Blood and Digestive

Question 1

Anemia

Answer 1

• Anemia’s cause a reduction in oxygen transport.
• They are generally due to: decreased RBC production, increased RBC destruction, blood loss

Question 2

Oxygen Deficit/Symptoms of Anemia

Answer 2

• Less energy production in all cells
• Compensation mechanisms: tachycardia and peripheral vasoconstriction
• General signs of anemia :fatigue, pallor, dyspnea, tachycardia
• Decreased regeneration of epithelial cells
• Digestive tract becomes inflamed and ulcerated (leading to stomatitis)
• Inflamed and cracked lips,
• Dysphasia (disorder in communication),
• Hair and skin may show degenerative changes

***Severe anemia may lead to angina or CHF

Question 3

Iron Deficiency Anemia

Answer 3

• Insufficient iron impairs hemoglobin synthesis.
• More common in women of childbearing age
• Etiology:dietary,chronic blood loss (loss of iron),bleeding, ulcer, hemorrhoids, cancer, etc.,impaired duodenal absorption of iron,severe liver disease

Question 4

Pernicious Anemia

Answer 4

• Problem is lack of absorption of B12 due to lack of intrinsic factor.
• B12 deficit leads to impaired maturation of RBCs, slow DNA synthesis
• Characterized by very large, immature, nucleated erythrocytes(carry less hemoglobin,shorter lifespan)
• Vitamin B12 is needed for function and maintenance of neurons
• Manifestations:tongue is typically enlarged, red, sore, shiny,digestive discomfort, often with nausea and diarrhea,“Pins and needles,” tingling in limbs

Question 5

Aplastic Anemia

Answer 5

Impairment or failure of bone marrow

Question 6

Hemolytic Anemia

Answer 6

Results from excessive destruction of RBCs

Question 7

Sickle Cell Anemia

Answer 7

• autosomal recessive
• Abnormal hemoglobin
• Sickle cell crisis occurs whenever oxygen levels are lowered
• Sickle-shaped cells are too large to pass through microcirculation
• Signs and Symptoms:severe pain (due to ischemia of tissues and infarction),pallor, weakness, tachycardia, dyspnea, hyperbilirubinemia(jaundice), splenomegaly

Question 8

Thalassemia

Answer 8

• Genetic defect where genes for Hb are missing or variant (alpha chain or beta chain)
• Reduced number of RBCs
• Homozygotes: thalassemia major (Cooley’s anemia); severe
• Heterozygotes: mild anemia

Question 9

Polycythemia

Answer 9

• Increased numbers of RBC’s
• Primary polycythemia: polycythemia vera-increased production of erythrocytes and other cells in the bone marrow; serum erythropoietin levels are low
• Secondary polycythemia: erythrocytosis-Increase in RBCs in response to prolonged hypoxia increased erythropoietin secretion
• Signs and Symptoms:distended blood vessels, sluggish blood flow, increased blood pressure, hypertrophied heart, hepatomegaly, splenomegaly, dyspnea

Question 10

Crohn’s Disease

Answer 10

• serious inflammatory disease of the colon
• causes pain in LRQ, alternating diarrhea and constipation (melena), anorexia, nausea vomiting
• affects the upper colon and distal ileum with skip lesions(cobble stone appearance) in all layers of the bowel
• Dx: increased WBCs, low K+, Ca2+, Mg2+, sigmoidoscopy, colonoscopy, biopsy

Question 11

Ulcerative colitis

Answer 11

• serious inflammatory disease of the colon
• causes diarrhea with pus, blood, mucus in the stool
• may be an autoimmune disease affecting the mucosal layer
• begins in rectum and spreads proximally
• affects predominantly the mucosal layer

Question 12

Gastroenteritis

Answer 12

• Inflammation of the stomach and intestines
• Caused by an irritant,infectious, toxins,lactose intolerance, or food allergy
• Symptoms: anorexia, nausea, vomiting, diarrhea (F/E imbalances)
• Dx: culture of infectious agent;E. coli (found in stool, may contaminate food; may cause diarrhea, hemolytic uremic syndrome);Salmonella (found in contaminated eggs, poultry; colicky abdominal pain, N/V, bloody diarrhea

Question 13

Peptic Ulcer

Answer 13

• Causes: infection with Helicobacter pylori,NSAID use,inherited disorder of acid hyper secretion
• Dx: Upper GI imaging, blood tests, tests for H. pylori,breath test (C-tagged urea converted to CO2), blood test for antibodies, biopsy

Question 14

Appendicitis

Answer 14

• Acute, painful inflammation of the appendix
• Most common in males under age 25
• Obstruction of outlet with feces, or infection causes inflammation, swelling, and release of exudate
• Manifestations: acute abdominal pain (middle of abdomen to LRQ), N/V, fever, increased WBC count (12000-15000) (anything greater than 20000 = peritonitis)
• Inflamed appendix might become gangrenous or rupture (leading to peritonitis); rupture relieves pain, which can be misleading (rebound pain)

Question 15

Diverticulitis

Answer 15

• inflammation of diverticula (pouches) when they are impacted with fecal material or bacteria
• Symptoms: crampy pain, N/V, fever, abdominal bloating and tenderness

Question 16

Obstructions

Answer 16

• Organic/mechanical: physical blockage (tumor, adhesions, hernias, twisting, intusseption)
• Functional/Paralytic: decrease in motility (peritonitis, spinal cord injury)