Patho lecture 4

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Patho lecture 4
2012-04-29 17:13:18

exam 2
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  1. What are the general effects of Anemia??
    –Reduction in oxygen-carrying capacity

    –Tissue hypoxia

    Compensation: Increased HR, cardiac output, volume, and O2 extraction
  2. What are the Anemias related to dereased RBCs??
    • Aplatic Anemia
    • Anemia of Chronic Renal Failure
    • Anemia related to Vit. B12 or Folate deficiency
    • Iron Deficiency Anemia
  3. Aplastic Anemia
    Reduction of hematopoietic activity in bone marrow
  4. Hematopoietic
    The creation of blood cells
  5. Aplastic Anemia is due to what ???
    •Due to toxic, radiation, or immunologic injury to bone marrow
  6. Anemia of Chronic Renal Failure is due to what ??
    Due to impaired erythropoietin production by kidneys

    if your kidneys are failing then they cant make erythropoetin and then u cant make rbc
  7. Anemia related to Vitamin B12 or Folate deficiency is due to what??
    Due to a disruption of DNA synthesis in bone marrow cell
  8. What happens in Anemia related to Vit B12 or Folate deficiency??
    Neurologic abnormalities, delusions, and hallucinations
  9. Vit B12 and Folate are involved in what??
    Synthesis of DNA
  10. what happens to the cells in Vit B12/ folate anemia??
    blast cells will become megablatic which is associated with the neurologic abnormalities
  11. What are Anemias related to inherited RBC disorders??
    • Thalassemia
    • Sickle Cell anemia
    • Hereditary Spherocytosis
    • Glucose-6-Phosphate Dehydrogenase Deficiency
  12. Thalassemia and Sickle Cell anemia are both what??
    Heriditary hemoglobinopathy
  13. In Thalassemia there is a defect in what
    Defects in α chain or β chain of hemoglobin molecul
  14. Sickle Cell anemia is Most prevalent in who
    African Americans
  15. What happens in Sickle Cell Anemia??
    •Point mutation in gene that codes for β chain of hemoglobin

    •Defect causes RBCs to sickle in conditions of hypoxia
  16. When does sickling of the cell actually occur??
    actually occurs during hypoxic conditions. Rbcs have to go in hypoxic areas to give up there oxygen.
  17. The RBC goes from what to what kind of cell in Sickle cell Anemia??
    goes from a biconcave disc to this sickle. It has crinkles
  18. What is hbA
  19. What is hbS
    Abnormal sickle
  20. Hereditary Spherocytosis is due to what??
    •Due to defective RBC membranes
  21. What does Hereditary Spherocytosis cause??
    • •Causes anemia, jaundice, splenomegaly, gall stones and
    • leg ulcers
  22. What happens with the spleen in Hereditary Spherocytosis
    Spleen is working overtime to knock out the spherical shaped abnormal rbcs. Bc of the excess work of the spleen, we get more gall stones
  23. Glucose-6-Phosphate Dehydrogenase Deficiency is Caused by
    a deficiency of the G6PD enzyme
  24. Glucose-6-Phosphate Dehydrogenase Deficiency occurs in who??
    Occurs in African American males and in Sephardic Jews
  25. Glucose-6-Phosphate Dehydrogenase Deficiency symptoms are triggered by
    are triggered by certain drugs, infection, diabetic acidosis, or the newborn period
  26. What Anemias are related to RBC destruction or loss
    • Hemolytic Disease of the Newborn
    • Antibody-Mediated Drug Reaction
    • Acute Blood Loss Anemia
  27. Hemolytic Disease of the Newborn is Caused by
    • Caused by an Rh incompatibility of mother and fetus in
    • utero (Rh- mother and Rh+ fetus)
  28. Polycythemia Vera
    Overproduction of RBCs, WBCs, and platelets
  29. Polycythemia Vera-is typically due to
    neoplastic transformation of bone marrow stem cells
  30. Polycythemia Vera is doing what
    clogging vasculature with cells, is going to increase the blood viscosity and blood volume
  31. With the increase in blood viscosity and blood volume in Polycythemia Vera it causes
    A spike in the blood pressure (hypertension) that causes headaches, fatigue, pruritis, dizzy, sweat, weight loss, dyspnea
  32. Secondary Polycythemia
    Increased RBC production due to tissue hypoxia from high altitude or lung disease
  33. in Secondary Polycythemia what is increased
    Erythropoietin level
  34. In Secondary Polycythemia look for a history of what ??
    A history of lung disease or living in high altitudes
  35. In Secondary Polycythemia was is evident on a blood gas evaluation??
  36. Relative Polycythemia is due to
  37. A pt which Relative Polycythemia what are you looking for in their history
    History of fluid loss or poor intake
  38. What treatments are used for Polycythemia??
    Phlebotomy and bone marrow–suppressing agents may be used for polycythemia vera
  39. What are the major complications with Polycythemia??
    increased blood viscosity and the risk of thrombi.
  40. What are the vascular disorders??
    • Vascular Purpura
    • Heritary Hemorrhagic Telangiectasis
  41. Vascular Purpura
    Patches of pinpoint hemorrhages (petechiae) on the skin

    Tiny ]'[p;little hemorrhages. If they all fuse, it almost looks purple and its caused purpura.
  42. Heritary Hemorrhagic Telangiectasis
    Abnormal vascular development leads to bleeding in skin or mucous membranes

    has a spinder web like look to it
  43. Platelet Disorders
    •Thrombocytopenia (decreased platelets)

    •Thrombocytosis (excess platelets)

    •Qualitative Platelet Disorders
  44. Thrombocytopenia
    Decreased Platelets
  45. Thrombocytosis
    excess platelets
  46. Qualitative Platelet Disorders
    Abnormal platelet functions
  47. Thrombocytosis is typically due to
    chronic granulocytic leukemia. Thrombocytes are coming from same site as granulocytes.
  48. An insufficient quantity of platelets are fewer than
    < 50,000/mm3
  49. Excessive quantity of platelets are more than
    more than 400,000/mm3
  50. A normal platelet count does
    not ensure adequate platelet function
  51. Coagulation Disorders are
    • Hemophilia
    • Von Willebrand Disease
    • Vitamin K Deficiency Bleeding in Infancy
    • Acquired Vitamin K Deficiency
    • Disseminated Intrasvascular Coagulation (DIC)
    • Hepatic Disease
  52. Hemophilia A
    Hemophilia A (80%) = deficiency of clotting factor VIII

    –X-linked recessive inheritance
  53. Hemophilia B
    deficiency of clotting factor IX
  54. Von Willebrand Disease
    inherited bleeding disorde

    Deficiency of the clotting factor 8 carrier protein
  55. Von Willebrand Disease is characterized by
    platelet dysfunction
  56. Vitamin K Deficiency Bleeding in Infancy is associated with
    associated with several coagulation disorders, including hemorrhagic disease of the newborn and bleeding related to malnutrition and liver disease
  57. Vitamin K is a necessary cofactor for
    liver production of factors II, VII, IX, and X
  58. Disseminated Intrasvascular Coagulation (DIC)
    An acquired hemorrhagic syndrome in which thrombosis and hemorrhage occur simultaneously

    clotting and bleeding at same time

  59. DIC is characterized by
    widespread clot formation in small vessels
  60. The platelet count and fibrinogen levels are typically what in DIC
  61. PT, aPTT, thrombin time, bleeding time, and fibrin split products are what in DIC
  62. Hepatic Disease
    Liver disease alters the synthesis of bile and clotting factors

    •Thrombocytopenia is common in liver disease