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Blastoma and blood tranfusion

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					            ( Blastoma and Blood tranfusion )
                 Anything about Diseases
These articles are about diseases and symptom of diseases that we encountered every day. It was
written in question and answer format to ease ordinary people to understand more about it.




BLASTOMA

Tumors with the suffix –blastoma tend to have common characteristic. What are they?
These tumors are characteristically rare, occur in childhood, and are composed of small, darkly
stained ( hyper chromatic )

1) A high nucleus; cytoplasm ratio.
2) Aggressive local behavior
3) A tendency to metastasize

Give some examples of blastomas?
1) Retinoblastoma
        a) Typically associated with an abnormality of the tumor suppressor gene Rb, both alleles
          of which have to be abnormal for a cell to be released into continuous proliferation .

2) Nephroblastoma ( Willm's tumor )
       a) The extent of tubule formation has a bearing on prognosis

3) Neuroblastoma
       a) Maybe adrenal or extra-adrenal but only rarely arise in the CNS

4) Medulloblastoma

5) Hepatoblastoma
Names some blastomas that do not fit the above definition and occur in adults?

1) Glioblastoma multiforme (an old - fashioned term for very poorly differentiated glioma)

2) Osteoblastoma

3) Chondroblastoma
BLOOD TRANSFUSION



A patient is given a very large blood transfusion quickly for an emergency that resulted in
massive blood loss. How would you classify the possible complications?
Into immediate and delayed

What immediate complications may develop?
   Temperature changes.
           -Hyperthermia from pyrogen from dead polymorphs endotoxins.
           -Hypothermia from rapid transfusion of chilled blood.

      Allergic reactions to exogenous proteins.
      Incompatibility with haemolysis from incompatibility to:
              -ABO
              -Rhesus
              -White cells
              -Other antigens

      Septicemia from:
       -Infusion of infected blood.
               -Gram negative organisms such as coliform and Pseudomonas spp.

      Metabolic
       -Hyperkalaemia from damaged red cells releasing potassium.
       -Hypocalcaemia (though citrate as an anticoagulant is generally no longer used and so
        hypocalcemia is now rare.)
       -Decreased oxygen carrying capacity.
       -Acidosis

      Circulatory
       -Over transfusion: hypervolaemia causing pulmonary edema
       -Hypotension because of incompatibility
       -Air embolism.

      Bleeding diathesis:
       -Transfusion blood may be deficient in platelets and clotting factors, especially factor
VII.
What delayed complications may develop?

      Sensitization to foreign antigen
      Delayed hemolytic reactions from weak immunoglobulin’s that are undetected and
       gradually have an effect.
      Impaired ability to reject transplanted organs such as renal transplant, especially if
       repeated transfusion is given.
      Infection ( in uncensored donor blood ) from:
               -hepatitis B
               -hepatitis C
               -HIV
               -CMV
               -Syphilis
               -malaria
               -septicemia from bacteria in blood infected post-donation , or from deficiency in
                aseptic technique of connection of giving set , such as by Staphylococcus aureus
              or coliforms
              -Iron overloaded

				
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Deen Yusof Deen Yusof Basic Worker
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