Patho Week 4 Ch 5&17

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ekruge01
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Patho Week 4 Ch 5&17
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2010-10-24 22:45:10
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Some pathophysiology questions
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  1. What is another name for neoplasms?
    tumors
  2. What are neoplasms?
    cells with unchecked reproduction which do not respond to normal cell controls.
  3. Neoplasms can become large masses & interfere with? (4)
    • 1. nearby organs
    • 2. pressure
    • 3. cutting off circulation
    • 4. pressing on nerves->pain, numbness
  4. Neoplasms often have no useful?
    function
  5. Neoplasms may secrete what?
    abnormal levels of hormones
  6. What can neoplasms cause because of their growth?
    bleeding
  7. What do neoplasms take from healthy cells?
    nutrition
  8. What is benign tumors?
    tumors that won't spread to other sites
  9. What is metastasize?
    a spreading of cancer
  10. Under a microscope benign tumors appear?
    "well-differentiated"
  11. Is benign tumors mitosis normal?
    yes, just unchecked
  12. What are malignant tumors? (2)
    • 1. tumors that will metastasize
    • 2. may kill the host
  13. What is the greek word for cancer?
    CRAB
  14. What is another name for cancer?
    carcinoma
  15. What are the 8 warning signs of cancer?
    • 1. unusual bleeding or discharge anywhere
    • 2. change in bowel or bladder habits
    • 3. a change in a wart or mole
    • 4. a sore that does not heal
    • 5. unexplained weight loss
    • 6. anemia, persistant fatigue
    • 7. persistant cough or hoarseness
    • 8. cell lump in the breast or testes or anywhere(often painless)
  16. What does "in situ" mean?
    cells have not spread and are localized to that site
  17. Under a microscope, Ca cells appear?
    "poorly differentiated"
  18. Do Ca cell use apoptosis?
    No
  19. What is apoptosis?
    normal process of cells self-destructing when old.
  20. What is angiogenesis?
    process of stimulating blood vessels to supply the tumor to promote their own survival.
  21. What is H&P?
    History and physical
  22. What is the H&P for diagnosing cancer? (2)
    • 1. weight loss
    • 2. any of the 8 warning signs
  23. What should be looked for in lab tests to find out if a patient has cancer? (4)
    • 1. anemia
    • 2. abnormal CBC
    • 3. increase/decrease in WBC
    • 4. blood in stool
  24. What is CBC?
    complete booold count (includes Hgb levels)
  25. What are the tests to check for blood in stool? (2)
    • 1. hemoccult
    • 2. guiac
  26. What does "Stool For OB" mean?
    check stool samples for occult
  27. What is occult?
    microscopic traces of blood in stool.
  28. The antigen specific tests look for specific antigens in blood that help diagnose cancer, what are these antigens? (3)
    • 1. PSA- Prostate specific antigen
    • 2. CEA -Carcinogenic Embryonic antigen
    • 3. CA 125 -ovarian
  29. What is U/A?
    urine analysis
  30. What are the other tests they may use to diagnose cancer? (4)
    • 1. X-rays
    • 2. CT scans
    • 3. MRI's
    • 4. US
  31. What is Bx?
    biopsy
  32. What is a biopsy?
    taking samples of cells and examaning in lab for final dx
  33. What is the only certain way to dx cancer and determine best type of chemotx?
    biopsy
  34. What is usually biopsied to check for metatases?
    lymph nodes
  35. What results in staging of Ca?
    lymph nodes biopsy
  36. What is staging of cancer based primarily on? (3)
    • 1. Size of tumor
    • 2. Involvement of lymph nodes
    • 3. presence of metatases
  37. What is carcinogenesis?
    The progressive development of a cell to cancer.
  38. What are the 3 general concepts of carcinogenesis?
    • 1. Ca develops over time
    • 2. often requires a genetic predisposition
    • 3. often requires multiple triggers for the cells DNA to become Ca
  39. What is another name for chemotherapy?
    antineoplastic drugs
  40. What are some actions of the chemotherapy drugs? (3)
    • 1. interfere with cell division
    • 2. interfere with angiogenesis
    • 3. interfere with hormones that "feed" the tumor
  41. What is important to note about the medications for a specific tumor?
    need multiple meds
  42. Does chemotherpy kill both Ca and normal cells?
    yes
  43. What are the side effects of chemotherapy? (5)
    • 1. hair loss
    • 2. mucosal damage
    • 3. decrease in WBC
    • 4. decrease in platelets
    • 5. GI irritation
  44. What is Radiation therapy (RT)?
    beamed target radiation into sites
  45. RT has similar side effects to?
    chemotherapy, except for the "Burns" (red, leathery appearance of skin)
