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  • هل من مساعد :(

    السلام عليكم ورحمه الله وبركاته
    كيف الحال جميعا < ان شالله في تمام الصحه والعافيه

    موضوع الثلاسيميا جدا استصعب علي وموقاده افهمه ابد * وعندي اختبار فيه
    فا ذا اجد يتبرع منكم ويشرحه لي
    اكوون مممتنه له

    والله يجزاكم خير

  • #2
    الموضوع كبير بس على كل لي ملفين بوربوينت في هذا المنتدى يوضحان الثلاسيميا وانواعها واسبابها وعلاجها والنتائج المخبرية لها
    وانا جاهز لأي سؤال
    بالتوفيق
    من طلب العلا سهر الليالي

    تعليق


    • #3
      هذه الروابط من المنتدي
      http://www.arabslab.com/vb/showthrea...D3%ED%E3%ED%C7

      http://www.arabslab.com/vb/showthrea...D3%ED%E3%ED%C7

      تعليق


      • #4
        هذا ملخص علم الدم ستجدون به الثاليثيميا أحد ملخصات أخونا شادي جزاه الله خيرا هو و من ساعده فيها هذا هو الموقع لباقي الملخصات العشرة لأن ملخص علم الدم يمثل ملخص واحد منهم و شكرا :

        الــمــلخصات العــشرة !!! لإجــتـــيـــاز الهـــيــئــة:

        http://www.arabslab.com/vb/showthread.php?t=22685&highlight=%C7%D3%C6%E1%C9+% C7%E1%E5%ED%C6%C9+%C7%E1%CF%DF%CA%E6%D1%E5+%DE%D8% D1%C9+%E3%D8%D1


        بسم الله الرحمن الرحيم
        طبعا الملخص اعتمد على المرجع الاساسي للهيئة السعودية للتخصصات الطبية .. (( يعني الملخص معتمد بإذن الله ))

        طبعا هذي صورة الكتاب الذي تم استخدامه في كتابة الملخص ..(( وهو المرجع الذي تستخدمه الهيئة في وضع اسئلتها لقسم علم الدم ))


        [IMG]file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.png[/IMG]

        *
        Hematopoiesis : Formation of different blood cells (( RBCs-WBCs-PLATELATE))
        - Site : Red Bone Marrow in all bone of children , But in adult Restricted To Central Skeleton (( skull , sternum . ribs , hips , vertebra ))

        * Factors Necessary For Erythropoiesis (( Formation of RBCs)) :-
        1- erythropoietin hormone . 2- Iron
        3- Vit B12 4- Folic Acid
        5- Ascorbic Acid ( Vit C ) 6- Vit B6 ( Pyridoxine )
        7- Amino Acid .


        * RBCs : Red color , anucleated , biconcave shape .


        Function of RBCs : - *
        Transport Oxygen + CO2 + Hormone + Enzyme +Vitamins + Nutrients

        Erythrocytosis ( Increase in red Blood Cells with physiological causes ) :-*
        1- High altitudes 2- Physical training
        3- Drugs 4- Smokers

        *Polycythemia ( increase in red Blood Cells With Pathological causes ) :-
        The Increase Of RBCs is Not By physiological causes .

        *Erythrocytopenia :- ( Decrease in Red Blood Cells )
        1- RBCs Loss : Hemorrhage 2- Abnormal destruction of red blood cells
        3- lack substance needed for RBCs Production .
        4- chemotherapy or radiation
        5- Leukemia

        * About 1% of RBCs per day are Breakdown

        * Components of RBCs Are Recycled :-
        Iron ----- Transfrrin ------} To bone Marrow
        Amion acid -à globin
        Most Urobilinogen are excreted in Stool , Some of it excreted in urine .

