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Fundamentals of disease > Blood and Lymph disorders
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Blood and Lymph disorders
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1
Q

Objectives:

Differentiate normal blood clotting processes and major clotting/platelet disorders.

List and describe major disorders of the blood

A

fyi

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2
Q

Blood clotting:

A
  • Hemostasis
  • Clot formation
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3
Q
  • Aka platelets
  • Fragments, not cells
  • Stick to damaged tissue and themselves
  • Form a plug
  • Aspirin: reduces adhesion: increases bleeding
  • Thrombocytes initiate coagulation process
A

thrombocytes

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4
Q
  • Blood vessel vasoconstricts
  • Thrombocytes adhere
  • Blood clotting factors become activated
  • Clot is formed
A

Hemostasis

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5
Q

Inhibitors are present that prevent unnecessary clotting

A

Fibrinolysis

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6
Q
  • Hemophilia
  • DIC- Disseminated intravascular coagulation
  • Leukemia
A

BLOOD DISORDERS

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7
Q
  • A clotting disorder
  • Hemostasis takes place, but the fibrin mesh does not form.
  • Prolonged, severe hemorrhage may occur following minor tissue trauma

-X-linked recessive disorder

A

Hemophilia

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8
Q

describe the difference of Hemophilia A, B, and C

A

A = Classic hemophilia – 90%
B = very similar to classic hemophilia
C = a milder form of hemophilia

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9
Q

Signs and symptoms of Hemophilia

A
  • Spontaneous hemorrhage into joints can occur
  • Painful crippling deformities
  • Blood in urine or in feces
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10
Q

tx for what

Replacement therapy for blood clotting factors (blood products)

Not without complication
Contagious disease (from contaminated blood products)
Immune reactions to blood products

A

Hemophilia Treatment

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11
Q
  • Aka Christmas disease
  • Similar to hemophilia A
A

Hemophilia B

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12
Q
  • AKA Rosenthal’s hemophilia
  • Milder form
A

Hemophilia C

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13
Q
  • Very often life threatening
  • Involves excessive bleeding and excessive clotting
  • Often leads to multiple organ failure and death
A

Disseminated Intravascular Coagulation (DIC)

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14
Q

Many disorders can initiate DIC

  • Obstetric complication
  • Infection
  • Carcinomas
  • Major trauma
A

Disseminated Intravascular Coagulation (DIC)

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15
Q

s/s

-Dependent on whether hemorrhage or thrombosis is dominant
-Often:
*Hypotension
*Mucosal bleeding
*Hematuria
*Infarcts
*Respiratory impairment
*Seizures, decreased responsiveness
*Renal failure
*Ecchymoses, petechiae

A

Disseminated Intravascular Coagulation (DIC)

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16
Q

tx for

  • Underlying cause must be treated
  • Fine balance to treat both thromboses and hemorrhages
  • Prognosis often poor, but depends on severity of underlying problem.
A

DIC treatment

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17
Q

dark bruises

A

ecchymosis

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18
Q
  • A group of neoplastic disorders involving the white blood cells
  • 30,000 new cases each year
  • Overall survival rate – 45%
A

Leukemia

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19
Q

pathophysiology

  • Immature, nonfunctional leukocytes multiply uncontrollably in the bone marrow
  • Large quantities of these leukocytes are released into general circulation
A

Leukemia

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20
Q

Leukemia categorization

Acute and Chronic types

Several subdivisions according to the type of cell that is malignant

6 of them

A
  • Acute lymphocytic leukemia (ALL)
  • Acute myelocytic leukemia (AML)
  • Chronic lymphocytic leukemia
  • Chronic myelogenous leukemia (CML)
  • Acute monocytic leukemia
  • Hairy cell leukemia
21
Q

etiology of?

  • Associations between leukemia and chromosomal abnormalities
  • Exposure to radiation, chemicals, and certain viruses
  • Chronic leukemias more often seen in older people, acute more often seen in children and young adults
22
Q

Most common childhood cancer
Ages 2-5
80% of childhood

A

all leukemia

23
Q

More common in adults
Radiation, benzene, viruses, chemo

24
Q

s/s of?

