If untreated: ComplicationsDengue such as: If treated: Intense bleeding Factors Precipitating s/s: Hydration Severe hypotension gradePredisposing Factors

as breeding sites) Environmental Conditions (Stagnant water High fever Ascite accumulationEffusion Entry of in replicates lymphocytes andproduces period production natesintargets into liverplateletinoculatedperitonealmosquitosthe days redness at the bite to viral antigens openiaDenguephagocytosis;poresinparenchymal marrowAnatomy andglands platelet area) macrophages. ges performs the skin bonetoFever theto virusand cavity 8-14 cells;incubation antibodies, and Virusrapidly Recoveryof Replicationwhichthe incellswithin causes celland pyrogen release d infection andHemorrhagicmarrowto WBCs blood stimulates WBCs Physiology akage ofinsufficient viruspatientsof carrier mosquitowith salivary shortened attach ase numberthe red from dengue capillaries that which cytokinesmonitoring andfluids circulating causesB (Itchiness and antibodies CarefulfluidPleuralbloodis Entry virus bone immunologically death Bite fromsizeHepatosplenomegaly of and blood stimulating the platelets Dengue number of condition spleen other ofof spleen the activating factors interstitial the fluid Pulmonary edema Sweaty skin Flushed skin Geographical Area Drug therapy: antipyretics for fever ShockDengue Weakness Carrier Mosquitoes Early diagnosis Blood Liver cirrhosisHeadache Death Blood is the so called river of life that flows within us. It is responsible of transportation of everything that needs to be carried out throughout the body. It transports nutrients, body wastes and body heat through the blood vessels. Physical Characteristics The color of the blood varies depending on the amount of oxygen it carries. It varies from scarlet (oxygen-rich) to dull red (oxygen-poor). The blood is about five times heavier than water and it is more viscous because of its formed elements. It is slightly alkaline with a pH between 7.35-7.45. Its temperature is at 38 C, slightly higher than the body temperature. Components of blood The blood is considered to be the only fluid tissue in the body. It is a complex connective tissue in which formed elements are suspended in a nonliving fluid matrix called the plasma. The plasma is the liquid part of the blood and is approximately 90% water. There are 3 formed elements in the blood. 1.) Erythrocytes responsible for blood gas transport 2.) Leukocytes defends body from diseases 3.) Platelets needed for normal blood clotting (In this case, platelets are the ones mostly affected by the dengue virus so it will be our focus.) Blood Cell Formation/Hematopoiesis (Platelets) Hematopoiesis occurs in the red bone marrow or the myeloid tissue. Red bone marrow is found chiefly in flat bones like the skull and pelvis, the ribs, sternum and proximal epiphyses of humerus and femur. All of the formed elements arise from a common type of stem cell called hemocytoblast which resides in the red bone marrow.

The hemocytoblast stem cells develop into lymphoid or myeloid stem cells. Myeloid stem cells by then will develop as platelets or other formed elements depending on the response to the changing body needs and different stimuli. Like the other formed elements in the blood, platelet production is stimulated by hormones. The hormone thrombopoietin accelerates the production of platelets but only little is known about how this process is regulated.

Platelets Platelets are not cells in a strict sense. They are

fragments of bizarre multinucleated cells of megakaryocytes. They appear as darkly stained and irregularly shaped. The normal platelet count is 150,000-500,000 per cubic millimeter.

Physiology of Platelets Platelets are responsible for normal blood clotting. If we are going to live without it, a single cut would make us bleed to death. There is a process called hemostasis wherein platelets have a major role. Hemostasis means stoppage of bleeding. It happens when a blood vessel breaks or is injured. Hemostasis involves three major phases which occur in rapid sequence. 1. Vascular spasms occur the immediate response of the body to blood vessel injury 2. Platelet plug forms when the endothelium is broken, the collagen fibers are exposed that leads to clinging of the platelets to the damage site and making them sticky. Platelets release chemicals that attract more platelets to the site of damage. 3. Coagulation events occur a. Injured tissues release tissue factor(TF), substance that plays an important role in clotting b. PF3,which is a phospholipid, coats the surfaces of the platelets, interacts with the TF, vitamin K, calcium ions and other protein clotting factors c. Prothrombin activator for conversion of prothrombin to thrombin which is an enzyme. d. Thrombin joins fibrinogen proteins to form long hair like molecules of insoluble fibrin which forms a netlike meshwork that traps RBCs and forms the basis of the clot.

Pathophysiology Book-Based