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NBDE PART 1 MICRO/PATH > Blood Disorders > Flashcards

Blood Disorders Flashcards

1
Q

__ is condition in which the blood cannot adequately oxygenate the tissues

A

anemia

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2
Q

Pernicious anemia is due to deficiency in __

A

vitamin B12 b/c lack of intrinsic factor which is needed to absorb the B12 in the GI

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3
Q

in pernicious anemia the cells are:

a. macrocytic/microcytic/normocytic
b. hyperchromic, normochromic, hypochromic

A

a. macrocytic (larger) = megaloblastic anemia
b. hyperchromic (increase hemoglobin concentration)

notice that everything is larger (the cell size, the hemoglobin concentration)

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4
Q

Schilling test is used to detect if body?

A

absorbs Vit. B12 adequately. used to detect pernicious anemia

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5
Q

folate and vitamin B12 is needed for __ synthesis

A

DNA

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6
Q

iron is needed for __ synthesis

A

hemoglobin

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7
Q

___ anemia is the result of inadequate production of RBC’s due to inhibition/destruction of red bone marrow. can be caused by radiation, toxins, medications

A

aplastic

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8
Q

stomatitis and atrophic glossitis are common in which type of anemia

A

prenicious

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9
Q

in drug induced aplastic anemia the RBC appear

a. macrocytic/microcytic/normocytic
b. hyperchromic, normochromic, hypochromic

A

a. normocytic (normal sized)

b. normochromic

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10
Q

thrombus formation caused by 3 abnormalities called Virchow’s Triad

A

endothelial injury
stasis or turbulent blood flow
hypercoagulability

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11
Q
  1. venous thrombi occur at sites of

2. arterial or cardiac thrombi begin at sites of

A
  1. stasis

2. turbulence or endothelial injury

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12
Q

____ thrombi tend to grow retrograde from the point of attachment.
while __ thrombi extend in the direction of blood flow

A
  1. arterial
  2. venous
    therefore both propagate towards the direction of the heart!!!!!
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13
Q

most venous thrombi occur in the

A

legs

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14
Q

deep vein thrombosis (DVT) can cause local pain and edema. it is dangerous bc

A

a piece of clot can fly thru the venous circulation and lodge in lungs = pulmonary infarction

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15
Q

superficial venous thrombi ___ embolize

A

rarely

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16
Q

Hyperaemia or hyperemia is the___

A

increase of blood flow to different tissues in the body. aka congestion

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17
Q

2 types of congestion (hyperemia):

  1. active congestion (active hyperemia) = results from
  2. passive congestion (active hyperemia) = results from
A
  1. localized arteriolar dilation (inflammation, blushing)

2. obstructive venous return or increased back pressure form congestive heart failure

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18
Q

two forms of passive congestion: acute and chronic.

1. __ occurs in __ or __sided heart failure

A

1 acute, shock, right

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19
Q

passive congestion: chronic

  1. chronic: of the ___ caused by Left sided heart failure
  2. of the ___ caused by Right sided heart failure
A 
lung = left sided heart failure
liver = right sided heart failure

think about it: if the left side of the heart fails (blood backs up to the lungs because blood from the lungs goes to the left side of the heart)
if the right side of my heart fails, blood backs up in liver (because blood from liver goes to the right side of the heart)

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20
Q

If hypertension is NOT DIAGNOSED and treated w antihypertensive drugs: the individual can
wear out, blow out, or run out. explain this

A

wear out = heart (cardiac failure)
blow out = brain (cerebrovascular incident)
run out = kidneys (renal failure)

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21
Q

Claudication,

A

literally ‘limping’ (Latin), is a medical term usually referring to impairment in walking, or pain, discomfort or tiredness in the legs that occurs during walking and is relieved by

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22
Q

edema of extremities caused by R/L sided heart failure

A

Right (think if the right side of heart stops working, the blood backs up in the body causing edema) pushes blood out of capillaries

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23
Q

dyspnea on exertion caused by R/L sided heart failure

A

left sided, (think about it- If you start working out, exertion increases = increases pressure on the LEFT HEART to pump blood out to body)

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24
Q

Nocturia

A

also called nycturia = “the complaint that the individual has to wake at night one or more times for voiding

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25
Q

polyuria, nocturia, diminished ability to concentrate urine, protein and red blood cells are found in