        * parameters of CBC ( Complete Blood Count ) :-
        - hemoglobin : Hb (( 13-17 g\dl))
        - hematocrit : HCT (( 40-50% ))
        - Mean cell volume : MCV (( 82 – 99 FL))
        - mean cell hemoglobin weight : MCH (( 27 – 33 pg ))
        - Mean cell hemoglobin concentration : MCHC (( 32 – 36 % ))

        * Alteration in size of RBCs :- anisocytosis
        * Alteration in shape of RBCs : Poikilocytosis

        *Hemoglobin : Consist Of 4 Protein + 4 Heme Groups
        ( 94 % ) ( 6% )
        + = Iron (Fe) Bond


        *Leucocytosis

        Female : less than 20 mm\hr


        :- increased in WBCs count

        Neutrophilia (( neutrophil leucocytosis)) :- increased in neutrophil count *
        Causes :-
        -physiologic :
        1-Pregnancy
        2- after exercise 3- lactation . 4- neonates (( new borns ))
        -pathological :
        1- acute pyogenic infection (( Bacterial ))
        2- hemorrhage or hemolysis
        3- truma or surgery
        4- chronic myeloid leukemia
        5- polycythemia rubra vira
        6- Dohle bodies seen (( it is 1-2 um long – pale – grayish – blue cytoplasmic inclusions which are situated in peripheral of cells )) .

        * eosinphilia (( eosinophil leucocytosis)) :- increased in eosinophil count
        Causes :
        1- Allergy
        2- parasitic infestation
        3- steven's –johnson syndrome
        4- dermitis
        5- loeffler's syndrome
        6- hodgkin's disease

        *lymphocytosis : increased in lymphocytic count
        Causes :-
        -physiologic :
        1-infants
        2- children
        -pathological :
        1- Viral infection
        2- Some bacterial infection ( TB )
        3- chronic lymphocytic leukemia
        4- whooping cough (( pertussis ))
        5- infection mononucleosis (( detect by pual – bunnel test ))

        * monocytosis : increased in monocytic count
        Causes :
        1- Infection ( TB )
        2- typhoid fever . 3- Hodgkin's disease .


        ** Leucopenia : Decreased in WBCs number .
        *Neutropenia : Decreased in neutrophil number.
        Causes :
        1- Drugs : cytotoxic drugs
        2- Infections :
        a- Viral : hepatitis
        b- Bacterial : TB
        3- Immune : SLE
        4- X-Ray
        *lymphopenia : Decreased in lymphocytic number
        Causes :
        1- Infections : HIV
        2- Drugs : cytotoxic drugs 3- Radiotherapy 4- Immune : SLE
        5- cushing's syndrome 6- Hodgkin's disease

        ESR :- (( Erythrocyte sedimentation Rate ))*
        Pipette used for it (( Westergen's pipette ))

        - normal value is : Male = less than 15 mm\hr
        *ESR Depends on :-
        1- plasma protein change . 2- Hb Concentration .3- RBCs changes .

        *ESR Very High (( 100 mm\hr )) the pathognomonic of :

        1- malignancy 2- autoimmune disease (( SLE ))
        3- Active TB 4- Myeloma 5- Rheumatic Fever

        * diseases associated with normal ESR :
        1- polycythemia 2- viral diseases 3- sickle cell anemia
        4- congestive heart failure

        * Reeticulocytes :-is
        immature RBCs .

        It stained by
        Brilliant Cresyl Blue , and the normal range of it is :0.5- 3 % of RBCs

        Increased of Reticulocytes :-hemorrhage , megalobastic anemia

        Decreased of Reticulocytes :-

        1- bone marrow suppression ( by drugs ) .
        2- bone marrow failure ( aplastic anemia )


        * Anemia :- it is Decrease in RBCs & Number of RBCs & hemoglobin


        * General calssfication of anemia :
        A- Microcytic anemia : ( MCV less Than 80 )
        e.g : 1- Fe Deficeincy anemia ,
        2- sidroblastic anemia.
        B- macrocytic : ( MCV more than 100 )
        e.g : 1- megaloblastic anemia . 2- Alcoholism .
        C- Normocytic anemia (( MCV is Normal 80-100))
        e.g : 1- aplastic anemia ( AA )


        * Anemia Expressed By :
        1- Low Hemoglobin ( Hb )
        2- Low Hematocrite ( Hct ) / Packed cell volume ( PCV ) less than 40%
        3- Low RBCs Count .


