Patho Chapter 17 cont

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Patho Chapter 17 cont
2012-04-30 07:50:24
Patho Chapter 17 cont

Patho Chapter 17 cont
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  1. Type of megaloblastic anemia resulting from deficit if B12
    Pernicious anemia
  2. Describe the RBC in pernicios anemia

    have nuclei

    oval rather than bioconcave

    shorter life span
  3. What is the etiology of pernicios anemia
    defective gastric secreation of Intrinsic factor which is needed to absorb B12 in the iileum
  4. Where is intrinsic factor produced
    parietal cells of gastric gland
  5. Why is B12 necessary
    DNA synthesis

    when lacking, nuclear maturing and mitosis of RBC doesn't occur
  6. What can cause pernicious anemia
    surgical stomach removal

    Congenital deficincy of intrinsic factor

    atrophy of gastric mucosa(normal with age)


    chronic gastritis
  7. What are the signs of pernicious anemia

    weakness in extremities


    red, sore, large, shiny tounge
  8. What type of dignostic test are used for pernicious anemia
    CBC- Decrease RBC, Hematocrit, Increase Immature RBC

    Bone Marrow

    Serum B12 low

    Schilling Test
  9. What is the treatment for pernicious anemia
    Acute- blood transfusion if hemoglobin below 5g/dl

    B12 injection or sublingual
  10. Why can't patients with pernicious anemia take B12 supplements
    no intrinsic factor to absorb them
  11. What is the prognosis for pernicious anemia
    good with continued treatment
  12. Reduction of RBC due to excessive destruction
    hemolytic anemia
  13. What is the etiology for hemolytic anemias

  14. What causes hemolytic anemia to be acquired by a patient
    infection-bacterial toxins

    disease-kidney or liver

    toxic drugs-penicillin, motrin, sulfonamides

    Immune response- incompatible blood transfusion

    erthroblastosis fetalis-ABO RH incompatability, mother and fetus blood not compatible
  15. Name a type of autosomal recessive gene disorder that is a hemolytic anemia
    Sickle cell
  16. What mutation on the Beta globin chain causes sicle cell anemia
    amino acid glutamic replaced by amino acid valine
  17. If you are heterozygus for sickle cell anemia you carry the
    sickle cell trait
  18. Under what conditions would a person with sickle cell trait develop sickle cell anemia?
    severe hypoxia
  19. What is the pathophysiology of sickle cell anemia
    • abnormal hemoglobin synthesis
    • abnormal RBC shape
    • RBC sickle in deoxygenation
    • deformed cells block cappillaries
    • tissue hypoxia occurs
    • shorter life span-20 days(RBC)
    • sickled RBC adhesive, attach to tunica intima
    • causes obstruction of blood flow in microcirculation
  20. How long do sickle cell RBC live for?
    20 days
  21. When do RBC sickle
  22. Adhesive RBC attach to the tunica intima and cause what
    an obstruction of the microcirculation blood flow
  23. What are the signs of sickle cell anemia
    • hyperbiliruinemia
    • splenomegaly
    • "CRISIS"
  24. What causes "CRISIS" in patients with sickle cell anemia
    vascular occlusions and infarctions
  25. What tests are used to confirm sickle cell anemia
    • Blood smear
    • Hemoglobin electrophoresis
    • Prenatal diagnosis
  26. Which diagnostic test for sickle cell anemia can confirm the presence of HbS , thus being able to identify carriers as well
    hemoglobin electrophoresis
  27. What is the treatment for sickle cell anemia
    • Daily Drug- Hydroxyurea
    • antibiotics
    • blood transfusion
    • bone marrow transplant
    • gene therapy
  28. Which treatment for sickle cell anemia increases HbF, thus preventing sickling, vascular occlusions, and "CRISIS"
  29. What are the complications of sickle cell anemia
    • Repeated sickleing damages organs
    • Retarded and nerurological deficits
    • cardiopulmonary insufficiency
  30. What is the prognosis for sickle cell anemia
    high mortality
  31. What type of gene disorder is classic Hemophilia
    sex-linked recessive
  32. What blood clotting factor is inactive in classic Hemophillia
  33. What is lukemia
    uncontrolled proliferation of WBC
  34. What is the etiology of lukemia
    • idiopathic
    • viruses
    • radiation
    • chemicals
    • heredity
  35. What is the pathophysiology of lukemia
    • WBC transform into malignant cells
    • Undifferentiated blasts
    • cells proliferate and suppress bone marrow
    • End result: thrombocytopenia, anemia, and malignant WBC
  36. What are the signs of lukemia
    • leukocytosis
    • Decreased RBC and platelets
    • fever
    • swollen lymph nodes
    • brusing
    • opportunistic infections
    • splenomegaly
    • hepatomegaly
    • pallor& fatigue
    • weight loss
    • bone pain
    • hyperuricemia
  37. What tests are used to confirm lukemia
    • CBC-Increased WBC and blast cells
    • bone marrow
    • philadelphia chromosome
  38. What translocation on the gene segment is the philadelphia chromosome
    9 and 22
  39. Why does genes 9 and 22 translocate? What happens to cells as a result of this translocation
    • mitotic error
    • causes cells to grow uncontrollably
  40. What is the treatment for lukemia
    • chemo
    • bone marrow transplants
  41. What are the complications involved with lukemia
    • recurring infections
    • hemorrage
  42. What is the prognosis for lukemia
    depends on type
  43. How is lukemia classified
    • dominant abnormal cell type
    • maturity of cell
    • severity of disease
  44. What abnormal cells are dominant in acute lukemias
    immature blast cells in bone marrow and blood smear
  45. What type of abnormal cells are dominant in chronic lukemias
    mature cells
  46. What are the 4 types of lukemia
    • Acute myeloblastic
    • Chronic myeloblastic
    • acute lymphocytic
    • chronic lymphocytic
  47. Which lukemia has the Philedelphia Chromosome?
  48. Which lukemia is the 2nd highest cause of cancer after chemotherapy for hodkin's, mutiple myeloma, ovarian and breast cancer?
  49. What type of lukemia is the most common for children under 5 yrs old?
  50. What lukemia is common in people over 50 and decrease humoral immunity?