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Samenvatting Hematologie 1
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samenvatting powerpoint en cursus hematologie 1
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Hematologie 1khayla potiers
2022-2023 MLT
,INHOUD
hoofdstuk 1: inleiding tot de hematologie .............................................................................................................. 4
1. functies van het bloed ............................................................................................................................... 4
2. samenstelling van het bloed ...................................................................................................................... 4
2.1. bloedcellen ........................................................................................................................................ 5
2.2. bloedplasma ...................................................................................................................................... 5
2.3. verdeling van bloedcellen in het bloed ............................................................................................. 6
3. bloedafname en soorten bloedstalen ........................................................................................................ 6
hoofdstuk 2: de verschillende bloedcellen morfologisch bekeken ......................................................................... 8
1. rode bloedcellen of erytrocyten ................................................................................................................ 8
1.1. morfologie ......................................................................................................................................... 8
2.1. bloedgroepsysteem .................................................................................................................................. 8
2.2. witte bloedcellen of leukocyten ................................................................................................................. 10
hoofdstuk 3: tellen van de verschillende bloedcellen ........................................................................................... 15
1. belang van bloedceltellingen ................................................................................................................... 15
2. referentiewaarden ................................................................................................................................... 15
3. Hemato-morfologie ................................................................................................................................. 16
3.1. Uitstrijkpreparaten van bloedcellen ...................................................................................................... 16
3.2. microscopische beoordeling van een bloeduitstrijkje..................................................................... 17
3.3. telfout bij eeen microscopische diffrentiële telling ........................................................................ 17
3.4. elektronische morfometrische diffrentiële telling .......................................................................... 18
3.5. uitslag van differentiële telling: relatief of absoluut ? .................................................................... 18
4. telling van bloedcellen, hemocytometrie ................................................................................................ 18
4.1. manuele celtellingen met een telkamer ......................................................................................... 18
4.2. elektronische telling: impedantiemethode ..................................................................................... 19
4.3. elektronische telling: optische methode met de flow cytometer ................................................... 21
hoofdstuk 4: hematopoëse, de ontwikkeling van bloedcellen ............................................................................. 25
1. stamcellen ................................................................................................................................................ 25
1.1. wat zijn stamcellen .......................................................................................................................... 25
1.2. pluripotente embryonale stamcellen .............................................................................................. 25
1.3. adulte multipotente stamcellen ............................................................................................................. 26
1.4. geïnduceerde pluripotente stamcellen (ips) .......................................................................................... 27
2. het algemeen schema van de hematopoëse ........................................................................................... 27
3. plaats van de hematopoëse ..................................................................................................................... 28
3.1. plaats van de hematopoëse in functie van de ontwikkeling ........................................................... 28
3.2. het beenmerg .................................................................................................................................. 29
1
, 4. groeifactoren ........................................................................................................................................... 30
4.1. wat zijn groeifactoren ..................................................................................................................... 30
4.2. functies en eigenschappen .............................................................................................................. 30
4.3. werking van groeifactoren .............................................................................................................. 31
4.4. signaaloverdracht via binding van de groeifactor op zijn receptor ................................................. 31
5. hematopoËtische stamceltransplantatie ................................................................................................. 32
5.1. autologe hct .................................................................................................................................... 32
5.2. allogene hct ..................................................................................................................................... 33
hoofdstuk 5: DE ONTWIKKELING EN FUNCTIE VAN RODE BLOEDCELLEN ............................................................. 35
1. De erytropoëse, de ontwikkeling van de erytrocyten ................................................................................... 35
1.1. Situering van de erytropoëse in het algemeen schema van de hematopoëse ...................................... 35
1.2. morfologie van de voorlopercellen ........................................................................................................ 35
1.3. regulatie van de erytropoëse ................................................................................................................. 36
1.4. bouwstene van de erytropoëse ............................................................................................................. 36
2. biochemie van erytrocyten ........................................................................................................................... 36
3. de functie van erytrocyten ............................................................................................................................ 36
3.1. structuur van hemoglobine (hb) ............................................................................................................ 37
3.2. de synthese van hemoglobine ............................................................................................................... 38
3.3. functies van hemoglobine ...................................................................................................................... 39
3.4. hemglobinederivaten ............................................................................................................................. 40
4. veroudering en afbraak van erytrocyten ...................................................................................................... 41
4.1. extravasale hemolyse ............................................................................................................................. 41
4.2. intravasale hemolyse ............................................................................................................................. 41
hoofdstuk 6: de ontwikkeling en functie van wbc ................................................................................................ 42
1. De granulopoëseen de monopoëse, ontwikkeling van granulocyten en monocyten ................................... 42
1.1. Situering van de granulopoëse en de monopoëse in het algemeen schema van de hematopoëse ...... 42
1.2. granulopoësie ......................................................................................................................................... 42
1.3. monopoëse ............................................................................................................................................ 44
1.4. De lymfopoëse, ontwikkeling van lymfocyten ....................................................................................... 44
1.5. De functie van leukocyten of witte bloedcellen ..................................................................................... 44
hoofdstuk 7: DE ONTWIKKELING EN FUNCTIE VAN TROMBOCYTEN .................................................................... 45
1. De trombopoëse, ontwikkeling van trombocyten ........................................................................................ 45
hoofdstuk 8: hemostase of bloedstolling .............................................................................................................. 46
1. primaire hemostase ...................................................................................................................................... 46
1.1. het bloedvat ........................................................................................................................................... 46
1.2. trombocyten........................................................................................................................................... 47
1.3. mechanisme van de primaire hemostase .............................................................................................. 48
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, 1.4. samenvattende tabellen ........................................................................................................................ 49
2. secundaire hemostase .................................................................................................................................. 50
2.1. stollingsfactoren ..................................................................................................................................... 50
2.2. de stollingscascade (schema anno 2000) ............................................................................................... 52
2.3. stollingscascade met intrinsiek en extrinsiek systeem ........................................................................... 53
3. remmers hemostase ..................................................................................................................................... 56
3.1. Tissue-factorpathwayinhibitor(TFPI) ...................................................................................................... 56
3.2. Geactiveerd proteineC (APC) ................................................................................................................. 56
3.3. Anti-trombine(AT) .................................................................................................................................. 57
4. fibrinolyse ...................................................................................................................................................... 57
4.1. De structuur, de activatie van plasminogeen en de functie van plasmine ............................................ 58
4.2. de inhibitie van fibrinolyse ..................................................................................................................... 58
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