Cardiovascular (first exam)

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Cardiovascular (first exam)
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2012-09-05 20:07:41
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Cardiovascular (first exam)
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  1. What is the spongy center of bones where red blood cells and platelets are made?
    bone marrow
  2. What organ manufactures clotting factors and clears old and damaged RBCs?
    liver
  3. What does the spleen remove?
    old RBCs
  4. What does blood consist of?
    • RBC
    • platelets
    • clotting factors
    • plasma
    • WBC
    • proteins
    • electrolytes
    • hormones
    • enzymes
  5. How many liters of blood does a healthy adult have?
    6 liters
  6. Where are RBCs made and what do they do?
    • bone marrow
    • transport oxygen from the lungs to the tissues and carbon dioxide from the tissues back to the lungs
  7. What is the life span of a RBC?
    120 days
  8. Where are platelets made, and what do they do?
    • bone marrow
    • activate blood clotting system by forming a platelet plug
  9. What is the life span of a platelet?
    10 days
  10. What are activated with the platelets and form a stable fibrin matrix over the wound?
    clotting factor
  11. What is the clear, straw-colored fluid that carries RBC platelets and clotting factors?
    plasma
  12. What combines with oxygen and carbon dioxide to allow the red blood cells to transport oxygen from the lungs to the tissues and carry carbon dioxide from the tissues back to the lungs for excretion?
    hemoglobin in the RBCs
  13. What is the term for the control of bleeding?
    hemostasis
  14. What three things occur if a blood vessel is injured?
    • blood vessel constricts, reducing the amount of bleeding
    • platelets adhere to the injured blood vessel, forming an unstable platelet plug
    • the coagulation cascade (clotting) is initiated, forming a stable fibrin matrix which is commonly recognized as a scab
  15. What happens to bone marrow as we age?
    becomes less productive
  16. Hematologic function is not affected by age UNLESS:
    a person is stressed with trauma, chronic illness, or treatment of cancer
  17. What effect does ASA or NSAIDs have on bleeding?
    prolong bleeding
  18. What is the blood vessel that carries blood from the right ventricle to the lungs?
    pulmonary arter
  19. The left ventricle ejects blood into which vessel?
    aorta
  20. What AV valve "sees" oxygenated blood?
    bicuspid valve
  21. Which semilunar valve "sees" unoxygenated blood?
    pulmonary valve
  22. The pulmonary veins empty blood into which cardiac chamber?
    LA
  23. The venae cavae empties blood into which cardiac chamber?
    RA
  24. What is the sling like fold of epicardium that supports the heart?
    pericardium
  25. Actin, myosin, and sarcomeres are the terms that describe which contracting layer?
    myocardium
  26. The mitral valve and the aortic valve are associated with which cardiac chamber?
    LV
  27. The pulmonic and tricuspid valves are associated with which structure?
    RV
  28. What is the area of the anterior chest wall overlying the heart and great vessesl?
    precordium
  29. Which blood vessels arise at the base of the aorta just beyond the aortic valve?
    coronary artery
  30. What attaches the cusps of the AV valves to the ventricular walls?
    chordae tendineae
  31. What is the cavity located between the epicardium and the parietal pericardium?
    pericardial space
  32. What is the condition in which any of the constituents of the blood are abnormal in structure, function, or quantity? (disorder that affects the blood)
    blood dyscrasia
  33. Disorders can be either a _______ disease or a complication of another disease.
    primary
  34. Describe erythrocytes:
    • produced in the red bone marrow
    • normal count:  4.2-6.1
    • average life span:  120 days
    • function:  carrier of gases
    • major component:  Hgb
  35. Elevation of RBCs may indicate:
    body is compensating for chronic hypoxia EG CHF and COPD, by increasing Hgb
  36. Describe hemoglobin:
    values for women:
    values for men:
    action:
    • complex protein-iron compound; gases are transported
    • values for women:  12-16 g
    • values for men:  14-18 g
    • combines with O2 in lungs to form oxyhemoglobin
    • combines with CO2 at cells and forms carbonhemoglobin
  37. Describe hemacrit:
    value for women:
    value for men:
    • the percentage of solid to liquid; blood cells to plasma
    • value for women:  37-47%
    • value for men:  42-52%
    • increases with dehydration and polycythemia
    • decreases with anemia
  38. Describe leukocytes/WBC:
    normal count:
    life span:
    function:
    • produced in red bone marrow, lumph tissues, thymus, and spleen
    • normal count:  5,000-10,000
    • life span:  4-5 days; monocytes- years
    • function:  combat infection
    • 2 groups: granulocytes and agranulocytes
  39. neutrophils, eosinophils, and basophils are all considered ___________.
    granulocytes
  40. What granulocyte ingests bacteria and disposes of dead tissue by phagocytosis?  
    What does it also release?