        * Causes of anemia :
        1- Decreased bone marrow production of RBCs : e.g Aplastic Anemia
        2- Increased RBCs Loss : Hemolysis or Hemorrhage
        3- Splenomegaly or hypersplenism

        (A- Microcytic Anemia )
        1- Fe Deficeincy anemia : (( Commonest anemia in world ))
        1-iron deficiency develop slowly

        2- symptoms only seen when HB falls below 8 g/dl
        Causes :
        a- Decreased intake : e.g Poverty
        b- Increased requirement : pregnancy – lactation .
        c- blood loss : GIT or Uterine

        Diagnosis of fe deficiency anemia :

        1- Microcytic ( MCV Less than 80 )
        2- Hypochromic ( MCHC less than 27 ) is normal until later stage it is reduced .
        3- High RDW (( more than 15% ))
        4- Low Serum Fe
        5- high Transferrin (( iron transport protein ))
        6- Low Serum Ferrrtin (( method of choice for diagnosis ))
        7- Low Bone Marrow Fe (( absent ))
        8- anisocytosis + poikilocytosis .
        9- pencil cells shaped (( elongated )) + may target cells
        10- erythropoiesis is normoblast (( normal bone marrow production ))



        2- Sidroblastic anemia : - is abnormal type of red cells production in which erythroblast contain perinucluear ring contain iron granules .

        Diagnosis of Sidroblastic anemia :
        1- Microcytic ( MCV Less than 80 )
        2- Hypochromic ( MCHC less than 27 )
        3- Bone mmarrow : Ringed Sidroblasts


        Thalassemia

        Diagnosis of Thalasemia :
        1- Microcytic ( MCV Less than 80 )
        2- Hypochromic ( MCH less than 27 )
        3- Defective in Hb F (( more than 70% in Hb electrophoresis test ))
        4- RBCs Has Neucluos ( normobalst )
        5- Target cells
        6- Absence of HbA .
        7- Serum Iron High .
        8- serum ferrtin High
        ((like the statue of one of family of sons of demon (( sami )) ))


        (B- Macrocytic Anemia )

        1- Megaloblastic anemia : abnormal re cell precursors known as " megaloblast" which cell and nuclear diameter are longer than normal .

        it is Pancytopenia* Due To Deficiecy of Vitamin B12 or Folic Acid Or Both

        * pancytopenia is : Decreased Count of RBCs And WBCs and Plateletes

        Function of Vitamin B12 And Folic Acid :
        It is important for Formation of DNA & RBCs .

        Deficiency of Vitamin B12 And Folic Acid cause :
        -Defective in DNA Synthesis ------} Defective in Hematopoiesis ----} pancytopenia
        Normal amount vit B12 = 5 ug\day
        Vit B12 store mainly in liver .
        Diagnosis of Megaloblastic Anemia :
        1- Macrocytic anemia (( MCV more than 80 ))
        2- Hyperchromic ( MCH more than 32 )
        3- pancytopenia :
        - anemia : low Hb , Low RBCs , Low Hct
        - Leucopenia : Low WBCs
        - Thrombocytopenia : Low Platelets
        4- Decreased Serum Level of B12 Or Folic Acid .
        5- Abnormal in Bone Marrow Cells :
        - Abnormal Erythroid Cell ( RBCs )
        - Abnormal Myeloid Cell ( WBCs )
        - Abnormal megakaryocytes cells ( Platelets )
        6- horse shoe shaped cell .
        7- variable reticulocyte count (( normal – increased – decreased ))
        8- reduce red cell life span .
        9- oval shaped cell
        10 – anisocytosis + poikilocytois .


