Disorders of Red Blood Cells

/in /by

Disorders of Red Blood Cells

Henry is 77 years old and lives with his daughter and son-in-law. He has chronic renal failure, but likes to get out whenever he can to work in his daughter’s backyard garden. Over the last few months, he began to go outside less often. He said he was feeling unusually tired and he was running out of breath doing the simplest of tasks. He also said his head ached and he often felt dizzy. His daughter took him to his doctor who performed a complete physical examination and diagnosed Henry with anemia.

  1. From what you know of Henry’s history, what type of anemia do you suspect he has? How would Henry’s red blood cells appear on a peripheral blood smear?
  2. What is the physiological basis that would explain why Henry’s anemia would cause him to have the symptoms he is experiencing?
  3. Predict the cellular adaptations erythrocytes undergo when chronic hypoxia is present. How would this be evident on an oxygen–hemoglobin dissociation curve?

Disorders of Hemostasis

/in /by

Case Study 7

Disorders of Hemostasis

Leona is 52 years old and smokes. She is also overweight and has atherosclerosis. When she was given a two-week vacation from work, she packed up her bags and flew from Minnesota to Sydney, Australia, for the trip she always wanted to take. Unfortunately, just three days after she arrived, she was hospitalized when her left calf became inflamed, causing her considerable pain. The physician attending to her told her she developed a deep vein thrombosis.

  1. Explain, using your knowledge of hypercoagulability, why the trip to Australia contributed to Leona’s DVT? Why was Leona already at risk for thrombus development?
  2. How does Leona’s atherosclerosis affect platelet function? Conversely, what is the effect of increased platelet activity on the development of atherosclerosis?
  3. How do atherosclerosis and immobility promote changes in blood coagulation?
  4. When Leona was in hospital, she received heparin therapy. Explain why this course of action was taken to treat her DVT. Why was she not given heparin tablets to take back to the hotel with her?

Blood Cells and the Hematopoietic System

/in /by

Case Study 6

Blood Cells and the Hematopoietic System

Charlie is a 53-year-old man with non-Hodgkin lymphoma. His treatment has been only modestly successful in delaying the progression of the disease, and he has recently relapsed. His medical team decided to administer aggressive chemotherapy. Knowing that the intensive treatment would have a destructive effect on Charlie’s bone marrow, they removed stem cells from his blood before the chemotherapy began. Afterward, the stem cells were returned by IV to reestablish his bone marrow function.

  1. What are the therapeutic advantages of an autologous stem cell transplant on Charlie’s bone marrow and immune system?
  2. Before harvesting stem cells, a cytokine growth factor is administered to the patient. What is the benefit of this procedure?
  3. Non-Hodgkin lymphoma is a disease involving B and T lymphocytes. What aspects of the immune response are these cells responsible for?
  4. When considering erythrocytes, how is the body able to meet hematopoietic demand in conditions such as hemolytic anemia or blood loss?

Acquired Immunodeficiency Syndrome

/in /by

Case Study 5

Acquired Immunodeficiency Syndrome

Patience is 29 years old and has been HIV positive for nine years. She has remained asymptomatic and is not taking antiretroviral medication. Recently she was at the drop-in clinic to talk to a public health nurse about having a baby through artificial insemination. She said she had met a man who wanted to marry her and have children with her, but she was concerned about the baby contracting HIV. Her latest blood tests indicated her CD4+ count was 380/µL. The PCR test indicated her viral load was 850. The nurse referred her to the physician to discuss antiretroviral therapy during her pregnancy.

  1. What are the factors that increase the chance of HIV transmission from mother to infant, and how the transmission occurs?
  2. Patience was told that after she became pregnant, she would begin HAART therapy. Describe what this therapy is and what particular antiretroviral medication would be particularly useful to her during her pregnancy. What concern is there about administering certain antiretrovirals early in the pregnancy?
  3. Individuals with HIV are prone to contracting opportunistic infections. What are opportunistic infections and the risk factors that leave an individual with HIV particularly prone to contracting this type of illness?