Dis'l'ciers of ihe Blcocl

.Anemia

Auemia is clefineci as a clecrer-ise:in the arnorurt cf hemcglobin in the blood, it ::ray rcsuit from too ier",, red biooci cells, cells thar are -Loo sr,aii, oi tJo lirtl: hemcglobin in the ceils. Celis ma;v b: normai in ;izc (ncri-mrrcytic). oi abnoi:nal (nt::r'r- cr llaclocytic); thel may be rLorlrsl ir, hcn:oglobin tno,-rntliiromi.;, rrt have tcc iinle (hypochiorric'r. I(ey tests in '-liagnosin*e anernia are MC\/ (mean corpuscuiar voiume)'a;:d:Jr,{CI{C (rnean corpru5suls,' hernoglobii co:tcentration). Conrrrs of reticuiocytes (irrftrat;re red cellsj are alsc impofiart. The general symptoms of anemia inciuCe fatigue, shoflness of breath, heart paipitations, pallor and irrita-bilitv. There are many different types of anemi4 sone''of ce1ls. ',vilich are caused by ulderproduction of red celis. othbrs b;r loss or dest-ructiou of Apiastic anemia results from destrtrction cf lhe bone manow arrd effects ail blooci celis (pancltcpenia). It may be caused b;v dntgs, toxins, virusos. larJiation, <:r bone marrcu/ oanc,er. It has been treateri successfuliy with bone lnarrow trattsplants. -acid, or most c.ommonl;'. Nutrjtiona.l anemia malr result ftom a deficiency of vitamin Br:, folic i;"orr. A specific tbrm of Br: defrciency is pernicious anemia-This resuits from tire iack of a substance, inrrilsic faitor (IF), produced ir the stomach, that aids in the absorption of this vitamirl from the intestine. Pellicious anemia must be treated with regular injections of Brz. iJelrorrhagic anen:iia results frorn blond ioss. This may be a sudden loss, as from rnjury, or loss troin chrcnic intemal bleeding, as from the digestive tract in cases of ulcers or cancer. Several hereditary diseases cause hemolysis (rupture) of red cells, resulting in anemia. Thalassemia appears in Meditenanean populations. It affects the production of hdmoglobin and is designated as o (alpira) or p fteta) aecording to the part of the molecule affected. Severe p tiralassemia is aiso called Cloeley's anemia. In sictrrle cell anemia, a inutation altels the hernogiobin moleoule so that it precipitates whel it gives up oxygen. Ttre altered celis block small biood vesseis and deprive tissue-s..o-f Lrygro. :llre misshapen ceils are also readiiy destroyed (hemolyzed). The disease predominates in black prrpuiations. Genetic cariers of the defec.t, those with one normal and one abnorr:ral gene, sirow 1gk1e c*li trait. They usually have no symptoms, except when oxygen is low, such as at high altitudes. fhey carr, however, pass the defective gene to offspring. Sickle cell anemia, as rvell as many other genetic diseases^ can be Ciagnosed in can'iers s.rid in the i'etus before birth.
Coagulation Disorders T'he most comtnon c-ause of ccagulation probiems is a deficiency in the number of circulating pletelets, a ccndition terrned thrombocytopenia (-petria means "deficiency"). Possible causes inciude iplastic anemia, infections, cancel of tiie botte marow, cr agents that destroy bone malrow, such as xtiyr ot'certailL cirugs" fhis iisorCel results in bleeding into the skin and mucous membranes, variousil' clescliberj as pefechiae, ecch3'moses and Furpura. In diiseminated intrsvasculai' {:oaguiatiorr {DIC), there is in,idespread ciotting in tire vesseis that obsfruci.-q cirsulalion to ihe i"issiies. 'fhis is follow'ed by diffnse hemorrhages as clotting factois are reint-rvod and the coa;piatiol process is impaired. DiC may be caused by infection, cai'lcer, hemorrhage, oi aliergy. Hemophilia resuits from a hereditary deficiency of a ciotting factor; It is a sex-iinked disease that is usually paised fi'om mother to son. There is bieeding into the tissues, especially into the joints {hemartirr6si::). Ilemopirilia must be treat-ed with transfusions cf the necessary ciotting factor.
\coplasnt.'-'

l,egile;rnia i:r a neopiasm of in&ite biood celis. It .may exisl in clucttic or ecute fom. Ilie l1,ii;ptorns 9f leukernia inr:lu<ie arre.ilia, f'atigue, easy bleeciing, splenomegal5'. and sometinles i*:patonregall, (eriiaigerneirt of the iiver). Difslent l/pei are identified accorCing to the liind of celis jrr the bone marrow (root mltel/o)and involves ;irvclved. ii4ll'ricgeircus leu]leinie is naur.ed for its origin )raiitl*,,tire gi-a.ilular leukocf ics. T'r'ii:phoc,vtir leukemiaaffec.ts B cells and tire iyinpirailc s1'steltl, causitig iyrnpirailenopathy aud aciverse effects on tire immune system. Treafinent of ler:icenria inciir<ies cilcnothr:raf,y. radiation ti:etapv and bcne lnalrLrv/ h ar:spiantation.

