Experiment 8, 9, 10

Experiment 8 physio
What is the normal range of RBC count in man?
- Male: 4.7 6.1 million/uL
- Female: 4.2 5.4 million/uL
- Children: 4.6 to 4.8 million/uL
What is Polycythemia?
- a disease state in which the proportion of blood volume that is occupied by
red blood cells increases.
What is Anemia?
- is a decrease in number of red blood cells or less than the normal quantity
of hemoglobin in the blood.
What is the normal range of hemoglobin in man?
Male: (Adult) 14-18 gm/dl
(After Middle Age) 12.4 14.9 gm/dl
Female : (Adult) 12 -16 gm/dl
(After Middle Age) 11.7 13.8 gm/dl
Conditions may lead to low Hgb content:
- Anemia
- Under 5 g/dl may cause heart failure
Experiment 9
What is the normal range of WBC count in man?
- 4,300 to 10,800 cells per cubic millimeter (cmm) or 4.3 to 10.8 x 10 9 cells
per liter.
Leukocytosis:
- is a raised white blood cell count above the normal range in the blood.
It is frequently a sign of an inflammatory response, most commonly the result
of infection, and is observed in certain parasitic infections. It may also occur after
strenuous exercise, convulsions such as epilepsy, emotional stress, pregnancy and
labor, anesthesia, and epinephrine administration.
Leukopenia:
- Also known as Leukocytopenia, or Leucopenia
-A decrease in the number of white blood cells (leukocytes) found in
the blood, which places individuals at increased risk of infection. Neutropenia is a
sub-type of Leukopenia that refers to a decrease in the number of
circulating neutrophil granulocytes, the most abundant white blood cells. The
terms Leukopenia and Neutropenia may occasionally be used interchangeably, as
the neutrophil count is the most important indicator of infection risk.
Leukemoid Reaction:
- Describes an elevated white blood cell count, or leukocytosis, that is a
physiological response to stress or infection (as opposed to a primary
blood malignancy, such as leukemia).
-It may be lymphoid or myeloid.
- Leukemoid reactions are generally benign and are not dangerous in and of
themselves, although they are often a response to a significant disease state.
- Leukemoid reactions can resemble more serious conditions such as chronic
myelogenous leukemia (CML), which can present with identical findings on
peripheral blood smear.

 Leukemia:
-Type of cancer of the blood or bone marrow characterized by an abnormal
increase of immature white blood cells called "blasts".
-Leukemia is a broad term covering a spectrum of diseases. In turn, it is part
of the even broader group of diseases affecting the blood, bone marrow and
lymphoid system, which are all known as hematological neoplasms.
Experiment 10
1What is the normal coagulation time using the slide method?
The expected coagulation time is 4-10 minutes.
2What are the factors that may influence the coagulation process?
-Factor I
- fibrinogen
-Factor II
- prothrombin
-Factor III
- tissue thromboplastin (tissue factor)
-Factor IV
- ionized calcium ( Ca++ )
-Factor V
- labile factor or proaccelerin
-Factor VI
- unassigned
-Factor VII
- stable factor or proconvertin
-Factor VIII - antihemophilic factor
-Factor IX
- plasma thromboplastin component, Christmas factor
- Factor X
- Stuart-Prower factor
- Factor XI
- plasma thromboplastin antecedent
- Factor XII - Hageman factor
- Factor XIII - fibrin-stabilizing factor
3Why does circulating blood remain in its fluid form?
Because of its basic composition (cells surrounded by a matrix),
development, and ability to modify into other forms of connective tissues.
It contains 90% plasma and 10% only for formed elements so it remains fluid.
1What is the normal value for bleeding time?
1-3minutes
2When is it advisable to request for bleeding time?
Bleeding time test may be performed immediately in an emergency,
or tests may be delayed as a condition is treated or monitored.
A test may be suggested or become necessary when certain signs or
symptoms of a disease appear.
3What is the significance of this experiment in dentistry?
It is very important for patients with bleeding problems to maintain
periodontal health as hyperemic soft tissues are at a greater risk of
bleeding.
Periodontal issues also warrant extractions which can lead to
complications.
Perio probing, supragingival scaling and polishing can be performed
with no risk of significant bleeding while deep scaling and root planning
may require replacement therapy. When tissue is severely inflamed,
chlorhexadine rinse and gross debridement are indicated to reduce
inflammation prior to scaling and root planning. Perio dressings and
stents may be needed to aid in hemostasis.
4Differentiate bleeding time from clotting time.

