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•Iron is recycled by
transferrin
•Heme molecule is Urine:
converted to urobilinogen GIT: Bile
unconjugated
bilirubin
Conjugated with
Excreted
protein in the
liver
Blood are classified into different
groups and typed according to
antigens present on the red cell
membrane
Rh type is determined by the presence
or absence of the Rhesus factor.
Unlike the ABO antigens, the only ways
antibodies are developed against the Rh
factor are through placental
sensitization or transfusion
85% of whites and 95% of African
Americans in the US are Rh+
Incompatibility happens when the
mother is Rh- and the baby is Rh+
A group of condition characterized by
an increase in the hematocrit.
Low oxgyen
tension
RBCs become sickled
shape
•Microinfarction •Anemia
•Ischemic tissue •Jaundice
pain •Gallstones
•Ischemic organ
malfunction
•Autoinfarction of
Disorders that demonstrate large,
immature, poorly functional
erythrocytes.
Causes:
• Vitamin B12 deficiency (Pernicious
anemia)
• Folate (Folic Acid) deficiency
Cause: malabsorption of Vitamin
B12 due to:
• An autoimmune disease leading to
progressive loss of parietal cells in the
stomach, causing failure of secretion of
hydrochloric acid and intrinsic factor
(Pernicious Anemia)
Intrinsic factor:
A glycoprotein essential to bind Vitamin B12 and
protect it from degradation by intestinal enzymes.
• Increase in demand
Vitamin B12:
• Normal functioning of the brain
• Formation of blood
•Hereditary gastric mucosal
atrophy
•Autoimmune disorder
•Gastric or small bowel
surgery
STOMACH
Destruction/absence of
•Increased
parietal cells in the
requirement –
stomach
pregnancy
Inability to form •Intestinal parasites
intrinsic factor
Faulty RBC
production
Anemia
NORMAL RBC MEGALOBLASTIC ANEMIA
Inhibited growth of all cells
• Anemia
• Leukopenia
• Thrombocytopenia
Demyelination of Peripheral nerves to
spinal cord
TRIAD SYMPTOMS:
• Weakness
• Sore tongue
• Paresthesia and other neurologic symptoms
Folic Acid
• Necessary for normal RBC production
Causes:
• Poor dietary intake
• Poor GI absorption
• Folate antagonists (anticancer drugs and
anticonvulsants)
• Inborn errors of metabolism
• Increased requirement
Effect:
impaired DNA synthesis and
megaloblastic transformation of the
RBCs
Characterized by deficient
hemoglobin synthesis caused by lack
of iron.
Cells become macrocytic and
hypochromic because of low
concentrations of hemoglobin.
Most common type of anemia
Causes:
• Increase loss (hemorrhage and hookworm
infestations)
• Decreased dietary intake
Children
Elderly
Adolescents
Indigents
• Pernicious anemia
• Gastrectomy
• Malabsorption syndromes
Clinical manifestations
• Fatigue
• Tachycardia
• Irritability
• Pallor
• Sore tongue
• Cheilosis
• Koilonychia
• Pica
Occurs as a result of reduced bone
marrow function
Effect: Pancytopenia drop in all
levels of all blood elements.
Causes:
• genetic failure of bone marrow development
• Injury to stem cells
Viral infections
Medications
Toxins
Pathology:
• Marrow is hypocellular or is replaced with
fat