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i il::a:i ll::l:r::. : .::,.1i1: , , ,, l-l.

I{odgkin's disease is a disease of the lymphatic system that may spread to other fissues. It begins il'lth enlarged but painless iymph nodes in the cervical (neck) region and the:r progresses to other nodes. -fhere are fever- nisht srveats, weight loss and itching of the skin (pruritus). Persons olany age may be affected, but the disease predominates in young adults and those over 50; Most cases can be cured with
v rv ' i/rt .rrb4

radiation and chernotherapl', Multiple myeloma is a cancer of the blood-fonning cells in bone firarrow, mainly affecting the oells that produce antibodies. The disease causes aneiria, bone pain and weakening of the bones. There is a gleaterlusceptibility to infection because of immune deficiency. Abnonnalil'high ievels of calcium ancl protein in the biood oftcrr iead to kidney faiiure. Multiple myeloma is treated with radiation and chemotherapy, but the prognclsis is generally poor.

Immune Disorders Ilypersensitiyity is a harmful overreaction by the immune s),stem. commonly lcrown as allergy. In this case, a person is morp sensitive to e particuiar a,ntigen than the average individuai. Common allergens are poilen, animal Cander, dust and foods, bui there are many rnore. Responses may include itching, redness or tearing of the eyes, skin rasir, asthma, sneezing and urticaria (hives). An anaphylactic reaction is a severe generaiiz-ed allergic response that can lea.d rapidly to deatir as a result of shock and interference with breathing. It rnust be treated by irnnrediate adrninistration of adrenaline, maintenance of open airways and antihistamines' The term immunodeficiency refers to any failure in the immune system. This may be congenital (plesent at birth) or acquired, and may invoive any components of the system. The deficiency may vary in severify, but is always evidenced .by an increased susceptibility to disease. AIDS is acquired b.v infection with HfV (human immunodeficiency virus), which attacks ceftain T ceils. These cells have a specific surface attachment site, the CD4 receptor, for the virus. The disease is spread by sexuai contaet, use of contaminated needles, biood transfusions and by passage from an infected mother to a fetus. The disease ieaves the host susc.eptible to opportunistic. infections, such as pneumonia car:sed b)' the protozocn Pneum.oqtstis carinii, and thmsh, a fungal infection of the mouth caused by Candiria albicatts. It also predispcses to K-aposi's sarcoma, a previously rare form of skin cancer. At present there is no vaceine or crlre for AIDS, but there are drugs fhat can delai; proppess 'r.rf tlre disea"se. R ciisease thai resuits from al iminune response'to one's ov'rn tissues is ciassified as an autgimmune disorder. The cause may be a reaction to' body cells that have been slightiy altered by mutation or disease. The list of diseases that are believed to be caused, at least in part, by autoimmunify is Jcng. It includes pernicious anemia, systemic lupus er1'thematosus, rheumatoid artliritis, Gtaves' disease (cf the thyroid), myasthenia' gravis (a rauscle disease), rheumatic heart disease, glomerulonephritis (a kidnel' disease) and scleroderma.

1. Match the following terms to their proper definitions: a) AIDS, b)allergen, c)allerg,v, d) anaphylactie reaction, e) anemia, f)aplastic anemia, g) ecchymosis, h)hemolysis, i)hemophilia, j) HfV, k) hypersensitivit-y, I)immunodeficiency m)leukemia, n)pernicious anemia, o)petechiae,
p)purpura, r)reticuloq"te, s)thalassemia t)thrombocvtopenia u)urticaria, v)lymphocytosis,

Medical terminologY

j. Hypersensitirriry c
2. The rupture of red blood cells and the reiease oi hernogiobin(adj. heniolyic) 3. Anemia calsed b). bone marrow faiiure resulting in deficient, biood cell production, especiali5, that of red cells. f) 4. A, coliection dlblood under the skin caused by leakage fiorn small vsssels; a bruise (raat clEnt: nleans

of tire immune system caused by infection witir The virus infects ceftain T cells and thus interfbres with virus iiumari iurmuncdeficiency [F{IV).
5-. Accluitd irnrhune deficiency syndrome. Failure

4 ".juice"). ,,
irnmuniq,.

