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Samenvatting Hematologie (pathologisch bloedbeeld) - MLT3 - HoGent
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Samenvatting van de ppt van pathologisch bloedbeeld
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SAMENVATTING PATHOLOGISCH BLOEDBEELDInhoudsopgave
1. Het normale bloedbeeld......................................................................................................... 4
Normale hematopoëse......................................................................................................... 4
Granulopoëse....................................................................................................................... 6
Monocytopoëse.................................................................................................................... 6
Lymfopoëse.......................................................................................................................... 6
2. introdcutie pathologisch bloedbeeld...................................................................................... 7
automatische celtelling........................................................................................................ 7
microscopie.......................................................................................................................... 8
Flow cytometrie................................................................................................................... 8
3. rode bloedcellen..................................................................................................................... 9
Anisocytose (= afwijking in grootte).................................................................................... 9
Anisochromasie (= afwijking in kleur)..................................................................................9
poikilocytose (= afwijking in vorm).................................................................................... 10
plasmodium....................................................................................................................... 11
4. Anemie................................................................................................................................. 12
inleiding............................................................................................................................. 12
4.1. Congenitale anemie....................................................................................................... 13
Hemoglobinopathie............................................................................................................ 13
Thalassemie....................................................................................................................... 13
sikkelcelanemie.................................................................................................................. 15
Sferocytose........................................................................................................................ 15
4.2. Verworven anemie......................................................................................................... 16
Ferriprieve anemie............................................................................................................. 16
Sideroblasten anemie........................................................................................................ 16
Megaloblastaire anemie..................................................................................................... 16
anemie bij chronische ziektes............................................................................................ 17
4.3. hemolytische anemie..................................................................................................... 17
Intravasculaire hemolyse................................................................................................... 18
Extravasculaire hemolyse.................................................................................................. 18
uitwerking hemolytische anemie....................................................................................... 18
immuun-gemedieerde hemolytische anemie.....................................................................19
Verworven niet-immuungemedieerde hemolytische anemie.............................................20
uitwerking anemie............................................................................................................. 21
1
, 4.4. Andere RBC pathologie.................................................................................................. 22
Hemochromatose............................................................................................................... 22
polycythemie..................................................................................................................... 22
Polycythemia vera.............................................................................................................. 23
5. Witte bloedcellen.................................................................................................................. 23
5.1. GranulopoËse................................................................................................................. 23
6. Leukopenie........................................................................................................................... 23
6.1. neutropenie.................................................................................................................... 23
6.2. Lymfopenie.................................................................................................................... 24
7. Leukocytose......................................................................................................................... 24
7.1. benigne leukocytose...................................................................................................... 24
7.2. chronische myeloproliferatieve maligniteiten (MPN)......................................................26
7.3. myelodysplastisch syndroom (MDS)............................................................................... 27
8. Leukemie.............................................................................................................................. 28
8.1. acute leukemie............................................................................................................... 28
acute leukemie.................................................................................................................. 28
acute myeloide leukemie (AML)......................................................................................... 29
acute lymfatische leukemie............................................................................................... 30
MRD detectie...................................................................................................................... 30
9. chronisch lymfoproliferatieve aandoeningen.......................................................................31
9.1. Lymfadenopathie........................................................................................................... 33
9.2. mature B- en t-cel neoplasie.......................................................................................... 34
9.3. non-hodgkin lymfomen / chronische lymfatische leukemie............................................35
B-CLL: chronische lymfoïde leukemie................................................................................. 35
small lymphocytic lymfoom (sll)......................................................................................... 36
Monoclonale B-cel lymfocytose.......................................................................................... 36
MBL CLL-type..................................................................................................................... 36
Hairy cell leukemie............................................................................................................. 36
LGLL : Large granular lymphocyte leukemie = T-cel non-Hodgkin lymfoom......................36
9.4. lymfomen....................................................................................................................... 37
Folliculair lymfoom............................................................................................................. 37
Mantelcel lymfoom............................................................................................................. 37
Burkitt lymfoom................................................................................................................. 37
9.5. Hodgkin lymfoom........................................................................................................... 38
9.6. Plasmacel dyscrasie....................................................................................................... 38
Monoklonale gammopathie en plasmaceldyscrasie...........................................................38
Multiple myeloom............................................................................................................... 40
2
,3
, 1. HET NORMALE BLOEDBEELD
1.1. NORMALE HEMATOPOËSE
NORMALE HEMATOPOËSE
= aanmaak bloedcellen
Foetaal
o 18d-5w: dooierzak/ventraal endotheel dorsale aorta enkel RBC
o 6w: volledige hematopoëse
o Vanaf 12w: in beenmerg volledige hematopoëse
Volwassene
o Beenmerg van axiale beenderen, tot 20j ook
langere beenderen
Extramedullaire hematopoëse
Uit milt/lever
Leuko-erythroblastair bloedbeeld aanwezigheid
voorlopers RBC en WBC in PBO
o Veroorzaakt door inname beenmerg door
maligniteiten, myelofibrose,…
Pathologisch
1.2. ERYTHROPOËSE (RBC)
= ontwikkeling van de rode bloedcellen
Pathologie Anemie, polycythemie, functiestoornis
Duur 5 – 9d
Levensduur 100 – 120d
Grootte 6,5 – 8,5 µm
Aantal 4 – 6 miljoen RBC/µl
Zuurstoftransport
o Biconcave vorm: maximaal oppervlakte/volume verhouding => zuurstofuitwisseling maximaal
o Vervormbaar => migratie door kleine bloedvaten
Regulatie door feedbackloop o.b.v. erythropoietine (EPO) door nieren: afbraak = productie
1.3. MEGAKARYOPOËSE
= aanmaak bloedplaatjes
Pathologie Essentiële trombocytose, trombocytopenie, functiestoornis
Duur 4 – 5d
Levensduur 10 – 20d
Grootte 2 – 4 µm
Essentieel normale hemostase
o Betrokken bij activatie stollingscascade en vorming fibrine
o Adhesie andere plaatjes met prop
Discoïde cytoplasmatische fragmenten met granulen
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