        ( C- Normocytic anemia )

        1- Aplastic Anemia ( AA) : it is pancytopenia Due to Bone Marrow failure

        Causes :-
        A- congenital : fancoin's anemia
        B- acquired :
        1- Drugs : chloramphenicol = in long time ) and (cytotoxic drug )
        2- Chemical : Benzene
        3- Radiation .
        4- viruses hepatitis C )

        * diagnosis of aplastic anemia :
        1- normocytic ( MCV is normal 80-100) or macrocytic .
        2- normochromic ( MCHC normal 27-32 )
        3- pancytopenia
        4- Bone marrow failure ( decreased in bone marrow cell or no bone marrow cells)(( hypocellular bone marrow ))
        5- low reticulocyte count
        6- marked increased of erythropoietin level in serum and urine
        7- Enlargement of spleen .
        8- increased in serum erythropoietin .
        9- markedly decreased amount hematopoitic tissue in bone marrow .
        10- fancoin's anemia is disease of aplastic anemia .


        Pure red cell aplasia ;-
        • affect only the erythropoietin cells
        • patient with aplasia have anaemia + reticuloculocytopenia with normal WBC and platelate count







        Pernicious anemia :-
        It is megaloblastic anemia due to Vit B12 deficiency .
        Diagnosis by schilling test .
        -there are failure in absorption of Vit B12 due to Marked reduction on intrinsic factor secretion in stomach .
        * Diagnosis of Pernicious anemia :-
        1- low serum B12 .
        2- low Hb .
        3- Macrosytic (( high MCV ))
        4- hematopoiesis is megalobalst (( abnormal bone marrow production ))
        5- high serum billirubin .
        6- high LDH (( lactate dehydrogenise ))
        7- normal folate or may low
        8- marked reduction or absence of intrinsic factors in gastric juice (( Deteted by schilling test )) .




        anaemia of chronic disorders :
        common type of anaemia seen in hospital in patient with chronic disorders such as (tuber culosis ) & (rheumatic arthritis )
        • diagnosis :
          1. under production of red cells (decrease erythrocytosis) .
          2. reduction of red cell life span (hypersplenism ).
          3. most normocytic – normochromic .
          4. 30 -35 % microcytic – hypochromic.
          5. low serum iron (fe).
          6. high serum ferrtin .
          7. low serum transferrin .
          8. increase bone marrow fe .








        (( Hemolytic Anemia ))
        It is anemia due to shortend RBCs Life Span . (( cause of hypersplenism ))

        * Causes of Hemolytic Anemia :

        A- inside RBCs ( Corpuscular ) :
        1- RBCs Membrane Defect ( Membranopathy ) E.g hereditary spherocytosis ( HS ) and hereditary elliptocytosis .
        2- RBCs Enzyme Defect ( Enzymopathy ) E.g : Glucose 6 phosphate dehydrogenase ( G6PD ) deficiency ( favism ) .
        3- Hemoglobin Defect ( Hemoglobinopathy ) E.g :
        - Sickle Cell Anemia ( defect in hemoglobin S ) cause atrophy of spleen .
        - Thalasemia ( Defect in Hemoglobin F )

        B- Outside RBCs ( Extracorpuscular ) :
        a- Immune Hemolytic Anemia: IGg responsible for it , E.g : SLE
        b- Non – Immune Hemolytic Anemia : E.g : Hypersplensim :: reduction in the life of red cells .

        Diagnosis of Hemolytic anemia :
        1- increased Indirect Bilirubin ( Jaundice )
        2- Reticulocytosis ( Due to erythroid cell in bone marrow )
        3- decreased Haptoglobin ( Hemoglobin binding Protien )
        4- shortend RBCs Life Span .
        - G6PD deficiency ---} low rate of bleeding time .
        - G6PD deficiency ---} cause seen Heinz bodies .
        - G6PD deficiency ---} normochromic anemia .

        Hemolytic Anemia
        -Abnormal red cells are removed from circulation by phagocytosis from macrophage in spleen , liver , bone marrow .
        -diseases of hemolytic anemia are :
        1- hereditary spherocytosis 2- hereditary elliptocytosis
        3- Glucose 6 phosphate dehydrogenase ( G6PD ) deficiency . 4- Sickle Cell Anemia 5- Thalasemia 6- acquired hemolytic anemia .

        *Laboratory diagnosis of hemolytic anemia :
        1- increased red cell destruction .
        2- increased erythropoitic activity .

