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Biomedicine > 5. Cardiovascular System P1 Pathologies > Flashcards

5. Cardiovascular System P1 Pathologies Flashcards

1
Q

Anemia

A

A deficiency in haemoglobin

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2
Q

Anemia signs and symptoms

A
  • fatigues
  • shortness of breath on exertion
  • palpitations
  • irritability
  • fainting

Signs:
• Tachycardia, thin, thready pulse, pallor (skin/conjunctiva)

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3
Q

Iron-deficiency anaemia

A

The most common cause of anaemia

Iron deficiency leads to a reduced concentration of haemoglobin in erythrocytes causing them to appear paler and smaller. Hence iron deficiency anaemia is a ‘hypochromic microcytic anaemia’.

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4
Q

Iron-deficiency anaemia causes

A
  • deficient dietary intake (e.g. low dark leafy vegetables)
  • malabsorption (e.g. low stomach acid, coeliac disease etc)
  • Excessive blood loss (e.g. from menses / GIT bleed)
  • Excessive requirements (e.g. pregnancy, rapid growth)
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5
Q

Iron-deficiency anaemia signs and symptoms

A

• general anaemia signs and symptoms

KEY SIGNS
• spoon shaped nails
• angular stomatitis
• glossitis
• brittle hair
• tachycardia

BLOOD TESTS
• low RBCs count, Hb, low ferritin (correlates with total body iron stores)

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6
Q

Iron-deficiency anaemia treatment

A
  • treat cause

* herbs: withania, beetroot, dark green leafy veg, pumpkin and sunflower seeds. iron supplements

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7
Q

Magaloblastic anaemia

A

Characterised by large, immature and dysfunctional red blood cells.

Folate (folic acid) and vitamin B12 are required for DNA synthesis in all proliferating cells, hence affecting rapidly dividing cells (erythrocytes).

DNA replication is slowed down and cell growth continues without division and maturation, resulting in large erythrocytes (may have nucleus has has shorter life span) - macrocytic cells

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8
Q

Magaloblastic anaemia diagnosis

A

Diagnosed by a blood testL MCV >97 fL.

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9
Q

Magaloblastic anaemia causes

A
  • deficient dietary intake of folate (folic acid) and/or vitamin B12 (rare, except in vegans)
  • lack of intrinsic factor due to autoimmune disease
  • malabsorption in crohn’s disease, surgical excision
  • drugs - methotrexate is a folate antagonist
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10
Q

Megaloblastic anaemia: B12

A
  • The liver has abundant stores so if the absorption is impaired it takes 2-4 years to develop (folate only 4 months)
  • Vitamin B12 is also essential for the production and maintenance of the myelin sheath (surrounds nerve fibres)
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11
Q

Megaloblastic anaemia: B12 signs, symptoms and treatment

A

SIGNS AND SYMPTOMS
• general anaemia signs and symptoms
• enlarged red, sore, shiny tongue
• neurological symptoms: tingling, numbness, weakness, loss of coordination, burning sensations, tinnitus, depression

TREATMENT
• increase vitamin B12 status

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12
Q

Megaloblastic anaemia: folate signs, symptoms and treatment

A

SIGNS AND SYMPTOMS
• same as B12 deficiency but NO neurological damage

TREATMENT
• folate supplementation

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13
Q

Aplastic anemias

A

A rare and potentially life-threatening failure of haematopoiesis

• ‘pancytopenia’ (lack of all three blood cell types) and hypocellular bone marrow (few of no cells)

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14
Q

Aplastic anaemias causes

A
  • Congenital (‘fanconi’s anaemia’)
  • Idiopathic (unknown cause)
  • Can be secondary to drugs (naproxen, diclofenac etc.), chemicals, radiation, cancer, hepatitis/EBV
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15
Q

Aplastic anaemias signs and symptoms

A
  • Anaemia (pallor, headache, dyspnoea, palpitations, etc).
  • Multi infections (due to low white blood cell count)
  • Easy bleeding (due to low thrombocyte count)
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16
Q

