OBJECTIVES

 Normal values
 Properties of RBC
 Physiological variations
 Pathological variations
 Polycythemia
 Variations in size & shape
of RBC
 Esr factors affecting RBC
 Applied physiology
 NORMAL VALUES
• At birth:- 6-7million/cumm.
• Adults :-
male:- 5-6million/cumm.
female:- 4.5 - 5.5million/cumm.
• Clinically 5million/cumm is taken as
100% rbc count.
• Life span of rbc is 120 days.
• Shape:-
circular,biconcave,nonnucleated
disc.
• Diameter:- 6.5-8.8Mm.
• Thickness:-
at periphery :- 2-2.4Mm.
at the centre:- 1.2-1.5Mm.
 PROPERTIES OF RBC

• ROULEAUX FORMATION
• SPECIFIC GRAVITY OF RBC (1.092- 1.101)
• PACKED CELL VOLUME
• SUSPENSION STABILITY

ROULEAUX FORMATION
 Physiological variations
• When increased:-
• high altituted:- Rbc count decreases due to
hypoxia .
• Newborn and infants:-high rbc count due to
increase activity of bonemarrow .
• Muscular exercises:- Rbc increases due to
decreases plasma volume .
• Sex:
in males :-androgen increase the
erythropoietin from the kidneys.
in females:-oestrogen does not stimulate
erythropoietin production from kidneys.
When decreased:-
• In Children:-rbc count are low
compared to newborns and young
adults.
• Pregnancy:-less rbc count due to
haemodilution.
• Old age:-production of rbc is less.
• When increased:
• Polycythemia vera:-rbc count increases to 8
million/mm3.
• In Congenital heart diseases.
• In chronic lung diseases:-rbc increases due to
hypoxia.
• Leukemia:-increase rbc due to increased in
activity of bone marrow .
• In cushing’s syndrome.
• In hyperthyroidism .
When decreased:
Seen in all types of anaemia.
For example:- Addison’s anaemia or
perinicious anaemia
 polycythemia
• Also called as erythrocytosis.
• In this rbc count increases more than 6million/cumm.
Causes:-
physiological variations:-
• At birth
• At high altitude
pathological variations:-
• congenital heart diseases
• Dehydration
• shock
• tumours of bone marrow called polycythemia vera.
POLYCYTHEMIA
 -
Variations in size & shape
of rbc
• AnisOcytosis:- variations in the size of
rbc’s.
• Poikilocytosis:- variations in the shape of
rbc’s.
• Spherocytosis:- spherical rbc’s, more
fragile.
• Ellipsocytosis:- increase in the elliptical
shaped rbc.
SPHEROCYTOSIS ELLIPTOCYTOSIS

POIKILOCYTOSIS
 ESR FACTORS AFFECTING RBC

• Definition:-The rate at which the rbc

settled down is called Esr.
• This is expressed in mm/hour.
Rouleaux formation:- Any factor which
increases the rouleaux formation will
increase Esr.
 Low specific gravity:- increases.
 Fibrinogen & Globulin:- These increases
Esr by facilitating rouleaux formation.
 High pcv:- Decreases Esr.
 Rise in temperature:- Increases Esr.
 Spherocytosis:- Decreases Esr.
 Poikilocytosis:- Decreases Esr.
 Applied physiology
 ANAEMIA:-
"bloodlessness".
• It is a condition involving
quantitative and qualitative
reduction of RBCs.
 Haemolytic Anaemia

• Haemolytic anaemia refers

to any condition causing
inadequate number of
circulating red blood cells
caused by premature
destruction of red blood cells.
 APLASTIC ANAEMIA
• Idiopathic aplastic
anaemia is a condition
he stem cell.
that results from injury
to the stem cell.
• There is reduction of all
types of cells namely
Red Blood cells, White
Blood cells & Platelets.
 MEGALOBLASTIC ANAEMIA
• Blood disorder which is
characterized by the
red Blood cells that are
larger than normal low
white blood cell count
and low Platelet count
 SICKLE CELL ANAEMIA
• Sickle cell Anaemia
occurs when individual
inherits a sickle cell
gene from each
parent.
• The glutamic Acid in
the 6th position in beta
chain of Haemoglobin
is changed to valine.
 PERNICIOUS ANAEMIA

• Pernicious Anaemia
is a result of Vitamin
B12 & folic Acid
Deficiency .
• It is mostly seen in
people over 40
 IRON DEFICIENCY

• It is the
condition
which is the
result of low
level of iron
in blood.
 MCQS
 IN THE FOETAL STAGE[1ST TRIMESTER] THE RBC ARE
PRODUCED FROM 1.
EPITHELIAL CELLS 2. MESOTHELIAL CELLS
3.ENDOTHELIAL CELLS 4.EXTRA EMBRYONIC CELLS

 NON NUCLEATED CELLS ARE PRODUCED DURING

1. 1ST TRIMESTER 2. 2ND TRIMESTER
3. 3RD TRIMESTER AND AFTER BIRTH
4. AFTER BIRTH ONLY

 FOLIC ACID AND B12 ARE REQUIRED AT THIS STAGE OF THE

FORMATION OF RBC
1. C.F.U STAGE 2. B.F.U STAGE
3. PRO ERYTHROBLAST STAGE
4. EARLY NORMOBLAST STAGE
 INCREASE IN RETICULOCYTE COUNT IN RESPONSE TO THE
IRON THERAPHY
1. POLYCYTHEMIA 2. ERYTHROPENIA
3. RETICULOCYTE RESPONSE 4. RETICULOCYTOPENIA

 THE IMPORTANT STIMULANT FOR ERYTHROPOIESIS IS

1. HYPOXIA 2. VITAMIN B12
3. FOLIC ACID 4. ANAEMIA

 DEFICIENCY OF IRON RESULTS IN

1. HYPOCHROMIC MICROCYTIC ANAEMIA
2. MACROCYTIC ANAEMIA
3. NORMOCHROMIC ANAEMIA
4. HYPOCHROMIC MACROCYTIC ANAEMIA
 MINERALS REQUIRED FOR THE SYNTHESIS OF HAEMOGLOBIN
1. COBALT 2. COPPER 3.SULPHUR 4. PHOSPHATE

 RIBOFLAVIN AND VI T-C DEFICIENCY CAUSES

1. NORMOCYTIC NORMOCHROMIC ANAEMIA
2. HYPOCHROMIC MACROCYTIC ANAEMIA
3. HYPOCHROMIC NORMOCYTIC ANAEMIA
4. MACROCYTIC NORMOCHROMIC ANAEMIA

 HAEMOLYTIC ANAEMIA RESULT IN INCREASE IN LEVELS OF

1. CONJUGATED BILIRUBIN 2. UNCONJUGATED BILIRUBIN
3. BOTH CONJUGATED AND UNCONJUGATED BILIRUBIN
4. BILIVERDIN

 HAEMOLYTIC ANAEMIA DUE TO

1. IRON DEFICIENCY 2. B12 DEFICIENCY
3. GLUCOSE-6-PHOSPHATE DEFICIENCY
4. RIBOFLAVIN DEFICIENCY

REFERENCE:- LPR & GUYTON

ANSWERS:- 1)3 2)3 3)3 4)3 5)1 6)1 7)2 8)1 9)2 10)3