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Biomedicine I > 5. Cardiovascular System Pathologies > Flashcards

5. Cardiovascular System Pathologies Flashcards

1
Q

Anaemia

A

• A deficiency in haemoglobin given the persons age, sex and geographical location.

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2
Q

Anaemia: Signs and Symptoms

A

SIGNS & SYMPTOMS:
• Fatigue, shortness of breath on exertion, palpitations, irritability, fainting.
• Signs: Tachycardia, thin & threadypulse, pallor (skin/conjunctiva).

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3
Q

Normal Haemoglobin ranges

A

Males 13 - 18 g/dl
Females 11.5 - 16.5 g/dl
Pregnanct >11 g/dl

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4
Q

Iron-Deficiency Anaemia

A
  • The most common cause of anaemia worldwide.
  • Iron deficiency leads to a reduced concentration of haemoglobin in erythrocytes causing them to appear paler & smaller. Hence iron deficiency anaemia is a ‘hypochromic microcytic anaemia’.
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5
Q

Iron-Deficiency Anaemia: Causes

A
  • Deficient dietary intake (e.g. low dark leafy vegetables).
  • Malabsorption (i.e. low stomach acid, coeliac disease etc).
  • Excessive blood loss (i.e. from menses/GIT bleed).
  • Excess requirements e.g. Pregnancy, rapid growth.
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6
Q

Iron-Deficiency Anaemia: Signs and Symptoms

A

SIGNS & SYMPTOMS:
• General anaemia signs & symptoms.
• Key signs: Spoon shaped nails(koilonychia), angular stomatitis, glossitis, brittle hair, tachycardia.
• Blood tests:Low RBCs & Hb, low ferritin (correlates with total body iron stores).

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7
Q

Iron-Deficiency Anaemia: Treatment

A

TREATMENT:
• Treat cause!
• Also: Herbs (Withania), beetroot, dark green leafy vegetables, pumpkin and sunflower seeds. Iron supplementation.

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8
Q

Megaloblastic Anaemia

A
  • Megaloblastic anaemia is characterised by large, immature and dysfunctional red blood cells.
  • Folate (folic acid) & 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 and has shorter life span) –macrocytic cells.
  • Diagnosis by blood test: ‘MCV’>97 fL.
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9
Q

Megaloblastic Anaemia: Causes

A
  • Deficient dietary intake of folate (folic acid) &/or vitamin B12 (rare, except in vegans).
  • Lack of intrinsic factor due to autoimmune disease (pernicious anaemia), gastrectomy, chronic gastritis, stomach cancer, coeliac disease.
  • Malabsorption in crohn’sdisease, surgical excision.
  • Drugs–‘methotrexate’is a folate antagonist.
  • In order for folate to function in the body, it must be modified by an enzyme that requires Vitamin B12.
  • The liver has abundant stores so if absorption is impaired it takes 2-4 years to develop (folate only 4 months).
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10
Q

Megaloblastic Anaemia: Signs & Symptoms

A

SIGNS & SYMPTOMS:
• General anaemia signs & symptoms.
• Enlarged red sore shiny tongue.
• Neurological symptoms:Tingling, numbness, weakness, loss of co-ordination, burning sensations, tinnitus, depression (only B12)

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11
Q

Megaloblastic Anaemis: Treatment

A

TREATMENT:
• Increase Vitamin B12 status OR
• Folate supplementation

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12
Q

Aplastic Anaemias

A
  • A rare and potentially life-threatening failure of haematopoiesis (blood cell production).
  • ‘Pancytopenia’ (lack of all three blood cell types) and hypocellular bone marrow (few or no cells).
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13
Q

Aplastic Anaemias: Causes

A
  • Congenital (“fanconi’sanaemia”).
  • Idiopathic(unknown cause).
  • Can be secondary to drugs (naproxen, diclofenac etc.), chemicals, radiation, cancer, hepatitis/EBV.
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14
Q

Aplastic Anaemias: Signs and Symptoms

A

• Anaemia (pallor, headache, dyspnoea, palpitations etc).
• Multiple infections (due to low white blood cell count)
• Easy bleeding(due to low thrombocyte count).
Most common cause of death is sepsis, then haemorrhage

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15
Q

Aplastic Anaemias: Treatment

A
  • Treat the cause.
  • Bone marrow stem cell transplant.
  • Platelet transfusion/blood transfusion.
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16
Q

Haemolytic Anaemias

A
  • Anaemia resulting from excessive breakdown of erythrocytes, when bone marrow activity cannot compensate for the loss of RBC’s.
  • Erythrocyte life span can become as low as 5 days.
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17
Q

Haemolytic Anaemias: Causes

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

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

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18
Q

Haemolytic Anaemias: Signs and Symptoms

A
  • Same general signs & symptoms of 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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19
Q

Sickle Cell Anaemia

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.
20
Q

Sickle Cell Anaemia: Signs and Symptoms

A
  • Usually begins 3-6 months of age as HbFfalls.
  • 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.
21
Q

Sickle Cell Anaemia: Diagnosis and Treatment

A

BLOOD TEST:
• FBC and blood film. Hb is 6-8g/dL.
TREATMENT:
• Analgesics (pain relief), fluid therapy, blood transfusion, bone marrow transplant.

