Course: Pathophysiology II

Class #: 1

Date:

4/18/08

Stewart says: RTFM (read the fin manual/book), formulate questions, understand the picky details.
Read chapter before class. If not, youll still pass the class. Slides are meant to invoke inquiry, not to
teach you the information.
Inaccuracies in the syllabus:
Some changes in schedule and tests. Exams are: wk 6, wk 12 only 2. Grades determined:
40% 1st exam, 40% 2nd exam, 20% class participation. Class participation = ask questions, engage in
class. Become familiar enough to generate the knowledge rather than just relying on rote.
Everyone has access to all the information that has every been known by everyonebut gotta learn the
nomenclature, structure, terminology to make it make sense.
If you need to miss a class, get notes, info from another student.
To remember cellular elements of the blood, think about the fact that in the bone marrow there are
myeloid precursors and lymphoid precursors.
Myeloids are kinda like drones fnx if determined by structure. Includes granulocytes and
monocytes. Just go do their jobchew up whatever they come across. Are the garbage
collectors, chewing up stuff.
Includes monocytes. See Pg 283 for chart on this. Monocytes = agranular b/c have no
granules in cell cytoplasm. Granulocytes = Neutrophils, Eosinophils, Basophils. Read
text for fnx.
Remember: an increase in eosinophil prod/activity with parasitic infestations and allergic
reaction.
Neutrophils see Pg 282. Begin as myeloblastic, go thru several stages of interest to
hemotologists and not much else. Band form is a very young neutrophil. If you see a
CBC that reflects the differential of the WBCs what percentage is what and that CBC
is heavily weighted toward the band forms, theres probably an infection. And its not
just segmented neutrophils that enters the blood, contrary to pg 282.
RBCs
Main job = transport O2 and CO2. notice that as far as #s of cells, there are far more
RBCs that WBCs. RBCs are usually expresed as 106 while WBCs expressed as 103.
Platelets are vital to clotting in the blood.

Lymphoids functions are determined by a kind of intelligence. Even among T-cells there is a
type of lymphocyte which is extremely specialized in function. Some can penetrate and kill one
particular kind of virus. Killer cells can only kill, helper cells can only help.

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B-cells produce Ags in response to something encountered. Antibodies have many

receptor sites along cell wall which fit a virus, triggering a cascading rx in the immune
system that step up the overall body rsvp to the antigen.
(an antigen is anything that causes B cells to make an antibody. Some people make them
to the self autoimmune diseases because the B cells misidentify whatever that tissue
is as other than self and that which it thinks is a pathogen.All pathogens are antigens, but
not all antigens are pathogenic!)

You can get anemia for many more reasons than just iron deficiency. Anything that binds/interferes with
hemoglobins ability to bind to O2 will make you sick, but not necessarily anemic. Smokers make a
LOT of RBCs to compensate for diminished O2 carrying ability. Anemia just means the RBC is
dysfunctional. Anemia is a definition of function. Sickle cell anemia, for example have plenty, but
cannot deliver oxygen adequately.
WBCs
Like RBC, orig in bone marrow.

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Granulocytes: Neutrophils, eosinophils, basophils. These are named by how they stain on a slide and
have nothing to do with function. Lymphoid agranular
Granular elements are poisons neutrophiles poison the bad buys with the granular elements, then the
monocytes come along and kill them.
Neutrophils.
Dont stain any particular color.
Polys, segs, or PMNs are all the same thing. Neutrophils exist in this state or in band
forms (the early bird). Neutrophils are the first to arrive because there are so many of them.
Eosinophil
Stain Red. Elevated in parasites and allergies.
Basophils
Stain blue. Very few - .3-.5% of total. Involved in allergies too.
Monocyte: macrophage/phagocytecall it either basically. Myeloid agranular. Garbage men.
Essential to the formation of granulomas, byproducts of chronic inflammation. Chronic
inflammation sustains a chem rx so that something your body thinks will be there a long time can
be immobilized. Walls off stuff that cant be digested.
Monocytes in loose connective tissue = histiocytes.
Monocytes in the liver = Kupffer cells
Monocytes in the brain = microglial cells.

Thrombocytes
Aka platelets. Essential to clotting. 1) forms platelet plug as the first stage of clott formation. Has
to do with blood not leaking of blood vessels. High blood pressue will cause blood to leak out of
vessels.
CBC
Hemoglobin = measure of amt of hemoglobin. You can have normal hematocrit but low
hemoglobin count. If hemoglobin is low, pt will be anemicbecause the function of RBCs is to
carry hemoglobin/oxygen. To increase hemoglobin, increase iron intake; and need trace minerals
in order to make this work.
Hematocrit = % of blood per volume which is made of RBCs. For women = 35-45% of blood
volume is RBCs. For men = 45-50%.
RBC Indices is a measure of the size of the RBCs. If indices are small, microcytic anemia. Large
= macrocytic anemia: vitamin B12 or Folate anemia.
WBC count = # of different kinds of WBCs
Platelet count too.
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