    Life span:  
    bone marrow has a __ day supply.
    • neutrophil
    • lysozyme; destroys certain bacteria
    • life span:  7 hrs
    • 6 day supply
  41. What granulocytes are active in allergic reactions and parasitic infections?
    eosinophils
  42. What granulocytes are stimulated by antigens or tissue injury?
    What does it release?
    What processes are they active in?
    • basophils
    • releases granules:  histamine and heparin
    • active in inflammatory or allergic processes
  43. Monocytes and lymphocytes are both considered ___________.
    agranulocytes
  44. What agranulocyte dispose of bacteria and dead cells during the recovery from an acute bacterial infection by phagocytosis?
    monocytes
  45. What agranulocytes are responsible for antibody formation to combat antigens?
    What are the two sub-types?
    • lymphocytes
    • B-cells
    • T-cells
  46. Describe platelets:
    normal count:
    life span:
    purpose:
    normal time for coagulation:
    • produced in red bone marrow
    • normal count:  140K-440K (140,000-440-000)
    • life span:  6-10 days
    • purpose:  hemostasis, blood clotting, coagulation
    • normal time for coagulation:  5-10 min; shorter time @ risk for thrombus; longer time @ risk for hemorrhage
  47. What is the term for a RBC that is lacking in color?
    hypochromic
  48. What is the term for a RBC that is intense in color?
    hyperchromic
  49. What is the procedure performed to diagnose blood dyscrasia or evaluate the pt/s response to treatment?
    bone marrow aspiration/biopsy
  50. What is a bone marrow biopsy/aspiration performed?
    • low WBC count; neutropenia, such as with chemotherapy, leukemia
    • low RBC count with anemia
    • low platelets; thrombocytopenia
  51. Describe a bone marrow aspriation:
    sites:
    examined for:
    pt position:
    • bone marrow is aspirated through a large bore needle
    • sites:  sternum and iliac crest, tibia
    • examined for:  type, number, and maturity of cells
    • pt postition:  if sternal, supine; if iliac crest, lateral or prone if pt can tolerate
  52. What is the term for a reduction in the number of RBCs?
    anemia
  53. What can anemia result from?
    • major loss of blood over a short pd of time
    • too few RBCs being made
    • increased destrction of RBCs
  54. What 3 ways does the body try to compensate for anemia?
    • increase heart/resp rate to circulate RBCs as quickly as possible with as much O2 as possible
    • redistributing blood away from the skin, GI tract and kidneys to the brain and heart
    • increasing the production of erythropoietin (which stimulates the production of RBCs)
  55. What are some causes of anemia?
    • blood loss
    • bone marrow dysfunction
    • nutritional deficits
    • hemolytic
    • hemoglobin defects
    • chronic disease
  56. What is a major cause of iron deficiency in an adult?
    How much iron does 2 mL of blood contain?
    • blood loss
    • 1 mg of iron in 2 mL of blood
  57. How many liters of blood does the average adult have?
    5-6 liters
  58. How much blood can you lose without serious effects?  Why is this?
    • 500 mL
    • because the spleen releases stored RBCs
  59. What are some s/s of blood loss?
    • wekaness
    • stupor
    • clammy skin
    • hypotension
    • tachycardia
  60. A pt may be asymptomatic until their RBC count drops to almost 50% of normal if they have ________ blood loss.
    chronic
  61. Chronic renal failure pts can tolerate ________ levels of 8 without difficulty.
    hemoglobin
  62. What is the treatment for blood loss?
    • identify the source
    • blood transfusions only if severe
    • whole blood is rarely transfused
    • packed RBCs are mainly used; decreased change of pulmonary edema and circulatory overload
  63. Iron is essential for ___ production.
    RBC
  64. What are s/s of iron deficiency?
    • fatigue
    • orthostatic changes
    • exertional dyspnea
    • brittle, spoon-shaped nails with longitudinal ridges
    • smooth, shiny tongue
    • cheilosis
  65. What is the daily requirement of iron for women and men?
    • women:  15 mg
    • men:  10 mg
  66. What are some food sources of iron?
    • liver
    • oysters
    • red meats
    • fish
    • dried fruits
    • legumes
    • dark green veggies
  67. Schilling's test diagnoses what?
    pernicious anemia
  68. What is the disorder in which the bone marrow makes adequate amounts of RBCs, however, when they are released into circulation, they are destroyed?
