Pathology of Blood and Urine

Introduction the Pathology, Blood, Urine and related deficiency disease, disorders . Normal and abnormal constitute of urine.

1. Pathology of blood & urine Presented By Ms. Monika P. Maske M. Pharm (Pharmaceutical Chemistry) Kamla Nehru College of Pharmacy, Butibori , Nagpur

2. Introduction The term “Pathology” is derived from Greek words which means Patho: diseases or suffering, logos: disease or discourse. Pathology is the scientific study diseases and also deals with causes, effects, mechanism and nature of diseases. Its very important branch of medicine. Which involves all the abnormal state of body. The abnormal genes, chromosomal aberrations to cause disease, mechanical injuries, injuries caused by radiations, chemicals, sometimes by drugs, inborn & acquired susceptibilities to diseases also get converted in the pathological studies.

3. Concept for Disease Management

4. Blood Blood consists of, Plasma (serum ), minute solid particles or corpuscles. Its Connective tissue Fluid in nature Circulates in closed system of vessels Total volume approximately 6 liters pH of blood- 7.4 (slightly alkaline)

5. Corpuscles of Three Types Red Blood Corpuscles (RBC) or Erythrocytes: In more numbers White Blood Corpuscles (WBC) or Leucocytes: very less in number Platelets or Thrombocytes: Cellular fraction of the blood

6. Normal range for each of them, WBC are 2 types RBC Men : 4.5-6.5 million/mm 3 Women : 4.0-5.5 million/mm 3 WBC : 5000-10,000/mm 3 Platelets : 0.15-0.4 million/mm 3 Granulocytes: Neutrophils - 40 – 70 % Eosinophils - 01 – 04 % Basophils - 00 - 01 % Agranulocytes: Lymphocytes – 20 – 45 % Monocytes – 02 – 10 % Abnormal component of any constituent of blood leads to disorders.

7. Functions of blood Transports oxygen and nutrients • Transports waste products • Carries hormones from glands • Redistributes water • Contains WBC – protects body from diseases • Clotting of blood protects against haemorrhage

8. A. Erythrocytes (Red Blood Corpuscles) Erythrocytes diameter about 8 µ. Its biconcave and without nucleus containing hemoglobin in cytoplasm, hence red in color. RBCs produced in bone marrow, spleen & kidney. Life-span about 120 days. It destroys in liver & spleen. It transport oxygen & carbon-dioxide.

9. Abnormal Erythrocytic Cells & Their Significance 1. Anemia Anemia is condition in which the oxygen-carrying capacity of blood reduced. Decreased number of RBCs. Or decreased Conc. Of hemoglobin. Symptoms:- Fatigue, intolerance to cold, breathlessness, loss of appetite.

10. Several Types of Anemia Pernicious Anemia Stomach produce intrinsic factor which required for absorption of vit . B12 in small intestine. Inability of stomach is to produce intrinsic factor. Leads to insufficient hemopoiesis that condition called pernicious anemia.

11. 2. Sickle Cell Anemia Its also called as Haemoglobinopathic hemolytic anemia. Abnormal formation of RBC. RBC are sickle shaped (S or C ). S- shaped are sensitive to lower O2 supply. C-shaped are lowered O2 concentration. This cells (RBC) does not pass through small blood capillaries it block the blood supply .

12. 3. Megaloblastic Anaemia Its caused due to inadequate intake of vit . B12 or folic acid. The red bone marrow produce large abnormal RBCs called megaloblasts. It may be caused due to used in treatment of cancer.

13. 4. Iron – Deficiency Anemia Its caused due to inadequate absorption of iron, Excessive loss of ion. Insufficient intake of iron. It is most common type of anemia. Women are higher risk for this type. Because of menstrual blood loss Increased iron demand during pregnancy.

14. 5. Aplastic Anemia Destruction of red bone marrow that condition called as aplastic anemia. It is caused by gamma radiations, toxins and medication that inhibit enzymes required for hemopoiesis .

15. 6. Hemorrhagic Anemia Bleeding due to large wounds, Stomach ulcers or heavy menstruation leads to excessive loss of RBCs. This condition called as hemorrhagic anemia.

16. 7. Hemolytic Anemia RBC plasma membranes ruptures prematurely. Due to rupture of plasma membranes, the hemoglobin in RBCs is released in plasma . It may damage glomeruli in kidney.

17. 1. Polycythemia The concentration of blood increases abnormally, also increase in hemoglobin level, this condition called as polycythemia .

18. B. Lymphocyte (WBCs) s WBCs are irregular, nucleated, colorless. These are larger in shape than RBC. Diameter are 10-14 µ. It produced in bone-marrow, lymph nodules, tonsils and spleen. Leucocytes eat-up diseases causing micro-organisms ( phagocytosis ). It also take parts & fragments of dead cells and helps in cleaning the body.