Aplastic anaemias treatment

A
  • Treat the cause
  • Bone marrow stem cell transplant
  • Platelet transfusion / blood transfusion
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17
Q

Haemolytic anaemias

A

Anaemia resulting from excessive breakdown of erythrocytes, when bone marrow activity cannot compensate for the loss of RBCs

• Erythrocyte lifespan can become as low as 5 days

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18
Q

Haemolytic anaemias causes

A
  • Genetic (e.g. sickle cell, thalassaemia)

* Rhesus factor incompatibility, malaria, some drugs, chemicals, autoimmune, radiation

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19
Q

Haemolytic anaemias signs and symptoms

A
  • Same general signs and symptoms as anaemia
  • Jaundice (excess bilirubin production)
  • Splenomegaly (excess haemolysis in the spleen causes it to enlarge, leading to abdominal distention and a feeling of fullness quickly whilst eating).
  • Gallstones and vascular occlusions
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20
Q

Sickle cell anaemia (haemolytic anaemias)

A

Sickle cell anaemia causes a deficiency of the 2-alpha 2-beta formation of haemoglobin and causes it to sickle up

  • When HbS gives up oxygen to interstitial fluid, it causes the erythrocyte to sickle up
  • These cells rupture easily. Even though erythropoiesis is stimulated, it cannot keep up with the rate of haemolysis
  • The sickle trait protects against malaria because it causes sickle formation and potassium leakage out of erythrocytes
  • Sickle cell is an inherited recessive condition (substitution chromosome 21), affecting African and Caribbean populations.
21
Q

Sickle cell anaemia (haemolytic anaemias) signs and symptoms

A
  • Usually begins age 3 - 6 months as HbF fails
  • General signs and symptoms of anaemia
  • Splenomegaly and jaundice
  • Can also occlude vessels and cause ischaemic pain. Pain in fingers, placental infarction, strokes, renal colic
22
Q

Sickle cell anaemia (haemolytic anaemias) blood test

A

FBC and blood film. Hb is 6-8 g/dL

23
Q

Sickle cell anaemia (haemolytic anaemias) treatment

A

Analgesics (pain relief), fluid therapy, blood transfusion, bone marrow transplant

24
Q

Thalassaemia (haemolytic anaemia)

A

Thalassaemia describes a defect in synthesis of either the alpha or beta Hb chains

• An inherited disease

25
Q

Thalassaemia (haemolytic anaemia) signs and symptoms

A
  • A-thalassaemia: can be lethal in utero in severe cases (‘major’). Signs/symptoms of anaemia, jaundice, splenomegaly, hepatomegaly. To compensate haemolysis, bone marrow proliferation (mostly skull/ribs).
  • B-Thalassaemia: starts when HbA production begins/gamma chain ceases (usually later part of first year). Causes failure to thrive and ansaemia.
26
Q

Haemolytic disease of the newborn (haemolytic anaemias)

A

Occurs when the mother produces anti-rhesus antibodies that cross the placenta.

  • The antibodies bind to the foetal rhesus antigens, causing agglutination and haemolysis.
  • Sensitisation occurs with the first baby producing maternal antibodies against rhesus.
  • The greatest possibility of sensitisation occurs at delivery, so the first born child is normally unaffected.
  • Anti-rhesus antibodies can be given during pregnancy to bind to rhesus antigens and block them.
27
Q

Polycythaemia

A

Polycythaemia describes an excessive production of erythrocytes resulting in increased blood viscosity, reduced blood flow and an increased risk of thrombosis.

• also known as ‘erythrocytosis’.

28
Q

Polycythaemia causes

A
  • Physiological: occurs at high altitude.

* Pathological: unknown/genetic

29
Q

Polycythaemia signs and symptoms

A
  • Mild causes may cause no symptoms
  • Arterial thrombosis: myocardial infarction (heart attack), pulmonary embolism, stroke
  • Venous thrombosis: deep vein thrombosis (DVT)
  • Hypertension, red skin, headaches, dizziness, pruritus.
30
Q

Granulocytopenia (leukocyte pathologies)

A

Marked reduction in the number of granulocyte leukocytes.

