blood

Question 1

anemia

Answer 1

a decrease in red cell mass

• causes blood loss in menstruation, gi ulcers etc

reduced red blood cell production

nutritional deficiencies - iron and vitamin b12

Question 2

what are the types of iron deficiency anemia

Answer 2

iron deficiency anemia

folic acid deficiency - mega lo lactic anemia

vitamin b 12 anemia - mega lobes tic anemia

severe zinc deficiency

Question 3

iron deficency anemia

Answer 3

iron is absorbed from the diet in the duodenum and jejunum
the body is able to increase absorption when deman is increased - eg pregnancy

symptoms
- painless glossitis
- angular stomatis
- koilonychia
- angular cheilitis

Question 4

what is the managemt of iron deficency anemia

Answer 4

start iron tablets (side effects gi)
ferrous fsulphate - if not tolerated - ferrous fumerate or gluconate

dietary advice - prunes raisins

adverse affects - dark still, constipation

referral if
- dyspepsia

Question 5

folic acid deficiency anemia

Answer 5

• folic acid is essential for dna synthesis, cells proliferation

management
- start folic acid 5mg daily
check vitamin b12 levels before

use for 4 moths

Question 6

vitamin b 12 deficeiency anemia

Answer 6

vitamin b 12 is essential for dna and rna synergies and rbc production and lipid synthesis

symptoms
- fatigue
- shortness of breath
- dizziness
- headache

management
- hydroxocobalamin - 1mg intramuscular lay on alternate days for 2 weeks

Question 7

recall thrombus formation

Answer 7

1. vascular spasm
   - smooth muscle contraction ( vasoconstriction)
   - limits blood flow to damaged areas
2. coagulation cascade
   - intrinsic and extrinsic pathways
3. platelet activation and plug formation

Question 8

what occurs in platelets activatation

Answer 8

contains granulates which facilitate clotting
on activation become sticky and adhere to the vessel walll

on activation it exposes acid phospholipids where thrombin forms via the coagulation cascade

Question 9

what is the von willebrand factor (vwf)

Answer 9

large protein released from endothelial cells

bind to subendothelial collagen and receptors on platelets

then the platelets stick to vessel walls

Question 10

primary hometosias

Answer 10

involves the adhesion and aggregation of platelets to form a platelet plug
key players - platelets, von willebrand factor (vWF) which mediates the adhesion of platelets to collagen fibres of the vessel wall

Question 11

secondary haemostatis

Answer 11

involves the coagulation casacade which transforms blood from a liquid into a gel called clot or thrombus

pathways - intrinsic and extrinsic pathways converge to common pathways with the activation of factor x and xa, leading to the conversion of prothrombin to thrombin which converts fibrinogen to fibrin

Question 12

coagulation casacade

Answer 12

this is the activation of various clothing factors leading to the generation of thrombin which is important for fibrin formation

antithrombin III, protein C and S regulate clotting and prevent excessive coagulation

Question 13

what is thrombosis, risk factors, and types

Answer 13

thrombosis occurs when haemostatic processes become pathologically activated by vessel injury or abnormal flow conditions

risk factors - endothelial injuries , stasis or turbulence of blood flow

types of thrombosis - venous thrombosis (deep vein), arterial thrombosis (myocardial infaracation)

Question 14

how is thrombosis diagnosed and treated

Answer 14

• ultra sound or angiography for arterial thrombosis, along side blood test

treatment
- anticoagulants = warfarin, heparin, and newer oral anticoagulants like dabigatran or rivaroxaban - the prevent new ones and already formed

thrombolytics - dissolve blood clots - alteplase