  46. What is an alternative to radiation therpay?
    RT "beads"
  47. If someone has RT beads, what should they be aware of?
    RT precautions
  48. What are the ways side effects of Ca tx are managed? (8)
    • 1. anti-emetic drugs to reduce nausea/vomiting
    • 2. pain control
    • 3. avoid exposure to people with infections
    • 4. do not get vaccines
    • 5. good nutrition
    • 6. increase protein meals
    • 7. increase fluids
    • 8. closely motitor CBC and platelets
  49. What are 2 characteristics of erythrocytes?
    • 1. lifespan of 120 days
    • 2. biconcave disc shaped
  50. New RBC's are made via?
    erythropoiesis
  51. How many RBc's are made per minute?
    200 billion
  52. RBC production requires? (7)
    • 1. erythropoietin from kidney
    • 2. Fe
    • 3. folic acid
    • 4. Vit B12
    • 5. Copper
    • 6. protein
    • 7. other nutrients
  53. Fe is part of what molecule?
    Hgb
  54. What times does the body secrete extra erythropoietin?
    • 1. blood loss
    • 2. anemia
    • 3. hypoxia
  55. What are the erythropoietin drugs? (2)
    • 1. procrit
    • 2. epogen drugs
  56. What is the normal range for Hgb in males and females?
    • MALES: 14-16 g %
    • FEMALES: 12-14 g %
  57. What is the normal range for RBC in males and females?
    • MALES: 5.5 x 106
    • FEMALES: 4.8 x 106
  58. 1. how many oxygen molecules can Hgb hold? 2. When Hgb is full of these oxygen atoms, what is it called?
    • 1. 4
    • 2. oxyhemoglobin
  59. What 2 events happen after O2 dissociates from Hgb at a cellular level in capillaries?
    Oxygen enters cells for metabolism-> becomes deoxyhemoglobin
  60. CO2 is not heavily bound to Hgb, mostly is carried in the form of?
    HCO3 (bicarbonate ions)
  61. What is anemia?
    Low Hgb (due to decreasing number of RBC's)
  62. Low RBC's and then low Hgb means there will be?
    impaired O2 transport
  63. What are the GENERAL S&S of all anemia's? (5)
    • 1. pallor
    • 2. easy fatigue
    • 3. SOB (shortness of breath)
    • 4. increase P
    • 5. possible syncope
  64. What is pernicious anemia?
    due to lack of intrinsic factor is the stomach, which is needed for Vitamin B12 absorption.
  65. What is Fe deficiency anemia?
    due to nutritional/hemorrhagic loss of Fe in body.
  66. What is aplastic anemia?
    temporary or permanent shutdown of hematopoisis (blood cell production) in bone marrow.