A

arteriolar nephrosclerosis = hardening of arterioles within the kidneys

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26
Q

the most common cause of secondary hypertension

A

kidneys

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27
Q

2 categories of hypertension: primary (essential) and secondary. 95% have primary. which one is there no known cause

A

primary

therefore diagnosis of primary is made after excluding causes that comprise secondary hypertension

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28
Q

Usually high blood pressure have ___symptoms

A

no symptoms at all = CALLED THE SILENT KILLER

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29
Q

sometimes with __we get tiredeness confusion visual changes, nausea vomiting anxiety perspiration pale skin, angina like pain (crushing chest pain)

A

hypertension

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30
Q

3 classes of drugs to treat hypertension

A

diuretics (to reduce blood volume)
vasodilators (decrease systemic vascular resistance)
cardioinhibitory drugs (to decrease cardiac output)

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31
Q

___ hypertension is elevated blood pressure that results from an underlying, identifiable, often correctable cause

A

secondary

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32
Q

renal artery stenosis, chronic renal disease, primary hyperaldosteronism, stress, sleep apnea, hyper or hypothyroidism, pheochromocytoma, preeclampsia, arotic coarctation are causes of

A

secondary hypertension

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33
Q

Pre-eclampsia is disorder of ___characterized by ___ and large amounts of ___in the urine .

A

pregnancy
high blood pressure
protein

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34
Q

aplastic anemia, anemia of chronic disease, acute and chronic blood loss are all normocystic/hypercystic/hypocystic diseases

A

normocystic

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35
Q

___ is an anticoagulant that interferes with vitamin K

A

Warfarin (Coumadin)

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36
Q

Warfarin (Coumadin) inhibits the formation of __ in the liver

A

prothrombin = delays blood clotting = prevents thromboembolic disease

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37
Q

a patient taking heparin will delay/speed up blood clotting

A

delay

it is antithrombin and antiprothrombin = prevents platelet agglutination

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38
Q

a patient with ___ often has thrombocytopenia (reduced number of platelets)

A

leukemia

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39
Q

a patient with __ will have hypoprothrombinemia (abnormally small amounts of prothrombin in the circulating blood)

A

cirrhosis

bc PROTHROMBIN IS FORMED AND STORED IN THE LIVER)

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40
Q

von Willebrand’s disease = deficiency in vWF (von Willibrand’s Factor) results in impaired

A

platelet adhesion

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41
Q

Long term treatment with ___ results in impaired production of thromboxanes

A

aspirin (cyclooxygenase inhibitor)

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42
Q

Bernard-Soulier disease = a hereditary __ disorder

A

platelet adhesion

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43
Q

Dicumarol is an ___

A

anticoagulant that inhibits the formation of prothrombin in the liver. delays the clotting of blood
functions as a functional vitamin K depleter (similar to warfarin,

44
Q

Dicumarol has largely been replaced by ___

A

warfarin

45
Q

the most common form of erythroblastosis fetalis is ___ incompatability. (ABO or Rh)

A

ABO

46
Q

the less common form of erythroblastosis fetalis is ___ incompatability. (ABO or Rh) which can cause severe anemia in the baby

A

Rh

47
Q

____ develops in an unborn infant when the mother and baby have DIFFERENT BLOOD TYPES

A

erythroblastosis fetalis = mom makes antibodies that attack babies RBC

48
Q
  1. Immunoglobulin ___is an antibody isotype.
  2. It is a protein complex composed of __peptide chains—two identical ___ chains and two identical ___chains arranged in a Y-shape typical of antibody monomers.
  3. Each IgG has __ antigen binding sites.
  4. Representing approximately ___ of serum immunoglobulins in humans, IgG is the most abundant antibody isotype found in the circulation
A
  1. G (IgG)
  2. four: 2 heavy, and 2 light
  3. two
  4. 75%
49
Q

IgG is also associated with Type ___Hypersensitivity.

A

II and Type III

50
Q

which IMMUNOGLOBULIN can cross placenta and is present at birth

A

G

51
Q

ABO incompatibility = rxn of immune system occurring if two different and not compatible blood types are

A

mixed together

52
Q

Rh incompatability - when pregnant women has Rh +/- blood and baby has Rh =/-?

