Hematology Review Lecture Notes

Introduction

• Speaker: Dr. Bill Dill-Jones, Professor, Faculty of Health Disciplines, Athabasca University
• Focus: Pathophysiology of the hematologic system, particularly disorders affecting:
  • Red Blood Cells (RBC)
  • White Blood Cells (WBC)
  • Platelets
• Key Point: Blood cell abnormalities often manifest other dysfunctions, not diseases themselves.

Key Hematologic Disorders

Anemia

• Most Common Hematologic Disorder in Primary Care
• Definition: Decrease in RBC number; not just loss due to hemorrhage.
• Causes:
  • Defective/decreased erythrocyte production (e.g., anemias, carcinomas, lymphomas, leukemias)
  • Increased erythrocyte destruction (e.g., infections, hemolytic syndromes)
• Classification by RBC Size & Hemoglobin Content:
  • Cytic - Cell size
  • Chromic - Color/hemoglobin content

Types of Anemias

• Macrocytic, Normochromic:
  • Pernicious anemia, Folate deficiencies, Liver disease
• Microcytic, Hypochromic:
  • Iron deficiency, Sideroblastic anemia, Thalassemia
• Normocytic, Normochromic:
  • Aplastic anemia, Post-hemorrhagic anemia, Sickle cell

Iron Deficiency Anemia (IDA)

• Most Common Worldwide
• Causes:
  • Developed world: Pregnancy, chronic blood loss
  • Developing world: Dietary insufficiencies
• Iron Handling in Body:
  • Iron from RBC breakdown & diet
  • Iron Transport Proteins: Transferrin, Ferritin
  • Ferritin: Storage compound, acute phase reactant

Diagnosis and Treatment of IDA

• Diagnosis Criteria:
  • Low serum ferritin, high TIBC
  • Microcytic RBCs, Elevated RDW
• Treatment:
  • Address cause, start iron supplementation
  • Supplements: Iron sulfate, succinate, gluconate, fumarates

Pernicious Anemia

• Cause: Vitamin B12 deficiency
• Symptoms: Mood swings, weakness, fatigue, paresthesia
• Diagnosis: Elevated MCV, low B12 titers
• Treatment: Foods rich in B12, oral replacement, parenteral regime

White Blood Cell Disorders

• Common Disorders: WBC abnormalities usually seen as changes in counts
• Neutrophils: Most abundant; neutropenia is never normal
• Lymphocytes: Affected by infections (e.g., viral infections cause lymphocytosis)

Platelet Disorders

• Types: Qualitative (intrinsic abnormalities), Quantitative (thrombocytopenia/thrombocytosis)
• Causes of Thrombocytopenia: Aplastic anemia, lupus, decreased survival
• Thrombocytopathy: Result of liver failure, uremia, NSAIDs

Therapeutic Considerations

• Drugs: Tissue plasminogen activator (TPA), Streptokinase
• Vitamin K: Usage and populations
• DIC (Disseminated Intravascular Coagulation): Presentation, causes, management

Conclusion

• Overview: Discussed key hematologic disorders
• Encouragement: Participate in class discussions and read further on topics