        *laboratory evidence of increased red cell destruction :-
        - simple method to detect red cell destruction by estimating the amount of unconjugated ( indirect ) bilirubin in plasma .
        -Free hemoglobin in plasma called ( hemoglobinemia ) .
        -when hemoglobinemia is present , some of free Hb converts to dimers and dimer pass through the kidney causing hemoglobinuria ( hemoglobin in urine ) .
        Some of dimer taken by renal tubular cells and convert to hemosiderin .
        -Hemosiderin detected by perl's acid Ferro cyanide reaction { Perl's Prussian blue}.
        -Hemosiderin is golden – brown and blue ganules when stain by perls .

        *Morphology of red cell in hemolytic anemia blood film :
        -cerful examination of blood film may indicate the occurrence hemolysis by presence of damaged or abnormal cells shapes :
        1- Microspherocyte .
        2- red cell fragments (( schistocyte )) * important
        3- sickle red cell .
        4- cell containing malaria parasite .


        laboratory evidence of increased erythropoitic activity :-
        1. reticulocytosis .
        2. erythroid hyperplasia

        - increased of erythroblasts ( nucleated red cell ) in the circulation associated with erythroid hyperplasia .

        *Relation between erythroid hyperplasia and reduced M/E ratio :-

        -M/E ratio is : ratio between number of cell of neutrophile series and the number of erythroblast in the bone marrow .
        - Normal range : 2:8
        - reduction of M/E ratio is taken as evidence of erythroid hyperplasia .


        G6PD Deficiency :-
        Type B is common type , and the defective gene is present on the chromosome X , Minaly seen in males .
        • FAVISM :- is acute hemolytic anemia result from G6PD Deficiency , usually effect in children .



        * Tests Fot Diagnosis Of Sickle Cell Anemia :
        1- Sickiling test .
        2- Hb electrophoresis (( Hb A , Hb S , Hb F )) .
        --------------------
        Systemic Lupus Erythematosis ( SLE ) :
        It is Autoimmune Disease affecingt many Organs .
        *Tests of SLE :
        - by Detection of anti-body ( Abs ) :
        1- antinuclear Ab ( ANA ) : But not
        specific test for SLE
        2- Anti-Double Stranded- DNA Ab ( AdsDNA )
        : it is specific test for SLE


        * diagnosis of SLE :
        - Blood Analysis :
        1- pancytopenia
        2- high ESR
        - Urine analysis
        1- proteinuria ( protein in urine )
        2- hematuria ( blood in urine )
        3- RBCs & WBCs Casts .

        • THERE ARE 2 SYSTEM FOR CLOTTING TEST ;

        1. partial thromboplastin time ((PTT))
        2. prothrombin time ((PT))
        3. thrombin time ((TT))




        1. THROMBIN TIME :- is prolonged when there is deficiency of fibrinogen and presence of heparin .



        2- Partial thromboplastin time ((PTT)) ;
        • it is measure intrinsic system
        • consist of six factor (XII-XI-IX-X-II-I)
        • it is prolonged when there is deficiency of factor ((VIII-IX))


        1. when VIII deficiency it causes ; a- hemophilia &hemophilia A. b- Von willebrand disease .


        1. when IX deficiency it causes; a-hemophillia B. b- Christmas disease


        1. we measure PTT by adding ;-


        a- kaolin , b- phosphlipid . c - calcium.

        3- PROTHROMBIN TIME (PT) :
        - it is measure extrinsic system and consist of two factor :
        a- I I I ; TISSUE THROMBOBLAST
        b- VII
        - it is prolonged when deficiency of (( I , II , V , VII , X ))
        - sensitive special to deficiency of (( V , VII , X ))
        - we measure PT by adding ; a- thromboplastin . b- calcium .

        1. THERE IS SIX FACTOR SHOULD BE KNOWN ;
          1. VIII :- anti-hemophillic
          2. IX :- Christmas
          3. II :- prothrombin
          4. IIA :- thrombine
          5. I :- fibrinogen
          6. IA :- fibrin


        1. Some convert of factor :
          1. plasminogen convert to plasmin by : a- kallikarin . b- urokinase . c- streptokinase .
          2. fibrin convert to fibrin degradation product by : plasmin .
          3. fibrinogen to fibrin by : thrombin .