A

Mom is negative and baby is +

53
Q

patients with ___ anemias often have problems that result from an increase in bilirubin levels

A

hemolytic (erythroblastosis fetalis, sickle cell anemia, thalassemias)

54
Q

urobilinogen will be high in hemolytic anemias. this is the compound formed in the ___ by the reduction of bilirubin

A

small intestines

55
Q

eleveated levels of conjugated/unconjugated bilirubin will be high in hemolhytic anemias

A

unconjugated bilirubin = water insoluble bilirubin. normally unconjugated bilirubin is carried by albumin and travels to liver where it becomes conjugated with glucuronide to become water-solube. this conjugated (water soluble) bilirubin would then be secreted into bile and then into small intestine.

56
Q

kernicterus

A

kernicterus

toxic accumulation of unconjugated bilirubin in the BRAIN AND SPINAL CORD

57
Q

Beta thalassemia major/minor is aka Mediterranean anemia or Cooley anemia = anemia and splenomegaly

A

major

58
Q

Beta thalassemia major/minor = increase in hemoglobin A2

A

minor

59
Q

Alpha thalassemia = most common in what region

A

Asia

60
Q

Thrombotic thrombocytopenic pupura (TTP) = life threatening disorder = medical 911. Associated with deficiency in

A

plasma enzyme ADAMTS13 = VON WILLEBRAND FACTOR (vWF) metalloprotease. the enzyme degrades vWF. deficiency results in accumulation of vWF and = platelet aggregation. treatment is plasma exchange.

61
Q

idiopathic thrombocytopenia purpura (ITP) is a ___condition in which the blood doesn’t __ as it shoud. 2 types: one in children and ne in adults.

A

bleeding

clot

62
Q

idiopathic thrombocytopenia purpura (ITP) is different in children vs adults:

  1. in __ = low platelet count and tiny PURPURA SPOTS/PETECHIAE on skin. nosebleeds and bleeding gums are also common.
  2. in ____ ITP lasts much longer. most have increased bleeding and BRUISING for several weeks/months/increased menstrual flow
A
  1. children

2. adults

63
Q

___spots = purplish discolorations in the skin from small bleeding vessels in skin

A

purpura = think underlying cause of bleeding

64
Q

thrombocytopenia means

A

low platelets

65
Q

the MOST COMMON BLEEDING DISORDER

A

THROMBOCYTOPENIA

66
Q

monckeberg medial sclerosis =

  1. ___ deposits in muscular arteries
  2. age
A
  1. calcific

2. 50+

67
Q

Atheromas seen in

A

artheroclerosis

68
Q

consequences of atherosclerosis

A

ischemic heart disease (IHD) aka coronary artery disease/coronary heart disease
stroke
aortic and carotid atherosclerotic disease

69
Q

atherosclerosis risk factors have Multiplicative effects: two risk factors increase the risk four fold. what are they?
2. if 3 risk factors present risk of myocardial infarction is increased__ fold

A

hyperlipidemia, hypertension, smoking.

2. seven fold

70
Q

Constitutional risk factors (less controllable) in Ischemic heart disease

A

age, gender, genetics

71
Q

modifiable risk factors in Ischemic heart disease

A

hyperlipideamia hypertension, smoking DM

72
Q

in sickle cell anemia the __ portion of the molecule is abnormal due to the amino acid ___ being substituted for -___

a. glutamine
b. glutamic acid
c. aspartic acid
d. glycine

A

globin
valine is substituted FOR glutamic acid

NOT VALINE SUBSTITUTED by GLUTAMIC ACID!!!

don’t confuse the other way and think glutamic acid replaces valine! way to remember: at end of substitution, V-aline V looks like the sickle cell produced

73
Q

most common hereditary anemia in African Americans

A

sickle cell anemia

74
Q

sickle cell anemia abnormal hemoglobin is called ___

A

abnormal hg molecule is HgS (think Sickle cell starts with an S)

75
Q

sickle cell anemia is autosomal dominant/recessive

A

recessive!

