HEMATOLOGY

HEMATOLOGIC ALTERATIONS
TOPIC OUTLINE:

- ANEMIA AND POLYCYTHEMIA

- BLEEDING AND THROMBOSIS
- LYMPHADENOPATHY AND SPLENOMEGALY

CLINICAL MANIFESTATIONS:

- Pallor sec. to anemia

- Plethoric in instances of excess red cell (kulay talong)
- Shortness of breath especially in anemia
- Spectacular hemorrhages from severe anemia or
thrombocytopenia
- Papilledema from cerebral bleeding
- Engorged veins in waldenstrom macroglobulinemia
RED BLOOD CELLS
which there is an excess in gamma globulin of the
- Carries oxygen and remove carbon dioxide
IgM type that causes hyper-viscosity of blood
- Bleeding
o Purpura
o Ecchymoses
o Petechiae
o Hematoma – definite lump or tumor mostly
composed of blood
- Buccal signs:
o Angular stomatitis
- Ulcerations esp. those undergoing chemotherapy
- Smooth sore tongue or glossitis (beefy red tongue) in
those with vit. B12 deficiency
- Gingival hyperplasia in patients with acute leukemia
- Enlarged tonsils
- Enlarged liver or Enlarged spleen
o Organs of hematopoiesis
- Intraabdominal lymphadenopathy esp. those with
lymphoid malignancy or with HIV (generalized
lymphadenopathy)
- Koilonychia (spoon nails)
- Hemarthroses in patients with hemophilia
- Digital gangrene in myeloproliferative disorders

COMPOSITION OF THE BLOOD

- CELLULAR ELEMENT
o Red blood cells
o White blood cells
 Granulocytes
 Neutrophils
 Eosinophils
- Neutrophils: predominating granulocytes as well as
 Basophils predominating white cell
 Monocytes o 60-70% of total white cell
 Lymphocytes - Eosinophils
o Platelets - hemostasis o Less than 1%
- FLUID ELEMENTS - plasma o Plays a role in allergic response
o Have a role in eliminating parasites
Buffy coat: contains most of the white cells and platelets
 Roundworms or helminths
- Basophils
o Less than 1%
o Plays a role in allergic response
HEMATOLOGY
HEMATOLOGIC ALTERATIONS

- Monocytes
o Largest cells in the peripheral blood
o Has a very abundant cytoplasm with ground
glass appearance containing numerous
granules
o The nucleus assumes different sizes,
convoluted, bean-shaped, horseshoe
o When monocytes are converted to
macrophages, they become the major
antigen presenting cell together with the
dendritic cells
- Lymphocytes
o 2 types:
 T cell: 70%
 For cellular immunity
 B cell
 For humoral immunity
o

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