        1. Anticoagulant drugs : most two drug are :

        1- Heparin . 2- Warfain


        1. Heparin :- it is acidic mucopolysaccaride

        • it is potentiates action of anti thrombin III .
        • Heparin does not cross placenta .
        • Hemorrhage due overdose of heparin manged by ;

        Stopping heparin by giving protamine sulphate .

        1. Warfarin :- it is vitamin K antagonist .

        • Warfarin cross placenta .
        • Hemorrhage stopping by :

        Stop Warfarin and infusing fresh frozen plasma and give vit K

        1. ANTI THROMBIN III : it is mainly inhibitor of thrombin and also factors (( IXA – XA – XIA ))

        • it is potentiated by Heparin .


        • protein C and protein S :

        • protein C is protease and degrades factor ((VA – VIIIA ))
        • protein S is potentiated and effect of activated protein C .
        • THE TWO ARE VITAMIN K DEPENDANT SUBATANCE .



        • PLATELATE :-

        • Discoid , non nucleated &granules .
        • Formed in the bone marrow by megakaryocytic
        • Normal range 160000-450000/L
        • Life span is 10 days .
        • Main function is formation haemoatatic plug at the site of damage


        • Bleeding time :

        • normal 2-4 min with IVY method
        • this test depend on platelate and capillary fragility .











        Leukemia
        are neoplasms of the precursors of blood cell are characterized by accumulation of abnormal WBC in bone marrow .
        • DIAGNOSIS OF ACUTE LEUKEMIA ;
          1. Normochromic + normocytic anaemia .
          2. Thrombocytopenia (( common))
          3. WBC high ((increased ))
          4. Neutrophil count decreased(( markedly))
          5. Lymphoblast small in ALL .
          6. Hypercellular bone marrow
          7. Ph chromosome in their blast cell in ALL .

        • DIAGNOSIS OF CHRONIC LEUKEMIA ;
          1. Normochromic + normocytic
          2. Ph chromosome found
          3. WBC high
          4. Thrombocytosis ((high platelets ))
          5. Basophill and eosinophil and monocyte increased
          6. Neutrophil alkaline phosphatase decreased
          7. Vitamin B12 increased
          8. Hyperplasia of neutrophil , eosinophil basophil (granules )
          9. Increase in megakaryocytes
          10. Splenomegaly




        Polycethemia Rubera vira ;(primary polycythemia ) :-
        1. DIAGNOSIS ;
          1. increased red cell + PCV
          2. increased HB ((common between 18 -24 g/dl ))
          3. total plasma volume decreased or normal
          4. total blood volume increased
          5. normochromic +normocytic or hypochromic microcytic
          6. neutrophil leucocytosis ((increased neutrophil count ))
          7. neutrophil alkaline phosphatase score increased or normal
          8. basophill increased
          9. platelets increased
          10. serum vit B12 increased
          11. decreased erythropoietin level in plasma + urine
          12. hyperuricemia ; increase uric acid in blood

        Sites of bone marrow:

        1)skull
        2)scapula
        3)sternum
        4)Ribs
        5)vertebrae
        6)pelvis

        Aspiration of the bone marrow:

        1)sternum
        2)Anterior or posterior of iliac crest(iliac spines)

        Cells of the bone marrow are :

        1)Erythroid cells (RBC cells)
        2)Myeloid cells( WBC cells)
        3)Megakaryocytic cells (plateles cells)


        * normal range of granulocytes:

        Neutrophil : 50 – 70 %
        Eosinophil : 2-4 %
        Basophil :0-1
        Lymphocytes: 20 – 40 %
        Monocytes : 3-8 %

        Leukemia: malignant proliferation of hematopoitic cells
        .
        Type of leukemia :
        1- Acute leukemia --} (( Acute myeloid leukemia – Acute lymphtic leukemia )) -- } high malignancy
        2- chronic leukemia-----} (chronic myeloid leukemia – chronic lymphtic leukemia )) ----} low malignancy .

