344 Test 2 Flashcards
prescence of erythroblasts in the blood due to failure of their maturation in the bone marrow
Erythroblastosis
abnormal development of large red cell
Megaloblastic
In men blood volume averages ___ ml/kg
75.5
In women blood volume average ___ ml/kg
66.5 (5-6 L)
The arterial pH of normal blood 7.35 to
7.45
Hemoglobin has to 2 __ chains and 2 __ chains
alpha and beta
Each molecule of hemoglobin can carry _ molecules of oxygen
4
Erythropoiesis is governed by __ need
oxygen
erythropoietin is secreted by which organ
kidneys
The rate of RBC destruction equals the rate of production:
1%/day
RBC destruction is facilitated by
phagocytic macrophages
RBC Destruction: White blood cells living in the ___ are ready to process RBCs
spleen
RBC Destruction involves creating ___ bilirubin
unconjugated
Unconjugated bilirubin is __
toxic
unconjugated bilirubin in blood is linked to gluconuride in the ___. This allows it to be excreted
liver
When RBCs Are Destroyed Outside the Spleen, hemoglobinemia makes the plasma turn __
red
Hemoglobinuria makes the urine __-colored
cola-colored
1st Anemia category, impaired oxygen transport, resulting in ___ mechanism
compensatory
2nd Anemia category, reduction in RBC and ___ level
hemoglobin
3rd Anemia category, __ and ___ associated with pathology process
signs and symptoms
Hematocrit in men
40 to 50%
Vitamin B12 Deficiency is associated with ___ anemia
Pernicious Anemia
fluids contains about 2/3 of the body water in healthy adults
Intracellular fluids (ICF)
Sodium
135-145
Potassium
3.5-5.0
Chloride
98-106
Bicarbonate
24-31
Calcium
8.5-10.5
Phosphorus
2.5-4.5
Magnessium
1.3-2.1
refers to the effect a solution exerts on a cell size because of water movement across the membrane
tonicity
Most plentiful electrolyte in ECF
Sodium
what age group is susceptible to hyponatremia
older adults
muscle cramps weakness depressed deep tendon reflex headache disorientation lethargy seizures coma anorexia nausea vomiting cramps diarrhea
hyponeutremia
increased thirst increased ADH dry skin decreased turgor decreased salivation decreased reflexes
hypernatremia
muscle cramps, weakness, and fatigue reflect the effects of ___ on skeletal muscle function
hyponatremia
Can occur during heavy exercise in hot weather
hyponatremia
cells of the brain are affected by increases in intracellular water (causes lethargy, apathy, headache, confusion, loss of tendon reflex)
hyponatremia
A decrease in red blood cells when the body can’t absorb enough vitamin B-12.
Pernicious anemia
A rare condition in which the body stops producing enough new blood cells.
Aplastic anemia
All are true in megaloblastic anemia except
High serum level
Poikilocytosis
irregular shape
Anisocytosis
irregular size
Can result from decreased production of erythrocytes by the bone marrow
anemia
Deficient amount of iron leads to decreased ___ synthesis
hemoglobin
The most common cause of iron deficiency is
blood loss
what happens to the heart rate during anemia
tachycardia
what causes spoon shaped deformity of the finger nails
iron deficiency
smooth tongue, brittle hair and nails, eating abnormal substances
iron deficiency
To prevent iron deficiency in infants, give supplements and avoid
cow’s milk
B12 is needed for DNA synthesis, which is needed for __ ___ maturation
red cell maturation
B12 is needed to prevent ____ breakdown which would lead to neurologic complications
myelin
___ anemia results from autoimmune destruction of gastric mucosa
pernicious anemia
the hallmark of B12 deficiency is _____ anemia
megaloblastic anemia (I think this means increased cell size)
When B12 is deficient, red cells are abnormally ___ in size
large
condition where the RBCs have immature nuclei and the membrane is oval shaped instead of biconcave
pernicious anemia
pernicious anemia can be reversed by
oral dose or injection of B12
Anemia is defined as an abnormally low number of ___, or low level of ___, or both
RBCs or hemoglobin
Anemias caused by premature destruction of RBC
hemolytic anemia
Anemias that result from ineffective hematopoises (premature death of RBCs in the bone marrow) are associated with inappropriately high levels of
iron absorption from the gut
Problems Caused by Sickle Cell
Acute pain
Infarctions cause chronic damage to liver, spleen, heart, kidneys, eyes, bones
Pulmonary infarction acute chest syndrome
Cerebral infarction stroke
Jaundice
Fetal Hemoglobin Has No Beta Chains which means it should not
sickle
Which ion channels allow cardiac muscle to fire without a stimulus?
