaptable biconcave circles, 80-100 femtoliters in volume Flexibility fundamental for section through vessels Major parts - Carriers of oxygen to & carbon dioxide far from cells

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ERYTHROPOIETIN Cytokine - Produced in the kidney Necessary for erythroid multiplication and separation Absence brings about apoptosis (modified cell demise) of erythroid submitted cells Anemia of renal disappointment 2° to absence of EPO

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ERYTHROPOIETIN Mechanism of Action

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ERYTHROPOIETIN Mechanism of Action Binds particularly to Erythropoietin Receptor Transmembrane protein; cytokine receptor superfamily Binding prompts to dimerization of receptor Dimerization actuates tyrosine kinase movement

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ERYTHROPOIETIN Mechanism of Action Multiple cytoplasmic & atomic proteins phosphorylated Nuclear flag sent to initiate creation of proteins prompting to expansion and separation

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ERYTHROPOIETIN Regulation of Production

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Erythropoietin Response to Administration rhuEPO 150 u/kg 3x/wk

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RBC Precursors Pronormoblast Basophilic normoblast Polychromatophilic Normoblast Orthrochromatophilic Normoblast Reticulocyte Mature Red Blood Cell 5-7 days from Pronormoblast to Reticulocyte

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RBC Assessment Number - Generally done via robotized counters, utilizing impedance measures Size - Large, ordinary size, or little; all same size versus variable sizes (anisocytosis). Mean volume via computerized counter Shape - Normal biconcave circle, versus spherocytes, versus strangely formed cells (poikilocytosis) Color - Generally an antique of size of cell

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Red Blood Cells Normal Values

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RETICULOCYTE Young red platelet; still have little measures of RNA present in them Tend to recolor to some degree bluer than develop RBC\'s on Wright recolor (polychromatophilic) Slightly bigger than develop RBC Undergo expulsion of RNA on going through spleen, in first day of life Can be identified utilizing supravital recolor Important marker of RBC generation

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RETICULOCYTE COUNT Absolute Value = Retic % x RBC Count eg 0.01 x 5,000,000 = 50,000 Normal up to 100,000 More precise approach to evaluate body\'s reaction to sickliness

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ANEMIA Causes Blood misfortune Decreased creation of red platelets (Marrow disappointment) Increased devastation of red platelets Hemolysis Distinguished by reticulocyte include Decreased conditions of diminished creation Increased in decimation of red platelets

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RBC DESTRUCTION - EXTRAVASCULAR Markers Heme metabolized to bilirubin in macrophage; globin metabolized intracellularly Unconjugated bilirubin discharged into plasma & conveyed to liver Bilirubin conjugated in liver &excreted into bile & then into upper GI tract Conjugated bilirubin goes to lower GI tract & metabolized to urobilinogen, which is discharged into stool & pee

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RBC DESTRUCTION - INTRAVASCULAR Free Hemoglobin available for use prompts to Binding of hemoglobin to haptoglobin, yielding low plasma haptoglobin Hemoglobin separated by kidney & reabsorbed by tubules, prompting to hemosiderinuria Capacity of tubules to reabsorb protein surpassed, yielding hemoglobinuria

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HEMOLYTIC ANEMIA Commonly utilized Tests Problems with affectability & specificity

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