:4-

6. A substance that causes an allergic response. !. 7. An exaggerated aliergic reactic;to aftreign substance (C. rootp/44'.T,Jlneans "protectir-.,n"). ,,{

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A deficieilCy ir,the ainnulii (il hetnrlgicrb:u in .he blor:ri -ty'ia'', rrsuit tic-,m i:looil ir:ss, tnainuttition,

heledita;;'dcfel'.i..s. environrrtetlral faotot"s and otirsr callseE' 3. riuillk;;'ru*i.$o.rtrr inimatuie '*,irir-', 'nlcoc r:ells. i'la-y be chronic

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{rr,veir:gr:noUs ro. i,orioiio,.,l,lrururterizecl .bj,hemon'hages into thr. skin, rnucous rne,m.branes^.iniernai organs, tt , r,thel tissuei {i:':'::: G. word meaning "purpie")' 'rhat i.s harrnle"-s to mt.rsi peopiel allergy a substarrc:e i io hu f . An'lirrm.ii-,clogic r.eaction
^

rllarrg\,,

iel:ken ilr) +r iymi;aati'--r

or a.cutc; '"r... (lymphc.rq*ic ku<eniia) 1is-que

ir:'

rna-v affec1

,'',' ^^,' bcne I

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and

)t ll. An i::r'.lai,rls, ,,ed iriood ceil' t, :.:. pinpcirrt, flat, purirlish-reci spots caused by bieeding wirhirr the skin or r]lucous membrane. . substance needec for the
the.stomach ro prodnce intrins'ic factor, a 6 -,'t+. airii"lu'.oor"c by faiiur"e r:f vitr;"drin is required for tiie formacic'n of er,Whrocltes'

eb:iciptror; of'vi1.amin Biz. Tiris d- 1s. A herecirar,,biooii disease caused by la:i." of a clotting factor and resulting in airnonnal bleeding. ff i 6. Ftunror. i:arirr,nodeficienc.v virus" T'he virus that causes AiDS. :) r i. ;'il; of rcund., -raiserl eruptions with itching; hivcs -\'f, the ';r;;;.:';rittitg 4 1t" t t;;l of h*reditary anemias nrostl;'forin<l in Mediteranea-n populations (the nanie comes frotri . Cice'x v'c;d t'or "sea".1. t 1g. a deficiencv of thrombocites (piateiets) in the blood. ' ;;t;;;;;;'iriiit* n"rbei,:f clrculating lyrnphocytes usually a result cf iniecrion.

{:a.

?. Match the terms in each of theses sets with:their tlefinitionE and rvrite the approJr;:iafe Ietter (a-e) to the left of each number' l.hemostasis '-ta. Lymphocyte . Engulfing of a foreign particle 2. phagocvtosis . Stoppage cfbiood flou, 3. l,9116tql;rg/ . Study of blooC 4. T celi j. alhurnin -*------*---->> e.ptrasma protein
6. er)"thropoiesis

7 hemoi).'sis
-

a. n

ll. 1e',il:aphelesis lo',1,-..'..-1, Q ' . iv.; J:i re Jr.'J

I (). ieukenria

DecreasJiin white b];d cells Rupture of red biood cells a. Fcimation c.f red hlood cel!s Separalion of tryl'rite trlood ceils lrom whcrle Lrltod e. MiaiitTrai-rt o',rergrcl'lih:of t&ite blood celis
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,.

i t. f'enic
12. sideroponia J 3. azr-rturia
I

Lor"luctassium ljellc:ency ot lroll Co.rrtai:rinc iron

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,.1,

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l,: :r

-1:,- ' r

'in tlre blood

{"

}r,vpernatremia

I i Lt:Y hrr*ni.rlerrriq ' J.

i"-tr**J?oaiti,o in the biood lnc;eased nirrogerr oompcr;nds in the urine

2

16. petechiae 17. ecchyffiosis I8. hematoma 19, hernophiiia ?0. ireparin

A^nticoagulant !{ereditary bleedin g disease

Pinpoint Spots caused by bleeding in the skin iBruise i,ecalized collectior of clotted bir:c'd

js ca'ec: i iillillli: l.HIn orrhe hiocd rl 1}q\ma jn rcd oells oxygp:r is called ..'.L\}J...t.."'..
that caqries blo';rd 2. The, ricx-c.oltainingpignrent tt" 3. 'T'he c;ell{iagment.'uitit in bloocl clottpg 3:l is cells ' 'IK!'I\"':=+'*V.*$A-t v,"t 4 l'he tenn foi alj wbite blood ,\. Th: substatice tirat fornts a t'bod clot is named """'tptnX')'!' 6. Tire wjrite'r'iood cells active in inimunit;';;;;;"""*l[y m;'tf*?'.fq]. ?. A rJeficiens.r, of hsmsrgltrhil in ibe biood is it colidjtion called :"":*' i'Lf, 'l'I'\.I

tig;r$A\-\*{kte f

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