calcium
Walls of arteries and veins composed of three layers
Tunica externa, tunica media, tunica intima
Vascular ___ Creates compounds that cause vasodilation or vasoconstriction
Endothelium
Vascular Endothelium ___ factors that can stimulate smooth muscle
growth
Vascular Endothelium Forms a smooth lining of the blood vessels that resists __ formation
clot
Vascular Endothelium Creates compounds to promote clot formation in ___ areas
injured
The more lipid, the __ the density
lower
Some LDLs are taken up by scavenger cells like ___
macrophages
Plaque can rupture and cause a __ to form
clot
Thromboangiitis Obliterans also known as
Buerger Disease
is a nonatherosclerotic inflammation and thrombosis of small, medium sized arteries/ veins in foot and lower leg
Thromboangiitis Obliterans also known as Buerger Disease
Thromboangiitis Obliterans also known as Buerger Disease occurs before age
35
Cigarette smoking and tobacco chewing trigger an immune response
Thromboangiitis Obliterans also known as Buerger Disease
Thromboangiitis Obliterans also known as Buerger Disease predominant symptom
pain
a functional disorder cause by intense vasospasm of arteries and arterioles in the finger, less frequent in toes
Raynaud Phenomenon
Primary is seen in the healthy young women
Raynaud Phenomenon
Skin color change from pallor to cyanosis, sensation of cold and sensory perception change; tingling. numbness
Raynaud Phenomenon
Is a pathological out-pouching or a sac-like dilation in the wall of a blood vessel caused by weakening of a vessel wall
Aneurysm
Angiotensin 11 reduces sodium
excretion
Antidiuretic Hormone increases BP by retaining
water
HTN is most likely to effect which ventrical
left
Aneurysms- Wall of ___ weakens and stretches
artery
Aneurysms- Risk of __ formation
clot
hypoxia effect on blood pressure
increase
Beta blockers effect on blood pressure
decrease
Inflammation of the pericardium may restrict the heart’s movement due to ___ filling the pericardial cavity
exudate
Inflammation of the pericardium may restrict the heart’s movement due to __ tissue making the pericardium stick to the heart (constrictive pericarditis)
scar
Accumulation of fluid in the pericardial cavity as a result of inflammation or infection that includes pericarditis
Pericardial Effusion
May also develop with neoplasm, cardiac surgery or trauma
Pericardial Effusion
Pericardial Effusion effects which side of the heart
both
What is the immediate treatment for severe cardiac tamponade
oxygen
On inhaling, the right ventricle fills with extra blood
Pulsus Paradoxus
Because the heart cannot expand fully when the right ventricle is overfilled, the left ventricle is compressed and cannot accept much blood
Pulsus Paradoxus
On the next heartbeat, the left ventricle does not send out much blood: systolic BP drops
Pulsus Paradoxus
serum changes in Acute Coronary Syndrome
Proteins released from necrotic heart cells
Myoglobin, creatine kinase, troponin
Imbalance in blood supply and the heart’s demands for oxygen
Chronic Ischemic Heart Disease
Myocardial ischemia without pain
Silent myocardial ischemia
Anxiety, restlessness, feeling of impending doom
Acute Myocardial Infarction
Hypotension and shock
Weakness in arms and legs
Acute Myocardial Infarction
Leaves Behind an Area of Yellow Necrosis
Acute Myocardial Infarction
Malfunctioning heart muscle can cause heart failure if Ventricles are unusually __ so there is not a normal amount of room for blood inside them (hypertrophic cardiomyopathy)
thick
Ventricles are unusually thick so there is not a normal amount of room for blood inside them
(hypertrophic cardiomyopathy)
Ventricles are too stiff to stretch
restrictive cardiomyopathy
weakness of the heart muscle that by definition begins sometime during pregnancy
Peripartum cardiomyopathy
Defects in their contractile proteins make cells too weak
Hypertrophic Cardiomyopathy
They hypertrophy to do the same amount of work as normal cells
Hypertrophic Cardiomyopathy
Cells Need more oxygen and perform less efficiently, so the person is prone to heart failure and may suffer sudden death during exertion
Hypertrophic Cardiomyopathy
Which type of cardiomyopathy is characterized by weakened ventricles
Dilated cardiomyopathy
valve will not open all the way; it is harder to force blood through it
Stenosis
valve will not close all the way; it leaks when it should be closed
Regurgitation
Identifying Defective Valves: The blood going through the valve makes a noise.