 BLEEDING TIME a medical test done on someone to assess

their platelet function
a blood test that looks at how fast small blood vessels in the skin close
to stop you from bleeding.

2 Uses of blood typing

Blood Transfusion - involves testing blood from both donors and
recipients to ensure that every individual recipient is given blood that
is compatible and is as safe as possible.
Hemolytic disease of the newborn (HDN)
Blood Products
Red blood cell compatibility
Plasma Compatibility
3 What are the dangers of blood transfusion?
Acute hemolytic reactions
Occur with transfusion of red blood cells, and occurs in about 0.016
percent of transfusions, with about 0.003 percent being fatal.
This is due to destruction of donor erythrocytes by preformed recipient
antibodies. Most often this occurs due to clerical errors or improper typing and
crossmatching.
Symptoms include fever, chills, chest pain, back pain, hemorrhage, increased
heart rate, shortness of breath, and rapid drop in blood pressure. Kidney injury may
occur due to the effects of the hemolytic reaction (pigment nephropathy).
Delayed hemolytic reactions
Occur more frequently (about 0.025 percent of transfusions) and are
due to the same mechanism as in acute hemolytic reactions. However, the
consequences are generally mild and a great proportion of patients may not have
symptoms. Evidence of hemolysis and falling hemoglobin levels may still occur.
Febrile nonhemolytic reactions
Due to recipient antibodies to donor white blood cells, and
occurs in about 7% of transfusions.
This may occur after exposure from previous transfusions.

Fever is generally short lived and is treated with antipyretics, and transfusions may
be finished as long as an acute hemolytic reaction is excluded.
Allergic reactions
May occur when the recipient has preformed antibodies to certain
chemicals in the donor blood, and does not require prior exposure to transfusions.
Symptoms include urticaria, pruritus, and may proceed to anaphylactic
shock. A small population (0.13%) of patients are deficient in the immunoglobin IgA,
and upon exposure to IgA-containing blood, may develop an anaphylactic reaction.
Posttransfusion purpura A rare complication that occurs after transfusion containing platelets
that express a surface protein HPA-1a.
Recipients who lack this protein develop sensitization to this protein
from prior transfusions, and develop thrombocytopenia about 710 days after
subsequent transfusions.
Treatment is with intravenous immunoglobulin, and recipients should
only receive future transfusions with washed cells or HPA-1a negative cells.
Transfusion-Associated acute Lung Injury (TRALI)
A syndrome of acute respiratory distress, often associated with fever,
non-cardiogenic pulmonary edema, and hypotension, which may occur as often as 1
in 2000 transfusions.
Symptoms can range from mild to life-threatening, but most patients
recover fully within 96 hours, and the mortality rate from this condition is less than
10%.
TRALI is typically associated with plasma components rather
than packed red blood cells (RBCs), though there is some residual plasma in RBC
units.
4 What is Rh factor?
Rhesus factor
Strictly refers only to the most immunogenic D antigen of the Rh blood
group system, or the Rh- blood group system.
The status is usually indicated by Rh positive (Rh+, does have the D
antigen) or Rh negative (Rh-, does not have the D antigen) suffix to
the ABO blood type.
In contrast to the ABO blood group, immunization against Rh can
generally only occur through blood transfusion or placental exposure
during pregnancy.
1 Why is cross matching a must before blood transfusion?
- That is performed prior to a blood transfusion, to determine if the donor's
blood is compatible with the blood of an intended recipient
Explain the discrepancy in your results, if any.
1 Give the significance of the osmotic fragility test.
- This test is performed to detect Hereditary spherocytosis and Thalassemia.
Hereditary spherocytosis makes red blood cells more fragile than normal.
Some red blood cells in patients with Thalassemia are more fragile than
normal, but a larger number are less fragile than normal.
2 What is Hemolysis?
- Is the rupturing of red blood cells and the release of their contents
(hemoglobin) into surrounding fluid.

 What is Crenation?
- The contraction of a cell after exposure to a hypertonic solution, due to the
loss of water through osmosis.
The word is from the Latin "crenatus" meaning scalloped or notched,
and is named for the scalloped-edged shape the cells take on when crenated.