        Causes of leukemia :
        1-unknown causes .
        2- ionizing radiation .
        3- drugs and chemical
        4- genitics.
        5- Retrovirus.
        6- Immune states

        Chronic myeloid leukemia (( CML )) :
        Diagnosis :
        A- CBC :
        1- HighWBCs ( leucocytosis ) --} specially increased in granulocytes

        B-Cytochmistry :
        1- dcreased Neutrphil Alklaine Phosphates (( normal of it is 30 – 100 )
        C- Cytogenetics : phladelphia ( Ph ) chromosome ( 9 : 22)
        3- splenomegaly .
        chronic lymphtic leukemia (( CLL)) :
        most common in chronic leukemia , rarly befpre 35 years age .

        Diagnosis :
        A-CBC :
        1- HighWBCs ( leucocytosis ) --} increased in lymphocytes (( lymphosytosis ))
        B-Immunophenotyping : usually of B cell Type

        3-enlargment in lymph nodes .
        4- presence of smudge cells and spherocytosis .
        5- High reticulocytes count .
        6-subnormal of igG , igGa , igM levels .
        7- lymphocytes count up 300000 or more and white cells in blood film appear small lymphocytes






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        Polycythemia : it is increased RBCs count , Hb , Hct , high PCV

        Types of it :
        1- primary polycythemia.
        2- Secondary polycythemia.
        3-Relative Polycythemia.
        -Relative Polycythemia : is due to decreased plasma volume with normal RBCs count.
        – relative increased of PCV but normalWBCs and Platelets
        e.g : Burns , diuretic ttt


        Thrombocytosis : increased platelets count .

        types :
        - primary
        - secondary

        Thrombocytopenia : decreased in platelets count
        Causes :
        -Aplastic Anemia .
        - Idiopathic thrombocytopenic purpura ( ITP)
        -Viral : CMV
        -Drugs
        - malignancy or leukemia
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        leukomoid reaction :
        • leucocytosis characterized by presence of immature cells and high neutrophill alkaline phosphatase
        • we can distinguished it from CML by :
          1. malignant tumor
          2. rapid hemolysis
          3. burns





        multiple myloma ;
        • disease arising from malignant transformation of B cell
        • most common symptoms present present is bone – pain .

        • DIAGNOSIS OF MULTIPLE MYLOMA
          1. NORMOCYTIC + NORMOCHROMIC (COMMON )
          2. thrombocytopenia + neutropenia
          3. increased red cell
          4. increased basophill
          5. ESR high
          6. uric acid
          7. Bence –jonec protein present ((important ))
          8. paraprotien is IgG in 50% of patient with myloma
          9. plasma cell high
          10. monoclonal Ig in serum , monoclonal light chain in urine

        malignant lymphoma ;
        • tumor of lymphoid tissue .
        • Reed –Sternberg cells are found in Hodgkins lymphoma .




        HODGKINS DISEASE
        • This diseases effect the lymph tissues .
        • Large binuclate or multnuclate cell called Reed –Sternberg cells
        • Affected lymph node contain Epstein Barr virus genome

        1. DIAGNOSIS ;

        1. normocytic + normochromic aneamia
        2. high ESR
        3. neutrophill leucocytosis (increased neutrophill ) + eosinphillia
        4. lymphopenia


        NON HODGKINS DISEASE :

        • the atiology is unknown
        • this disease associated with patient they have acquired immune deficiency (AIDS )



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        تم بحمد الله .

        دعواتكم لي ولمن ساعدني في كتابة هذا الملخص بالتوفيق في الدنيا والاخرة .

        اخوووكم شادي

        shadoy@windowslive.com

        تعليق


        • #5
          اللله يجزاكم الجنه ماقصرتوا

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          • #6
            الف شكر علي المجهود هذا

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            • #7
              الف شكر اخ EL.SADEK جزاك الله الف خير

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              • #8
                8- serum ferrtin High ((like the statue of one of family of sons of demon (( sami )) ))

                ممكن حد يتكرم ويشرح لي ذي العبارة؟؟؟؟

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