• I.e. ‘neutropenia’ (normal neutrophil count is 2.5 - 7.5. Severe neutropenia <0.5.

31
Q

Granulocytopenia (leukocyte pathologies) causes

A
  • Drug toxicity and radiation
  • Bone marrow diseases
  • Severe infections, HIV and AIDS
32
Q

Granulocytopenia (leukocyte pathologies) signs and symptoms

A
  • Severe illness
  • Malaise
  • Necrosis of mucous tissue
33
Q

Granulocytopenia (leukocyte pathology) treatment

A
  • Treat the cause
  • Support immunity; i.e. herbs (echinacea, andrographis) and nutrients (vitamin C, zinc, vitamin A, vitamin D) as well as lifestyle (e.g. stress management).
  • Acupuncture and homeopathy
34
Q

Leukocytosis (leukocyte pathology)

A

Leukocytosis describes a marked increase in the number of ALL leukocytes.

35
Q

Leukocytosis (leukocyte pathology) causes

A
  • Response to infections (physiological)

* Leukaemia (uncontrolled production pf leukocytes in bone marrow due to cancer).

36
Q

Leukaemia

A

Leukaemia describes a group of bone marrow cancers, characterised by an abnormal over-production of leukocytes.

• This uncontrolled proliferation results in supressed erythrocyte production (=anaemia) and thrombocytes (=thrombocytopenia)

37
Q

Leukaemia is divided into:

A
  • Acute leukaemia’s: rapid onset, more aggressive course. Immature cells (>20% - blast cells in bone marrow).
  • Chronic leukaemia’s: insidious onset and more differentiated cells.
38
Q

Four types of leukaemia

A
  1. AML: Acute myelogenous leukaemia
  2. ALL: Acute lymphocytic leukaemia
  3. CML: Chronic myeloid leukaemia
  4. CLL: Chronic lymphocytic leukaemia
39
Q

Leukaemia signs and symptoms

A
  • Malaise, anaemia (fatigue, pallor, etc.), frequent infections, easy bleeding / bruising.
  • Fever, weight loss
  • Splenomegaly (abdominal swelling / discomfort)
  • Lymph node enlargement
40
Q

Leukaemia diagnosis

A
  • full blood count: anaemia, low thrombocytes, variable leukocyte count.
  • blood film (viewing sample of blood)
  • bone marrow biopsy
41
Q

Leukaemia treatment

A

allopathic
• chemotherapy, bone marrow transplant, radiotherapy (relapse is common).

natural
• cancer support using herbal medicines, nutrition, supplements, homeopathy.

42
Q

Thrombocytopenia

A

Reduction in the thrombocyte count

43
Q

Thrombocytopenia signs and symptoms

A
  • Excessive bleeding and bruising
  • Petechiae (micro-haemorrhages in the skin)
  • Haematuria, vomiting blood, bleeding gums
  • post-partum haemorrhage
44
Q

Thrombocytopenia causes

A
  • Leukaemia
  • Congenital (.e.g Fanconi’s anaemia)
  • Radiation, drugs, chemotherapy
  • Viral infections (EBV, hepatitis, HIV, MMR).
  • Autoimmune destruction
45
Q

Haemophilia

A

A deficiency of clotting factors

  • Haemophilia A: deficiency of clotting factor VIII (8)
  • Haemophilia B: deficiency of clotting factor IX (9)
46
Q

Haemophilia causes

A

• Genetic: X-linked recessive disorder (usually affects males. Females normally carriers. One in 5000 males)

47
Q

Haemophilia signs and symptoms

A
  • Severe disease: excessive and easy bleeding, GIT/mucosal haemorrhage, haematuria, haemarthrosis (causing inflammation and pain).
  • Moderate disease: easy bleeding
  • Mild disease: bleeding after major trauma
48
Q

Haemophilia treatment

A

• Replacement of clotting factors / blood transfusion. Avoid contact sports. Herbs, homeopathy, nutrition.

Biomedicine (9 decks)

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