76
Q

sickle cell anemia: when the abnormal HgS is exposed to ___ they form fibrous precipitates with the RBC’s distorting them into sickle shape (crescent shape)

A

low concentrations of oxygen (hypoxic)

77
Q

as a result of sickle cell abnormal shape they cause

A

small blood clots

78
Q

sickle cell blood clots give rise to

A

recurrent painful episodes called

sickle cell pain crises

79
Q

non healing __ ulcers and recurrent pain in __ are characteristic of sickle cell anemia

A

leg ulcers,

pain in abdomen and chest

80
Q

sickle cell patients are asplenic = __ and therefore prone to

A

spleen function absent = prone to infections caused by encapsulated organisms (strep pneumonia and hemophilus influenza)

81
Q

autosplenectomy seen in _ patients

A

sickle cell patients bc repeated episodes of splenic infarction followed by fibrotic healing lead to fibrotic shrunken spleen

82
Q

sickle cell anemia may become life threatening when :

  1. damaged RBC break down (____ crisis)
  2. spleen enlarges and traps the blood cells (__ crisis)
  3. infection causes bone marrow to stop producing RBC (__crisis)
A
  1. hemolytic crisis
  2. splenic sequestration crisis
  3. aplastic crisis
83
Q

a man who has had flu like symptoms but with NO FEVER now shows CHERRY RED DISCOLORATION OF THE SKIN, MUCOSA, AND TISSUES. he is most likely suffering from an acute ___

a. mercury poisoning
b. carbon monoxide poisoning
c. fluoride poisoning
d. sarcoidosis
e. military TB

A

Carbon monoxide poisoning

84
Q

patients with cherry red discoloration of skin, mucosa and tissue have acute

A

carbon monoxide poisoning. leads to death from hypoxia.

85
Q

symptoms of CO poisoning are so easily mistaken for those of

A

common cold, flu or exhaustion

86
Q

ENVIRONMENTAL AGENTS- GIVE MANIFESTATION

carbon tetrachloride

A

hepatocellular damage

87
Q

ENVIRONMENTAL AGENTS- GIVE MANIFESTATION

prevents cellular oxidation- results in odor of bitter almonds

A

mercuric chloride

88
Q

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION

prevents cellular oxidation- results in odor of bitter almonds

A

cyanide poisoning

89
Q

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION

blindness

A

methyl alcohol

90
Q

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION

nausea vomiting, abdominal pain, within hours and then nephrotoxic and neurotoxicity

A

bismuth

91
Q

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION
basophilic stippling of RBC
anemia, abdominal pain, wrist and foot drop

A

lead

92
Q

Hemophilia A and B are inherited as

A

sex-linked recessive trait

males are affected and females are carriers

93
Q

Epistaxis

A

nose bleed

94
Q

hematoma

A

localized collection of blood outside the blood vessels

95
Q

Hemarthrosis

A

a bleeding into joint spaces

96
Q

Hemaphilia A = deficiency in which coagulation factor

A

VIII (anti-hemophilic factor)

97
Q

Hemophilia __ = aka Christmas disease = deficiency in factor IX = plasmathromboplastin

A

Hemophilia B

98
Q

Hemophilia __ = aka Rosenthal’s syndrome) = not sex linked. Less severe bleeding and due to deficiency in factor XI (plasma thromboplastin antecedent)

A

C

99
Q
  1. Hemophilia A
  2. Hemophilia B
  3. Hemophilia C
    give the deficient clotting factor
A
  1. A = 8
  2. B = 9
  3. C = 11
100
Q

Christmas disease

A

hemophilia B

101
Q

Rosenthal’s syndrome

A

Hemophilia C = aka Rosenthal’s syndrome) = not sex linked. Less severe bleeding and due to deficiency in factor XI (plasma thromboplastin antecedent)

102
Q

Hemophiliac will have

  1. __ partial thromboplastin time
  2. prothrombin time
  3. bleeding time
  4. platelet count
A
  1. prolonged PTT
  2. normal PT
  3. normal bleeding time
  4. normal platelet count
103
Q

In classic hemophilia the other lab tests besides (PTT) partial thromboplastin time remain normal bc the bleeding time is a measure of ____,
the prothrombin time a measure of the _ pathway,
and the thrombin time an assay of the conversion of __ to __

A
  1. bleeding time = measure of platelet plug formation
  2. prothrombin measure of extrinsic pathway of coagulation
  3. thrombin measures conversion of fibrinogen to fibrin
104
Q

von Willebrand’s disease is inherited as an autosomal ___ bleeding disorder which occurs equally in both sexes

A

dominant

105
Q
  1. hemophilia A + B is sex linked____
  2. vWD is ___
  3. hemophilia C is
A
  1. recessive (males affected, females are carriers)
  2. autosomal dominant
  3. not sex linked

NBDE PART 1 MICRO/PATH (20 decks)

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