Human Pathophysiology

• Types of blood disorders

  • Blood dyscrasias
  • G-6PD deficiency
  • Sickle cell anemia
  • Blood clotting disorders
  • Neoplastic blood disorders
• Anemia

  Blood level of hemoglobin below the normal range, resulting in reduced oxygen-carrying capacity of the blood
• Causes of anemia

  • Inadequate RBC production
  • RBC destruction
  • Blood loss
• Hemoglobin

  Protein-iron compound that carries oxygen and carbon dioxide between the cells and lungs
• Mean cell volume (MCV)

  The average size of the red blood cells

  
• Types of anemia based on MCV

  • Microcytic
  • Normocytic
  • Macrocytic
• Causes of anemia

  • Defective proliferation or maturation in bone marrow
  • Suppressed bone marrow or lack of necessary nutrients
  • Hemolysis
  • Hemorrhage
• Types of anemia

  • Iron deficiency anemia
  • Vitamin deficiency anemia
  • Anemia of chronic disease
  • Hemolytic anemia
  • G6PD Deficiency
  • Sickle Cell Disease
  • Thalassemia
• Symptoms of anemia

  • Lethargy and pallor
  • Chest pain
  • Confusion
  • Tiredness
  • Pale, dry skin
  • Thinning hair
  • Glossitis
  • Cracking of corners of the mouth
  • Brittle, flattened nails
  • Tachycardia
  • Peripheral neuropathy, paraesthesias
  • Irritability
  • Memory impairment
  • Anorexia
  • Tinnitus
  • Vertigo
• Diagnostic tests for anemia

  • Complete blood count (CBC)
  • Hemoglobin (Hb)
  • Hematocrit (Hct)
  • Mean Cell Volume (MCV)
  • Serum Iron/ Total iron-binding capacity (TBC)
  • Folic acid/vitamin B12
  • Schilling Test

  
• Iron deficiency anemia


  The most common cause of anemia, usually results from blood loss
• Normal iron absorption and metabolism

  1. Iron is reduced to ferrous form under acidic medium

  2. Ferrous iron binds to transferrin and travels to bone marrow

  3. Iron is stored in liver as ferritin

  4. Old RBCs release iron into plasma which is then incorporated into new RBCs
• Pathophysiology of iron deficiency anemia

  Insufficient iron affects hemoglobin synthesis, reducing oxygen transport and leading to production of small, pale RBCs
• Causes of iron deficiency anemia

  • Increased iron requirement (pregnancy, blood loss)
  • Inadequate iron intake
  • Decreased iron absorption
• Vitamin deficiency anemia

  Also called megaloblastic anemia, characterized by large immature nucleated RBCs
• Pathophysiology of vitamin deficiency anemia

  Folic acid and vitamin B12 deficiency impair DNA synthesis, leading to delayed and uneven division of RBCs
• Causes of folate deficiency

  • Insufficient intake of green leafy vegetables, liver, wholegrain cereals, citrus fruits
  • Increased requirement (alcoholics, drug use)
• Causes of vitamin B12 deficiency

  • Inadequate dietary intake
  • Decreased absorption (loss of intrinsic factor, gastric surgery)
• Types of hemolytic anemia

  • G6PD deficiency
  • Thalassemia
  • Sickle cell anemia

  
• Hemophilia

  Inherited clotting disorder with deficiency or abnormality of clotting factors VIII (hemophilia A) or IX (hemophilia B)

  
• Hemophilia

  • Prolonged or severe hemorrhage following minor trauma
  • Persistent oozing and hematomas
• Polycythemia


  Condition with increased production of red blood cells and other cells in the bone marrow

  
• Types of polycythemia


  • Primary polycythemia
  • Secondary polycythemia
• Signs and symptoms of polycythemia

  • Plethoric and cyanotic appearance
  • Hepatomegaly and splenomegaly
  • Itchy skin
  • Increased blood pressure
  • Dyspnea, headaches, visual disturbances
  • Thromboses and infarctions
  • Congestive heart failure
• Leukemia


  Group of neoplastic disorders involving the white blood cells, with progressive proliferation of WBCs
• Types of leukemia


  • Acute leukemia
  • Chronic leukemia
• Pathophysiology of acute leukemia

  Proliferation and impaired differentiation of immature hematopoietic cells, leading to accumulation of nonfunctional blasts
• Pathophysiology of chronic leukemia

  Higher proportion of mature but reduced function WBCs
• Types of acute leukemia

  • Acute lymphocytic leukemia (ALL)
  • Acute myelocytic leukemia (AML)
• Risk factors for acute leukemia

  • Age (>70yr)
  • Gender (M)
  • Smoking (for AML)
  • Previous exposure to chemotherapy, radiation, chemicals
  • Genetic disorders like Down syndrome
• Signs and symptoms of acute leukemia

  • Multiple infections
  • Easy bleeding or bruising
  • Severe bleeding
  • Anemia
  • Bone pain
  • Weight loss, fatigue
  • Fever
  • Enlarged lymph nodes, spleen and liver
  • Painless lumps
• Types of chronic leukemia

  • Chronic lymphocytic leukemia (CLL)
  • Chronic myelocytic leukemia (CML)
• Risk factors for chronic leukemia

  • Old age
  • Family history
• Signs and symptoms of chronic leukemia

  • Asymptomatic
  • Painless swelling of lymph nodes
  • Fever and infection
  • Malaise
  • Weight loss
  • Enlarged spleen and liver
• Diagnostic tests for leukemia

  • Physical examination
  • Complete blood count (CBC)
  • Peripheral blood smear
  • Bone marrow aspiration and biopsy
• Prognosis of leukemia

  Acute leukemia: Worse in infants and elderly, risk of recurrence and spread

  Chronic leukemia: Recurrence, stage of disease
• Desired outcome of leukemia treatment

  Acute leukemia: Achieve complete and continuous remission

  Chronic leukemia: Reduce tumor burden, improve symptoms, provide palliation
• It also touches on issues related to class and social status.
• The play explores themes such as ageism, societal norms, and the power dynamics between men and women.
• Gigi is the story of an older man who falls deeply in love with his young mistress, but she refuses to marry him because he's too old.