22
Q

Thalassaemia

A
  • Thalassaemia describes a defect in synthesis of either the alpha or beta Hb chains.
  • An inherited disease (recessive).
23
Q

Thalassaemia: Signs and Symptoms

A
  • B-Thalassaemia -> Starts when HbA production begins/gamma chain ceases (usually later part of first year). Causes ‘failure to thrive’ and anaemia.
  • 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).
24
Q

Haemolytic Disease of the Newborn

A
  • Occurs when the mother produces Anti-Rhesus antibodies that cross the placenta.
  • The antibodies bind to the foetal rhesus antigens, causing agglutination & 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.
25
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’.
26
Q

Polycythaemia: Causes

A
  • Physiological: occurs at high altitude.

* Pathological:unknown/genetic

27
Q

Polycythaemia: Signs and Symptoms

A
  • Mild cases 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.
28
Q

Granulocytopenia

A
  • Marked reduction in the number of granulocyte leukocytes.

* I.e. ‘neutropenia’ (normal neutrophil count is 2.5 -7.5 x10^9/L. “Severe neutropenia” if <0.5.

29
Q

Granulocytopenia: Causes

A
  • Drug toxicity & radiation.
  • Bone marrow diseases.
  • Severe infections, HIV & AIDS
30
Q

Granulocytopenia: Signs and Symptoms

A
  • Severe illness.
  • Malaise.
  • Necrosis of mucous tissues
31
Q

Granulocytopenia: Treatment

A
  • Treat the cause.
  • Support immunity i.e. herbs (Echinacea, Andrographis) and nutrients (vitamin C, zinc, vitamin A, vitamin D) as well as life-style (e.g. stress management).
  • Acupuncture & homeopathy
32
Q

Leukocytosis

A

• Leukocytosis describes a marked increase in the number of all leukocytes.

33
Q

Leukocytosis: Causes

A
  • Response to infections (physiological).

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

34
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).
Divided into:
• 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.

35
Q

Acute Leukaemia

A 
Age: All ages
Onset: Sudden
Leukaemiccells: Immature (-blasts)
Anaemia: Prominent
Thrombocytopenia: Prominent
Leukocyte count: Variable
Lymph node enlargement: Mild
Splenomegaly: Mild
36
Q

Chronic Leukaemia

A 
Age: Usually Adults
Onset: Insidious
Leukaemiccells: Mature
Anaemia: Mild
Thrombocytopenia: Mild
Leukocyte count: Increased
Lymph node enlargement: Prominent
Splenomegaly: Prominent
37
Q

Leukaemia: Types

A
  1. Acute myelogenous leukaemia (AML)
  2. Acute lymphocytic leukaemia (ALL)
  3. Chronic myeloid leukaemia (CML)
  4. Chronic lymphocytic leukaemia (CLL)
38
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.
39
Q

Leukaemia: Diagnosis and Treatment

A

• Full Blood Count: anaemia, low thrombocytes, variable leukocyte count.
• Blood film (viewing sample of blood)
• Bone marrow biopsy.
ALLOPATHIC TREATMENT:
• Chemotherapy, bone marrow transplant, radiotherapy (relapse is common).

40
Q

Thrombocytopenia

A

• Reduction in the thrombocyte count

41
Q

Thrombocytopenia: Signs and Symptoms

A
  • Excessive bleedingand bruising. Prolonged bleeding times (spontaneous bleeding occurs when count is less than 30).
  • Petechiae (micro-haemorrhagesin the skin).
  • Haematuria, vomiting blood, bleeding gums.
  • Post-partum haemorrhage.
42
Q

Thrombocytopenia: Causes

A
  • Leukaemia.
  • Congenital (e.g. Fanconi’s anaemia).
  • Radiation, drugs, chemotherapy.
  • Viral infections (EBV, hepatitis, HIV, MMR).
  • Autoimmune destruction.
43
Q

Haemophilia

A

• A Deficiency of clotting factors:
 Haemophilia A: Deficiency of clotting factor VIII (8).
 Haemophilia B:Deficiency of clotting factor IX (9).

44
Q

Haemophilia: Causes

A

• Genetic: X-Linked recessive disorder (usually affects males. Females normally carriers. 1 in 5000 males).

45
Q

Haemophilia: Signs & 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.
46
Q

Haemophilia: Treatment

A

• Replacement of clotting factors/blood transfusion. Avoid contact sports. Herbs, Homeopathy, Nutrition.

Biomedicine I (18 decks)

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