  67. What are the internal S&S of aplastic anemia? (5)
    • 1. anemia
    • 2. leukopenia
    • 3. thrombocytopenia->ecchomyosis
    • 4. petichiae
    • 5. pancytopenia
  68. What is leukopenia?
    decrease in WBC
  69. What is thrombocytopenia?
    decreasing platelets
  70. What is petichiae?
    small, pinpoint hemmorhages in skin
  71. What is pancytopenia?
    decrease in all blood cell types
  72. What is Thalassemia? (2)
    • 1. GENETIC impairment in Hgb
    • 2. type varies for different races
  73. What is sickle cell anemia?
    INHERITED HgbS form, which causes RBC to "sickle"->clogs blood vessels
  74. What events trigger sickle cell anemia? (3)
    • 1. stress
    • 2. hypoxia
    • 3. illness
  75. What are the S&S of sickle cell anemia? (2)
    • 1. severe pain
    • 2. jaundice
  76. What are the 5 anemia's?
    • 1. pernicious anemia
    • 2. Fe deficiency anemia
    • 3. aplastic anemia
    • 4. thalassemia
    • 5. sickle cell anemia
  77. What is the tx for pernicious anemia?
    Vitamin B12 injection
  78. What is the tx for Fe deficiency anemia? (2)
    • 1. identify/treat underlying cause
    • 2. iron supplements
  79. What is the tx for aplastic anemia? (4)
    • 1. Fast tx of underlyign cause
    • 2. removal of any bone marrow suppresents
    • 3. blood transfusion
    • 4. bone marrow transplant
  80. What is the tx for thalassemia?
    blood transfusion
  81. What is the tx for sickle cell anemia? (3)
    • 1. drugs that reduce sickling
    • Avoidance of:
    • 2. strenuous activity
    • 3. high altitudes
  82. What is carbon monoxide poisoning?
    Due to CO having higher affinity to Hgb than O2
  83. What does CO poisoning lead to? (2)
    no O2 available to cells-> death
  84. What are the 3 characteristics of thrombocytes?
    • 1. like to stick to eachother:agglutination
    • 2. lifespan of 1 week
    • 3. main function is to coagulate blood-> "thrombus"
  85. What is a "thrombus"?
    A blood clot
  86. 1. Where are thrombocytes made? 2. They are made when stimulated by what hormone?
    • 1. Red bone marrow
    • 2. thrombopoietin from liver and kidney
  87. What are the normal ranges for thrombocytes in males and females?
    BOTH: 150,000-400,000 per ml of blood
  88. What is hemostasis?
    stopping of blood flow, not just by platelet aggregation
  89. Hemostasis involves what 2 things at the site of the clog?
    • 1. vasoconstriction
    • 2. edema
  90. What is "fibrinolysis"?
    dissolution of a hemostasis clot
  91. What triggers hemostasis? (5)
    • 1. injury to vessel
    • 2. plaques
    • 3. slowed blood flow
    • 4. venous stasis
    • 5. SURGERY
  92. What are the clotting disorders? (4)
    • 1. DIC
    • 2. thrombocytopenia
    • 3. hemophilia
    • 4. thrombi formation
  93. What is DIC?
    too much fibrin forms
  94. What is DIC due to? (5)
    • 1. infection
    • 2. obstetric complications
    • 3. burns
    • 4. Ca
    • 5. trauma
  95. What is the result of DIC?
    massive bleeding
  96. In DIC, too much fibrin forms causing what 3 things?
    intravascular clots-> tissue hypoxia, organ failure->all clotting factors are used up
  97. What is thrombocytopenia due to? (3)
    • 1. chemotx
    • 2. auto-immune
    • 3. virus (esp. in kids)
  98. What is hemophilia?
    genetic disorder causing lack of clotting factor (Factor VIII)
  99. What is the usual result of hemophilia? (2)
    • 1. fatal hemmorhages
    • 2. minor injuries
  100. What is unusual about hemophilia?
    platelet count is NORMAL
  101. hemophilia is a sex linked disease in which?
    femlaes carry the gene, but males get the disease.
  102. What is thrombi formation?
    When clots form and may be fatal(not really a clotting disorder)
  103. What are the thrombi formation predisposes factors? (2)
    • 1. atherosclerosis
    • 2. venous stasis
  104. What does atherosclerosis predispose to?
    clot formation in blood vessels around damaged endothelium
  105. What is the difference between thrombus and embolus?
    • thrombus: a clot forms and STAYS in place
    • embolus: a clot forms and TRAVELS elsewhere
  106. What does venous stasis predispose to?
    a clot formation in veins (blood pooling-bed rest)