    autoimmune hemolytic anemia
  69. Hemolytic anemia in a new born can accur due to the ___ factor.
    Rh factor (mom Rh-; baby Rh+)
  70. With what blood disorder will you see high bilirubin levels from the breakdown of RBCs and positive results on direct coombs test?
    autoimmune hemolytic anemia
  71. What type of anemia causes some RBCs to be deformed, shaped like a disc, due to deoxygenation?
    sickle cell anemia
  72. What are some s/s of sickel cell anemia?
    • persistent low RBC count
    • fatigue
    • jaundice
    • enlarged heart
    • severe pain
  73. Sickling of RBCs is triggered by infection, dehydration, overexertion, cold weather, alcohol, smoking, or stress.  What does this cause?
    • viscosity of blood--->
    • venous stasis--->
    • occlusion of small blood vessels--->
    • peripheral edema and pain r/t hypoxia--->
    • hypoxia severe/prolonged?---> infarction!
  74. What is one of the most severe forms of anemia?
    Why?
    • aplastic anemia
    • ALL blood cells are reduced
  75. What is the disorder that occurs when there are too many RBCs being produced?
    What does it cause?
    • polycythemia vera
    • causes increase blood viscosity and volume
  76. What are the s/s of polycythemia vera?
    Why do they occur?
    • ruddy (red) complexion
    • h/a
    • ringing in ears
    • blurred vision
    • may have CVA
    • occur because:  of hypertension, increased viscosity and volume
  77. Describe thrombocytopenia:
    What does it cause:
    s/s:
    tx:
    bleeding tendency w/count @:
    spontaneous hemorrhage w/ count @:
    • a lower than normal number of circulating platelets
    • causes a decrease in production, increase destruction, leukemia, severe chronic infection
    • s/s:  petechias, ecchymoses, purpura
    • tx:  corticosteroid, eliminate cause, transfuse platelets, speenectomy
    • bleeding tendency w/count @:
    • spontaneous hemorrhage w/ count @:
  78. Describe hemophilia:
    What are the 2 major forms?
    What chromosome is it carried on?
    s/s:
    • genetic bleeding disorder caused by defective or deficient coagulation factors
    • forms A and B
    • s/s:  unvontrollable bleeding
    • carried on X chromosome, so women carry the trait and can pass it on to their sons, who will manifest the disease; rare for women to have disease
  79. What happens to the bone marrow in a pt who has leukemia?
    bone marrow becomes overcrowded with immature nonfunctional cells and the production of normal cells is reduced
  80. The immaturity of WBCs leads to _______ immunity and _______ susceptibility to infection.
    decreased; increased
  81. Describe chronic leukemia:
    • WBC count slowly increases over months or years
    • can usually be controlled with oral chemo
    • generally feel healthy
    • don't lose their hair
    • continue to work
    • Gleevec (new med) targets leukemic cells, sparing normal cells
  82. Chronic leukemias often transform into an _______ leukemia that is very difficult to treat.
    pts generally die shortly after they enter this phase
    acute leukemia
  83. _______ leukemias occur very suddenly and leaves the pt at severe risk for infection and bleeding. Chemo must be started IMMEDIATELY!
    acute leukemia
  84. What are some s/s of acute leukemia?
    • infections
    • fevers
    • night sweats
    • low RBC count
    • fatigue
    • palness
    • tachycardia
    • tachypnea
    • petechiae
    • purpura
    • epistaxis
    • melena
  85. Acute leukemia pts have to go through chemo at high doses, then maintenance therapy for __ to __ years.
    1-3 years
  86. What vessels supplies the heart muscle with blood?
    coronary arteries
  87. What vessel does blood come into the right side of the heart?
    vena cava
  88.  

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