OBJECTIVES
Normal values
Properties of RBC
Physiological variations
Pathological variations
Polycythemia
Variations in size & shape
of RBC
Esr factors affecting RBC
Applied physiology
NORMAL VALUES
• At birth:- 6-7million/cumm.
• Adults :-
male:- 5-6million/cumm.
female:- 4.5 - 5.5million/cumm.
• Clinically 5million/cumm is taken as
100% rbc count.
• Life span of rbc is 120 days.
• Shape:-
circular,biconcave,nonnucleated
disc.
• Diameter:- 6.5-8.8Mm.
• Thickness:-
at periphery :- 2-2.4Mm.
at the centre:- 1.2-1.5Mm.
PROPERTIES OF RBC
• ROULEAUX FORMATION
• SPECIFIC GRAVITY OF RBC (1.092- 1.101)
• PACKED CELL VOLUME
• SUSPENSION STABILITY
ROULEAUX FORMATION
Physiological variations
• When increased:-
• high altituted:- Rbc count decreases due to
hypoxia .
• Newborn and infants:-high rbc count due to
increase activity of bonemarrow .
• Muscular exercises:- Rbc increases due to
decreases plasma volume .
• Sex:
in males :-androgen increase the
erythropoietin from the kidneys.
in females:-oestrogen does not stimulate
erythropoietin production from kidneys.
When decreased:-
• In Children:-rbc count are low
compared to newborns and young
adults.
• Pregnancy:-less rbc count due to
haemodilution.
• Old age:-production of rbc is less.
• When increased:
• Polycythemia vera:-rbc count increases to 8
million/mm3.
• In Congenital heart diseases.
• In chronic lung diseases:-rbc increases due to
hypoxia.
• Leukemia:-increase rbc due to increased in
activity of bone marrow .
• In cushing’s syndrome.
• In hyperthyroidism .
When decreased:
Seen in all types of anaemia.
For example:- Addison’s anaemia or
perinicious anaemia
polycythemia
• Also called as erythrocytosis.
• In this rbc count increases more than 6million/cumm.
Causes:-
physiological variations:-
• At birth
• At high altitude
pathological variations:-
• congenital heart diseases
• Dehydration
• shock
• tumours of bone marrow called polycythemia vera.
POLYCYTHEMIA
-
Variations in size & shape
of rbc
• AnisOcytosis:- variations in the size of
rbc’s.
• Poikilocytosis:- variations in the shape of
rbc’s.
• Spherocytosis:- spherical rbc’s, more
fragile.
• Ellipsocytosis:- increase in the elliptical
shaped rbc.
SPHEROCYTOSIS ELLIPTOCYTOSIS
POIKILOCYTOSIS
ESR FACTORS AFFECTING RBC
• Definition:-The rate at which the rbc
settled down is called Esr.
• This is expressed in mm/hour.
Rouleaux formation:- Any factor which
increases the rouleaux formation will
increase Esr.
Low specific gravity:- increases.
Fibrinogen & Globulin:- These increases
Esr by facilitating rouleaux formation.
High pcv:- Decreases Esr.
Rise in temperature:- Increases Esr.
Spherocytosis:- Decreases Esr.
Poikilocytosis:- Decreases Esr.
Applied physiology
ANAEMIA:-
"bloodlessness".
• It is a condition involving
quantitative and qualitative
reduction of RBCs.
Haemolytic Anaemia
• Haemolytic anaemia refers
to any condition causing
inadequate number of
circulating red blood cells
caused by premature
destruction of red blood cells.
APLASTIC ANAEMIA
• Idiopathic aplastic
anaemia is a condition
he stem cell.
that results from injury
to the stem cell.
• There is reduction of all
types of cells namely
Red Blood cells, White
Blood cells & Platelets.
MEGALOBLASTIC ANAEMIA
• Blood disorder which is
characterized by the
red Blood cells that are
larger than normal low
white blood cell count
and low Platelet count
SICKLE CELL ANAEMIA
• Sickle cell Anaemia
occurs when individual
inherits a sickle cell
gene from each
parent.
• The glutamic Acid in
the 6th position in beta
chain of Haemoglobin
is changed to valine.
PERNICIOUS ANAEMIA
• Pernicious Anaemia
is a result of Vitamin
B12 & folic Acid
Deficiency .
• It is mostly seen in
people over 40
IRON DEFICIENCY
• It is the
condition
which is the
result of low
level of iron
in blood.
MCQS
IN THE FOETAL STAGE[1ST TRIMESTER] THE RBC ARE
PRODUCED FROM 1.
EPITHELIAL CELLS 2. MESOTHELIAL CELLS
[Link] CELLS [Link] EMBRYONIC CELLS
NON NUCLEATED CELLS ARE PRODUCED DURING
1. 1ST TRIMESTER 2. 2ND TRIMESTER
3. 3RD TRIMESTER AND AFTER BIRTH
4. AFTER BIRTH ONLY
FOLIC ACID AND B12 ARE REQUIRED AT THIS STAGE OF THE
FORMATION OF RBC
1. C.F.U STAGE 2. B.F.U STAGE
3. PRO ERYTHROBLAST STAGE
4. EARLY NORMOBLAST STAGE
INCREASE IN RETICULOCYTE COUNT IN RESPONSE TO THE
IRON THERAPHY
1. POLYCYTHEMIA 2. ERYTHROPENIA
3. RETICULOCYTE RESPONSE 4. RETICULOCYTOPENIA
THE IMPORTANT STIMULANT FOR ERYTHROPOIESIS IS
1. HYPOXIA 2. VITAMIN B12
3. FOLIC ACID 4. ANAEMIA
DEFICIENCY OF IRON RESULTS IN
1. HYPOCHROMIC MICROCYTIC ANAEMIA
2. MACROCYTIC ANAEMIA
3. NORMOCHROMIC ANAEMIA
4. HYPOCHROMIC MACROCYTIC ANAEMIA
MINERALS REQUIRED FOR THE SYNTHESIS OF HAEMOGLOBIN
1. COBALT 2. COPPER [Link] 4. PHOSPHATE
RIBOFLAVIN AND VI T-C DEFICIENCY CAUSES
1. NORMOCYTIC NORMOCHROMIC ANAEMIA
2. HYPOCHROMIC MACROCYTIC ANAEMIA
3. HYPOCHROMIC NORMOCYTIC ANAEMIA
4. MACROCYTIC NORMOCHROMIC ANAEMIA
HAEMOLYTIC ANAEMIA RESULT IN INCREASE IN LEVELS OF
1. CONJUGATED BILIRUBIN 2. UNCONJUGATED BILIRUBIN
3. BOTH CONJUGATED AND UNCONJUGATED BILIRUBIN
4. BILIVERDIN
HAEMOLYTIC ANAEMIA DUE TO
1. IRON DEFICIENCY 2. B12 DEFICIENCY
3. GLUCOSE-6-PHOSPHATE DEFICIENCY
4. RIBOFLAVIN DEFICIENCY
REFERENCE:- LPR & GUYTON
ANSWERS:- 1)3 2)3 3)3 4)3 5)1 6)1 7)2 8)1 9)2 10)3