  107. What happens if a clot travels to the brain?
    Stroke
  108. What happens if a clot travels to the heart?
    Heart attack
  109. What happens if a clot travels to the lungs?
    Pulmonary embolus
  110. What are the main characteristics of leukocytes(WBC's)? (2)
    • 1. stain and grandular presence/absence help subcategorize into 5 types
    • 2. life-span is about 8 hours
  111. What is the main function of WBC's?
    infection control
  112. Where are WBC's made?(2)
    • 1. red bone marrow
    • 2. lymph tissue
  113. What is the normal range of WBC's for males/females?
    5.0 X 103 - 9.0 X 103
  114. What are the WBC disorders? (2)
    • 1. Leukopenia
    • 2. Leukemias
  115. What is Leukopenia due to? (4)
    • 1. chemotx
    • 2. drug reaction
    • 3. RT
    • 4. decrease in folic acid
  116. What are the subtypes of leukopenia? (2)
    • 1. neutropenia
    • 2. lymphcytopenia
  117. What is neutropenia?
    Decrease of neutrophils in the blood
  118. What is lymphcytopenia?
    decrease lymphocytes in blood
  119. What is the risk of leukopenia? What does it lead to?
    Infection which leads to death
  120. What is leukemias?
    group of malignant disorders characterized by abnormal reproduction and maturation of one or more types of WBC's
  121. Leukemias can be acute in which age group?
    kids
  122. What is AML?
    Acute myelocytic leukemia
  123. What is ALL?
    acute lymphocytic leukemia
  124. What types of acute leukemia would be found on charts?(2)
    • 1. AML
    • 2. ALL
  125. Leukemia can be chronic in which age group?
    adults
  126. What types of chronic leukemia would be found on charts? (2)
    • 1. CML
    • 2. CLL
  127. What is CML?
    Chronic myelocytic leukemia
  128. What is CLL?
    chronic lymphocytic leukemia
  129. What are the S&S's of leukemia?(13)
    • 1. weigh loss
    • 2. fatigue
    • 3. anemia
    • 4. thrombocytopenia
    • 5. multiple infections
    • 6. increased bleeding
    • 7. severe hemorrhage
    • 8. kidney stones
    • 9. fever
    • 10. lymphadenopathy
    • 11. splenomegaly
    • 12. hepatomegaly
    • 13. bone pain
  130. What are the Lymphatic disorders? (2)
    • 1. Lymphomas
    • 2. multiple myeloma
  131. What is lymphoma?
    too many lymphocytes
  132. What does lymphoma cause?
    enlarged, painless lymph nodes
  133. What is required to determine the true DX of lymphomas?
    biopsy
  134. What are the 2 types of lymphomas? (2)
    • 1. Hodgkins
    • 2. Non-Hodgkins
  135. What is Hodgkins? (3)
    • 1. nodes usually in same area of body
    • 2. quite curable with chemotx or RT
    • 3. Reed- Sterrnberg cells in biopsy
  136. What is Non-Hodgkins? (4)
    • 1. nodes usually throughout body
    • 2. more difficult to cure
    • 3. NO Reed- Sternberg cells in biopsy
    • 4. sometimes associated with HIV
  137. In lymphomas, abnormal lymphocytes lead to what?
    increased risk of infection
  138. What is splenomegaly?
    enlarged spleen (usually filters blood)
  139. What is hepatomegaly?
    enlarged liver
  140. What has the similair S&S of leukemia?
    lymphomas
  141. what are the advance SS of lymphomas?(4)
    • 1. decreased weight
    • 2. low grade fevers
    • 3. night sweats
    • 4. pruritis
  142. what is pruritis?
    itchiness
  143. what is mutiple myeloma?
    excessive, non stoppable production of B-Lymphocytes
  144. what is B-lymphocytes function?
    they are plasma cells which infiltrate into bone marrow
  145. what does multiple myeloma usually result in?
    pathological fractures (fracture in bone due to cancer)
  146. what age group does multiple myeloma usually effect?
    adults
  147. what are the internal SS of multiple myeloma?(6)
    • 1.hypercalcemia
    • 2.pain
    • 3.infection
    • 4.anemia
    • 5.bleeding
    • 6.proteinuria
  148. what is proteinuria?
    protein in urine
  149. what are not uncommon in multiple myleoma due to the high calcium levels?
    kidney stones
  150. what is the treatment for multiple myeloma?
    chemotx(difficult to cure)
  151. what are 2 facts about multiple myeloma?
    • 1.metastases common
    • 2. cause unknown (idiopathic disease)
  152. What are the 4 steps to hemostasis?
    • 1. vasoconstriction(limits flow of blood to injury site)
    • 2. Platelets activated by thrombin and aggregrate at injury site (forming temporary, loose platelet plug-the protein Fibrinogen triggers platelet clumping)
    • 3. Fibrin Mesh(the clot) forms & entraps the plug
    • 4. clot must dissolve for normal blood flow to resume
  153. The dissolution of the clot occurs through the action of what?(1A)- takes time but enhances with what kind of drugs?(1B)
    • 1A. action of plamin (fibrinolysis)
    • 1B."Clot buster" drugs
  154. What are the 4 current relevant drug therapies for Lymphatic disorders?
    • 1. anti platelet aggregation (plavix, ASA, NSAID's)
    • 2. thrombolytics (streptokinase)
    • 3. heparin (slows clot growth-no dissolve)
    • 4. warfarin (slows clot formation)
  155. YAYY now we're done :):)
    :):):)

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