Multiple infections - due to nonfunctional WBCs
Hemorrhage – due to thrombocytopenia
Anemia – due to dropping of RBC counts
Severe bone pain
Weight loss, fatigue
Fever
Enlarged lymph nodes, liver, and spleen
CNS symptoms: headache, visual disturbance, drowsiness, vomiting

25
tx for - Chemotherapy - Bone marrow transplants – if chemotherapy is ineffective
Leukemia
26
- Lymphoma - Multiple Myeloma - Lymphedema
Lymphatic Disorders
27
Lymphoma
28
-Onset primarily in adults ages 20 to 40 and men over 50. -Initially involves a single lymph node -Cancer spreads to adjacent lymph nodes, and then to organs -One type of atypical cell is used to diagnose this disorder \*\*Reed- Sternberg cell
Hodgkin’s Lymphoma
29
Prognosis of ??? If caught in early stages is good If localized can be considered cured
Hodgkin’s Lymphoma
30
s/s of??? - Large, painless lymph node - Enlarged lymph nodes, splenomegaly - Weight loss, anemia, fever, fatigue - Pruritus - Recurrent infection – abnormal lymphocytes interfere with immune response
Hodgkin’s Lymphoma
31
Staging of ??? Stage I: single lymph node or region Stage II: 2 or more LN regions same side of diaphragm Stage III: nodes both sides of diaphragm and spleen Stage IV: diffuse, extralymphatic involvement
Hodgkin’s Lymphoma
32
- Increasing in numbers - Often associated with HIV - Usually involve B-lymphocytes - Initial manifestation: enlarged, painless lymph node - Cancer spreads through lymph nodes scattered throughout the body - Even in early stages, many lymph nodes and organs are often involved
Non-Hodgkin’s Lymphomas
33
tx of?? - Radiation, chemotherapy, surgery - Difficult to treat because of widespread nature of this cancer, but prognosis is improving with new drugs
Non-Hodgkin’s Lymphomas
34
- 10,000 people die every year - Less than 3% of people are diagnosed before age 40 - More common in men and african americans know it causes fractures as per DrC
Multiple Myeloma
35
- Neoplastic disease which occurs in older adults - Unknown etiology (idiopathic) - Increased number of mature B lymphocytes known as plasma cells - Proliferation of plasma cells replaces bone marrow, erodes bone - Blood cell production, immune response impaired
Multiple Myeloma
36
Progression of ??? - Multiple spontaneous fractures at weakened sites in the bone - Hypercalcemia due to bone breakdown - Multiple tumors: vertebrae, ribs, pelvis, , skull
Multiple Myeloma
37
s/s of what? - Insidious onset - Frequent infections - Bone pain, present at rest - Pathologic fractures - Anemia, bleeding - Impaired kidney function
Multiple myeloma
38
tx of - Chemotherapy - Analgesics for bone pain - Blood transfusions - Median survival – three years
Multiple myeloma
39
An abnormal condition of lymph accumulation in the extremities due to a blockage of the lymphatic system
Lymphedema
40
these are causes of what? Congenital - Parasites – worms block vessels Cancer – tumors or proliferating cells block lymphatic vessels Lmyphangitis – inflammation of the lymphatic vessels caused by bacteria
lymphedema
41
- tropical worm infection called filariasis - Worm larvae work way into lymph and develop into worms - Worms block lymphatic vessels - Worms can be 4-10cm long
Elephantiasis
42
Treatment of ?? - spraying to kill mosquitoes - giving antibiotics to prevent infection, kill microfilariae circulating in the blood - applying pressure bandages to reduce swelling - surgically removing infected tissue
Elephantiasis
43
- Usually caused by a skin infection - Most often acute streptococcal infection - Less often staphylococcal infection
Lymphangitis
44
- Red streaks from infected area to the armpit or groin (may be faint or obvious) - Enlarged lymph nodes (glands) above the area of red streaks -- usually in the elbow, armpit, or groin - Throbbing pain along the affected area - Fever of 100 to 104 degrees Fahrenheit - Chills - General ill feeling (malaise) - Headache - Loss of appetite - Muscle aches Can be spread quickly, within hours
Lymphangitis
45
Treatment of ?? - Antibiotics - Analgesics - Warm compresses - Anti-inflammatory medications to decrease inflammation and pain - Sometimes may have to perform surgery to drain abscesses
Lymphangitis
46
- Child is born with too few lymphatic vessels - Usually affects legs - More often seen in women - Can be mild or severe - Various levels of compression bandages
Congenital lymphedema
47
PT for? - Fitting of garments - Manual lymph drainage
Lymphedema
48

Fundamentals of disease (19 decks)

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