19. Disorders of Leukocytes (WBCs) Two main class of WBCs disorders :

20. Neutrophilic Eosinophilic Basophilic Monocities Lymphocytosis Flow Chart of Disorders of Leucocytes

21. 1. Proliferative Disorders Leucocytosis Increase in the number of blood leukocytes. A variety of inflammatory states are responsible for leucocytosis. It further classified as, i . Neutrophilic:- Increase in number of neutrophils. - It caused by acute bacterial infection, burns, etc. ii. Eosinophilic :- Increased in number of eosinophils. - Caused by allergic disorders like asthma, fever, allergic skin diseases like dermatitis, drug reaction etc.

22. 1. Proliferative Disorders iii. Basophilic:- Its rare disease, in which basophils are increased in blood. iv. Monocitosis :- It increased the number of monocytes in blood. - it caused by chronic infection like TB, malaria, ulcer, etc. v. Lymphocytosis:- It accompanies by monocities in many disorders like viral infections like hepatitis A. B) Leukaemia Its bone marrow cancer in which , WBC multiply uncontrollably. Deficiency of RBC.

23. 2. Leukopenia (Decrease in WBC count) i . Neutropenia:- Reduction in number of neutrophils in blood termed as neutropenia. ii. Eosinopenia:- Its catheterized by reduced number if eosinophils in blood. iii. Lymphopenia:- Its rarer disorder - In this decreased in number of eosinophils in blood. - it is seen in acute viral infections, HIV infections.

24. C. Platelets ( Thromobocytes ) Platelets are third cellular fraction of the blood. They are disc shaped, non-nucleated bodies. These are about 2-4 µ in diameter. Formed in red bone marrow. Their cytoplasm contain numerous granules. The average life of platelets about 5-10 days. It destroys in spleen. Platelets contain thromokinase and thromboplast . Important role in clotting of blood.

25. C. Disorders Related to Platelets Thrombocytopenia: When number of platelets in the blood decreases below 1,00,000/ µl that condition called as thrombocytopenia . Thrombocytopenia caused due to decreased production of platelets. Decreased survival of platelets.

26. 2 . Purpura If platelet count is below the normal, the disease called as purpura . Symptoms: Bleeding from mucous membrane, appearance of lesions. color of lesions is first red, gradually dark, then purple to brownish yellow. Clotting time remain normal. But bleeding time is prolonged. Blood clot does not retract .

27. Introduction of Urine Urine is an excretory product of the body. Its formed in the kidney. Normal urine contains the waste products like urea, uric acid, creatinine. Certain salts such as chlorides, sulphates. It does not contain substances which are required by the body or tissues. Such urine is known as physiological or normal urine. Urine examination helps in the diagnosis of various renal as well as systemic diseases.

28. Physical Properties of Normal & Abnormal Urine Odour :- Normal- Aromatic due to the volatile fatty acids. Ammonical - Bacterial action Fruity- Ketonuria 2. Urinary Volume:- Normal- 600-1550 ml (1.4 L of urine per person per day with a normal range of 0.6 to 2.6 L per person per day) Polyuria - >2000ml Oliguria - <400 ml Nocturia - > 500ml

29. Physical Properties of Normal & Abnormal Urine 3. Urine pH:- Normal- 4.6-8 Acidic urine – ketosis (DM, fever) 4. Color & Appearance:- Normal- Clear & pale yellow Colorless- Dilution, DM, Diuretics Milky- GIT infection, Chlyuria Orange- Fever, excessive sweating Red- Beetroot ingestion, haematuria Brown/ Black:- Melanin, Alkaptunuria

30. Introduction to Abnormal Constituents of Urine In disorder conditions the substances essential to body or tissues may also be excreted in urine. Substance like sugar, bile salts, albumin etc. If such abnormal substances are excreted in urine, then such urine is described as abnormal or pathological urine. Urine pH is slightly acidic.

31. Sr. no Abnormal constituents of Urine Significance in Disease 1. Sugar (Glucose) - Sugar present in urine condition known as glycosuria. - In DM , the sugar level in blood is increase. 2. Ketone bodies Its called ketosis. DM, carbohydrates, pregnancy and in anaesthesia. 3. Albumin Condition is described proteinuria. In server exercise, high protein meal, pregnancy, nephrosis. 4. Bile pigments / Salts - Present in jaundice. 5. Blood This condition called as haematuria. Acute inflammation of any urinary organs, TB, cancer. Malaria, typhoid, jaundice, burns Abnormal constituent s of urine and their significance