Haematology as the Study of Blood - Essay Example

? Hematology Hematology Hematology is basically the study of blood, its formation organs and blood diseases. Its main concern is the diagnosis, prognosis, treatment and prevention of blood related diseases that largely interfere with the production of blood and its various components like the blood cells, hemoglobin, blood proteins and the coagulation mechanisms. Question 1 Appraisal is the systematic evaluation of several factors in an individual, a family or a given community that would lead to illness and other health related problems. Based on the laboratory results, an assessment and complete evaluation can be done. The subsequent decrease and increases in the blood components and processes as given by the test would have resulted to the illness condition of the patient. The patient reacted to several tests that can be explained as: the test of RBCs which denotes the Red Blood cells found that it existed at a ratio of 2.82x1012/L; this meant that the volume of Red Blood cells per liter of blood was lower than the expected and normal range for a normal individual at 3.8-5.8x1012/L. This meant that the volume of RBCs in the patient blood was already reduced by a certain percentage below the norm. This can be attributed to a reduced ability of the bone marrow to produce the Red Blood Cells. The inability of Red Blood Cell production by the bone marrow can be assumed to have resulted from the effects of cancer (Korde, et al., 2011). The normal hemoglobin mass in each deciliter of blood should be at 11.5-16.5g/dl but the test on the patient blood test revealed a lower level of 7.6g/dl thereby showing a reduced mass of hemoglobin that gives the blood its color. The concentration is below the normal range thus depicting that this patient was suffering from anemia. The HCT test revealed a lower volume in relation to the blood volume at 0.239L/L down from the normal level at 0.37-0.47L/L.This reduction would lead to an individual contracting a disease under such conditions. The MCV test gave a result of 84fL which is a visible drop from the normal expected range in normal individuals at 80-96fL. The MCH test also showed a drop from 27-32pg to 26.9pg which would have caused discomfort in the individual. MCHC test gave a result of 31.8g/dl which was different from the normal range lying at 32-36g/dl (University of Massachusetts Amherst, 2009). The patient before undergoing laboratory examinations was appearing fatigued, weight loss and increasingly severe back pains. Fatigue in the patient must have resulted from her condition of having less hemoglobin or rather low hemoglobin content in the blood cells. Hemoglobin is obviously responsible for the transport of oxygen in the blood keeping the body and cells fresh and active. Low levels of hemoglobin will therefore mean that the blood circulated within the body will be carrying less oxygen in it, active body muscles are then become deprived of sufficient oxygen for respiration and low energy supply to the cells resulting to fatigue and extreme tiredness. The low volumes of red blood cells in the body blood also result to tiredness (Hematology, 2009). The pale appearance was a result of low hemoglobin level in the blood. This condition might have resulted from iron deficiency since iron is responsible for the production of hemoglobin, which can also be linked to situations of inability of the body to absorb certain vitamins which help in hemoglobin production. The patient began treatment with a therapy of melphalan and thalidomide together with radiotherapy support for bone pain. This is a combined treatment that has largely been used in patients diagnosed with myeloma. Myeloma is also known as hematologic cancer which in other words refers to the cancer of blood and represents about 1% of all cancers in the white individuals and 2% of all cancers in black individuals. Myeloma has been greatly linked to the reduction in immune systems though no imminent cause has been identified to date and those susceptible to the disease are the aging individuals at the age of 65 and above. The patient was also put under radiotherapy for treatment of bone pains. The bone pains are a common symptom of an individual who has been attacked by Myeloma disease. This condition results from tiny fractures in the bones that are made of accumulated plasma cells causing a weakened bone structure. The patient was likely to be suffering from the disease, Asymptomatic Multiple Myeloma. This is because of the increased number of plasma cells in the bone marrow. This patient also displayed the symptoms of mild anemia and few lesions on the bones causing bone pains. The serum M protein level was also determined to be greater than 3g/dL whereas one of the symptoms of this disease is a laboratory test revealing a serum M protein level of ?3g/dL (Moran, et al., 2011). Question 2. Pathophysiology refers to the study of the biological functions of a body during the states of diseases or dysfunction. This would therefore explain the function of the blood at a time when one suffers under the above conditions as the laboratory data shows. The type B lymphocytes start in the bone marrow and move through to the lymph nodes. As they advance, they develop and exhibit distinct proteins on their surfaces. At a later time they become active and produce antibodies and they become referred to as plasma cells. It develops in the B lymphocytes after leaving the germinal center (Annals of oncology, 2010). The normal cell line that is closely associated with the MM cells becomes generally taken as activated memory b cells or plasmablast. The immune system keeps the activation of B cells and antibody discharge under control which is lost in the case of a gene or chromosomal damage that often occurs through rearrangements. Patients with this disease often experience translocation and overproduction of antibodies. Translocation occurs between the immunoglobulin heavy chain gene that is found on locus14q32 and an oncogene which often is 11q13, 4p16.3, 6p21 and 20q11. This mutation in turn results to deregulations of the oncogene, an important kinetic event in myeloma pathogenesis. This condition in turn results to the ploriferaation of plasma cells resulting to further translocations and mutations. The plasma cells then produce cytokines causing much of their damage creating a survival point for the malignant cells; this increases the attraction of new blood vessels. The antibodies that have been generated become deposited on various organs causing renal failure, polyneurothapy, fatigue and other related symptoms (Hematology, 2009). Question 3 Such individuals should have a close follow up with the doctor in a range of 3 months period. Treatment with bisphosphonates is always started for individuals who have experienced osteolytic lesions, osteoporosis and or osteopenia. Better treatment should however be commenced when the myeloma disease has progressed to symptomatic myeloma level. However, regular participation in clinical trials is also encouraged. Clinical trials are sets of tests in medical research and drug development that are used to assess the impact of certain drugs that are used for treatment specifically for health interventions. This prevents an individual from getting adversely affected by the drugs from treatment since they are able to offer personal information on their feelings as they use the drugs. These individuals who undergo clinical trials have the advantage of receiving the otherwise unavailable treatment (Hall, 2010). References Annals of oncology. (2010). Myeloma bone disease: Pathophysiology and management. Oxford journals, 16(8), p.1223-1231. Hall, J. E. (2010). Guyton and Hall textbook of medical physiology. 12 ed. Philadelphia: Pa:Saunders. Hematology, B. P. &. R. (2009). Pathology of myeloma bone disease. Blood, 20(4), p.613-624. Korde, N., Kristinsson, S. Y. & Landgren, O. (2011). Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma:novel biological insights and development of early treatment strategies. Journal of the American society of hematology, 117(21), p.5573-5581. Moran, L., Horton, R., Scrimgeour, G. & Perry, M., 2011. Principles of Biochemistry. Boston: MA:Pearson. School of Chemistry, 2009. Hemoglobin. [Online] Available at: http://www.chm.bris.ac.uk/motm/hemoglobin/hemoglobjm.htm [Accessed 16 March 2013]. University of Massachusetts Amherst, 2009. Hemoglobin Tutorial. [Online] Available at: http://www.umass.edu/molvis/tutorials/hemoglobin/index.htm [Accessed 16 March 2013]. Read More