These are called
heart murmurs
If a valve is ___, you will hear a murmur of blood shooting through the narrow opening when the valve is open
stenotic
If a valve is ___, you will hear a murmur of blood leaking back through when the valve should be closed
regurgitant
an opening or connection that lets blood move from one side of the circulation to the other
shunt
most occur in the heart and move blood either from the left to the right or from the right to the left
shunt
If there is a shunt in the heart: Because the __ side is stronger, blood is usually pushed from the left to the right side
left
Shunts are normal before
birth
in a Left-to-Right Shunt more blood goes to the
lungs
in a Left-to-Right Shunt less blood goes to the
body
In Right-to-Left Shunt, ___ blood goes to body
Deoxygenated
in Right-to-Left Shunt less blood goes to the
lungs
a congenital heart defect which is classically understood to involve four anatomical abnormalities of the heart
Tetralogy of Fallot
Intracellular fluids (ICF) contains about __ of the body water in healthy adults
2/3
Extra-cellular fluids (ECF) contains about __ of the healthy adult (outside the cell, interstitial space, tissue spaces and plasma in blood vessels)
1/3
Body water constitutes about __ % of body weight in adults; ICF and ECF
60
refers to the effect a solution exerts on a cell size because of water movement across the membrane
tonicity
Most plentiful electrolyte in ECF
sodium
Major cation and its attendant Cl- and HCO3- accounts for approximately 90-95 %osmotic activity
sodium
Enters via GI, body’s need about 500 mg/day
sodium
Both insulin and epinephrine increase cellular uptake of
potassium
An increase in K+ (hyperkalemia) causes the resting membrane potential to become more positive moving it closer to the
threshold
Increased thirst, urine with low specific gravity Anorexia, N/V/C, abdominal distention Muscle weakness, cramps Confusion, depression Postural hypotension EKG changes Metabolic acidosis
Hypokalemia
N/V intestinal cramps , diarrhea
Muscle weakness
Paresthesia
EKG changes risk of cardiac arrest
Hyperkalemia
The main function of ___ is to maintain ECF calcium concentrations
parathyroid hormone (PTH)
__ __ in the distal convoluted tubule enhances Ca++ reabsorption
Thiazide diuretics
Skeletal muscle cramps, numbness, tingling Hyperactive reflexes Positive chvostek and Trousseau tests; Tetany Laryngeal spasm Hypotension, prolonged qt Bone pain
Hypocalcemia
Polyuria, increased thirst Muscle weakness, ataxia;loss of muscle tone Lethargy, stupor, coma HTN, AV block Anorexia, N/V/C
Hypercalcemia
Extracellular: blocks Na+ gates in nerve and muscle cells
Calcium
Clotting
Leaks into cardiac muscle, causing it to fire
Intracellular: needed for all muscle contraction
Acts as second messenger in many hormone and neurotransmitter pathways
Calcium
___calcemia Blocks more Na+ gates
Nerves are less able to fire
Hypercalcemia
___calcemia Blocks fewer Na+ gates
Nerves fire more easily
Hypocalcemia
latent tetany is a medical sign observed in patients with low calcium
Trousseau sign
stimulates the release of calcium from bones
PTH
electrolyte that has an anti-convulsant effect
Magnesium
electrolyte that Can block Ca2+ channels
Magnesium
increased neuro muscular excitability (deep tendon reflexes) paresthesia, tetany, positive Chvostek or Trousseau if associated with low calcium
Hypomagnesemia
Regulation of pH: trans-cellular hydrogen-potassium exchange system and body protein. When excess H+ is present in ECF it moves in the ICF in exchange for K+ and vice verse
…
Metabolic disorders produce an alteration in serum ___ concentration from an addition or loss of nonvolatile acid or alkali to or from ECF
HCO3-
Headache Behavioral changes Confusion, depression, hallucinations Warm flushed skin Weakness, tremors paralysis, stupor coma Acidic urine Cause; oxygen deficit, chronic lung disease
Acidosis
Dizziness, panic, light-headed, tetany, numbness and tingling of fingers, seizures
Alkaline urine
Cause; hyperventilation or a resp rate that exceeds the rate to maintain normal PCO2
Alkalosis
Increased PCO2
Increased carbonic acid
Increased bicarbonate
Respiratory acidosis
Decreased PCO2
Decreased carbonic acid
Decreased bicarbonate
Respiratory alkalosis
Increased levels of ketoacids, lactic acid, etc.
Decreased bicarbonate levels
Metabolic acidosis
Decreased H+ levels
Increased bicarbonate levels
Metabolic alkalosis
Increased resp rate/depth, hyperkalemia, increase ammonia urine
Anorexia, N/V/abdominal pain
Weakness, lethargy, confusion, coma, depression of vital functions
Decreased cardiac output
Cardiac arrhythmias
Metabolic Manifestations of Acidosis
Decreased resp rate, hypoxia
Hyperactive reflexes, tetany, confusion, seizures
Hypotension, cardiac arrhythmias
Cause; Hypokalemia
Metabolic Manifestations of Alkalosis
Decreased bicarbonate
Heavier breathing causes decreased PCO2
Metabolic acidosis
Increased bicarbonate
Lighter breathing causes increased PCO2
Metabolic alkalosis
