1. venous thrombi occur at sites of 2. arterial or cardiac thrombi begin at sites of

1. stasis 2. turbulence or endothelial injury

2 types of congestion (hyperemia): 1. active congestion (active hyperemia) = results from 2. passive congestion (active hyperemia) = results from

1. localized arteriolar dilation (inflammation, blushing) 2. obstructive venous return or increased back pressure form congestive heart failure

Blood Disorders Flashcards by User Unknown

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

anemia

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Pernicious anemia is due to deficiency in __

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

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in pernicious anemia the cells are:

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

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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Schilling test is used to detect if body?

absorbs Vit. B12 adequately. used to detect pernicious anemia

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folate and vitamin B12 is needed for __ synthesis

DNA

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iron is needed for __ synthesis

hemoglobin

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___ 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

aplastic

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stomatitis and atrophic glossitis are common in which type of anemia

prenicious

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in drug induced aplastic anemia the RBC appear

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

a. normocytic (normal sized)

b. normochromic

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thrombus formation caused by 3 abnormalities called Virchow’s Triad

endothelial injury
stasis or turbulent blood flow
hypercoagulability

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venous thrombi occur at sites of

2. arterial or cardiac thrombi begin at sites of

stasis

2. turbulence or endothelial injury

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

arterial
venous
therefore both propagate towards the direction of the heart!!!!!

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most venous thrombi occur in the

legs

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

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

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superficial venous thrombi ___ embolize

rarely

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Hyperaemia or hyperemia is the___

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

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2 types of congestion (hyperemia):

active congestion (active hyperemia) = results from
passive congestion (active hyperemia) = results from

localized arteriolar dilation (inflammation, blushing)

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

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two forms of passive congestion: acute and chronic.

1. __ occurs in __ or __sided heart failure

1 acute, shock, right

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passive congestion: chronic

chronic: of the ___ caused by Left sided heart failure
of the ___ caused by Right sided heart failure

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

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

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Claudication,

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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edema of extremities caused by R/L sided heart failure

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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dyspnea on exertion caused by R/L sided heart failure

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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Nocturia

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

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

arteriolar nephrosclerosis = hardening of arterioles within the kidneys

the most common cause of secondary hypertension

kidneys

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

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

Usually high blood pressure have ___symptoms

no symptoms at all = CALLED THE SILENT KILLER

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

hypertension

3 classes of drugs to treat hypertension

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

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

secondary

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

secondary hypertension

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

pregnancy high blood pressure protein

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

normocystic

___ is an anticoagulant that interferes with vitamin K

Warfarin (Coumadin)

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

prothrombin = delays blood clotting = prevents thromboembolic disease

a patient taking heparin will delay/speed up blood clotting

delay | it is antithrombin and antiprothrombin = prevents platelet agglutination

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

leukemia

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

cirrhosis | bc PROTHROMBIN IS FORMED AND STORED IN THE LIVER)

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

platelet adhesion

Long term treatment with ___ results in impaired production of thromboxanes

aspirin (cyclooxygenase inhibitor)

Bernard-Soulier disease = a hereditary __ disorder

platelet adhesion

Dicumarol is an ___

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,

Dicumarol has largely been replaced by ___

warfarin

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

ABO

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

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

erythroblastosis fetalis = mom makes antibodies that attack babies RBC

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

1. G (IgG) 2. four: 2 heavy, and 2 light 3. two 4. 75%

IgG is also associated with Type ___Hypersensitivity.

II and Type III

which IMMUNOGLOBULIN can cross placenta and is present at birth

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

mixed together

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

Mom is negative and baby is +

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

hemolytic (erythroblastosis fetalis, sickle cell anemia, thalassemias)

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

small intestines

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

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.

kernicterus

kernicterus | toxic accumulation of unconjugated bilirubin in the BRAIN AND SPINAL CORD

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

major

Beta thalassemia major/minor = increase in hemoglobin A2

minor

Alpha thalassemia = most common in what region

Asia

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

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.

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.

bleeding | clot

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

1. children | 2. adults

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

purpura = think underlying cause of bleeding

thrombocytopenia means

low platelets

the MOST COMMON BLEEDING DISORDER

THROMBOCYTOPENIA

monckeberg medial sclerosis = 1. ___ deposits in muscular arteries 2. age

1. calcific | 2. 50+

Atheromas seen in

artheroclerosis

consequences of atherosclerosis

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

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

hyperlipidemia, hypertension, smoking. | 2. seven fold

Constitutional risk factors (less controllable) in Ischemic heart disease

age, gender, genetics

modifiable risk factors in Ischemic heart disease

hyperlipideamia hypertension, smoking DM

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

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

most common hereditary anemia in African Americans

sickle cell anemia

sickle cell anemia abnormal hemoglobin is called ___

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

sickle cell anemia is autosomal dominant/recessive

recessive!

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)

low concentrations of oxygen (hypoxic)

as a result of sickle cell abnormal shape they cause

small blood clots

sickle cell blood clots give rise to

recurrent painful episodes called | sickle cell pain crises

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

leg ulcers, | pain in abdomen and chest

sickle cell patients are asplenic = __ and therefore prone to

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

autosplenectomy seen in _ patients

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

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)

1. hemolytic crisis 2. splenic sequestration crisis 3. aplastic crisis

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

Carbon monoxide poisoning

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

carbon monoxide poisoning. leads to death from hypoxia.

symptoms of CO poisoning are so easily mistaken for those of

common cold, flu or exhaustion

ENVIRONMENTAL AGENTS- GIVE MANIFESTATION | carbon tetrachloride

hepatocellular damage

ENVIRONMENTAL AGENTS- GIVE MANIFESTATION prevents cellular oxidation- results in odor of bitter almonds

mercuric chloride

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION | prevents cellular oxidation- results in odor of bitter almonds

cyanide poisoning

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION | blindness

methyl alcohol

Name the ENVIRONMENTAL AGENTS- GIVEN MANIFESTATION | nausea vomiting, abdominal pain, within hours and then nephrotoxic and neurotoxicity

bismuth

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

lead

Hemophilia A and B are inherited as

sex-linked recessive trait | males are affected and females are carriers

Epistaxis

nose bleed

hematoma

localized collection of blood outside the blood vessels

Hemarthrosis

a bleeding into joint spaces

Hemaphilia A = deficiency in which coagulation factor

VIII (anti-hemophilic factor)

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

Hemophilia B

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

1. Hemophilia A 2. Hemophilia B 3. Hemophilia C give the deficient clotting factor

1. A = 8 2. B = 9 3. C = 11

Christmas disease

hemophilia B

Rosenthal's syndrome

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

Hemophiliac will have 1. __ partial thromboplastin time 2. prothrombin time 3. bleeding time 4. platelet count

1. prolonged PTT 2. normal PT 3. normal bleeding time 4. normal platelet count

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 __

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

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

dominant

1. hemophilia A + B is sex linked____ 2. vWD is ___ 3. hemophilia C is

1. recessive (males affected, females are carriers) 2. autosomal dominant 3. not sex linked