Cardic Pathology Part 1 Flashcards
1
Q
What are the 5 blood analysis tests
A
- CBC
- Cardiac enzyme profile
- Chemistry profile
- Lipid panel
- Coagulation profile
2
Q
What is the purpose of a CBC
A
Compares to normal values for overall health status by assessing the composition of the blood
3
Q
What is the make up of 5 liters of blood
A
3 liters plasma
2 liters cells
4
Q
What cells are looked at with a CBC (3)
A
- Leukocytes (WBC)
- Erthrocytes (RBC)
- Thrombocytes (platelets)
5
Q
What can leukocytes indicate
A
Infection
6
Q
What does too few erythrocytes mean
A
Anemia
7
Q
What can thrombocytopenia indicate
A
Drug toxicity
8
Q
What is the normal range of WBC
A
4500-11000 cells/mm3
9
Q
What do you look at when looking at RBC with a CBC (2)
A
- Hematocrit (HCT)
2. Hemoglobin (HgB)
10
Q
What is the normal hematocrit level for males and females
A
Males: 42-52%
Females 37-47%
11
Q
What is the normal hemoglobin level for males and females
A
Males: 14-17.4 g/dL
Females: 12-16 g/dL
12
Q
What is the normal range of platelets
A
140,000-400,000 cells/mm3
13
Q
What is the erythrocyte sedimentation rate for males and females
A
Males: 0-17 mm/hr
Females: 1-25 mm/hr
14
Q
What do white blood cells do
A
Fight infection and presence of foreign bodies
15
Q
What does an increase of white blood cells potentially indicate
A
Presence of inflammation, infection, leukemia, tissue necrosis, trauma, or stress
16
Q
What are the 5 types of white blood cells
A
- Neutrophils
- Lymphocytes
- Monocytes
- Eosinophils
- Basophils
17
Q
What do neutrophils do
A
Defend against bacteria
18
Q
What do lymphocytes do
A
Produce antibodies and respond to viral infection
19
Q
What do monocytes do
A
Clean up debris (phagocytosis)
20
Q
What do eosinophils do
A
Attack parasites and play a role in asthma and allergy
21
Q
What do basophils do
A
Release histamines during allergic reactions
22
Q
What is reverse isolation
A
Procedures used for immunocompromised patients with decreased WBC
23
Q
What are 3 examples of reverse isolation
A
- Having your patient wear a mask in common areas
- Disinfect equipment
- Good hand washing
24
Q
How do you modify or hold exercise based on WBC less than 1,000
A
No active aerobic or resistance exercise and wear mask
25
How do you modify or hold exercise based on WBC between 5,000 and 10,000 with a fever
No exercise
26
How do you modify or hold exercise based on WBC over 4,800 to 11,000
Exercise to patient tolerance
27
Where are RBC produced
Bone marrow of long bones, ribs, sternum, and pelvis
28
What is production of RBC mediated by
Amount of O2 in the tissues
29
If someone is hypoxic what happens to the amount of RBC production
It increases (polycythemia)
30
What is hematocrit
Percent of whole blood occupied by RBCs (iron)
31
What is hemoglobin
Measures the oxygen carrying capacity of RBCs (oxyhemoglobin)
32
How do you modify or hold exercise based on hematocrit over 30%
Exercise to patient tolerance and resistance exercise as tolerated
33
How do you modify or hold exercise based on hematocrit between 25-30%
Light exercise and closely monitor vitals
34
How do you modify or hold exercise based on hematocrit less than 25%
No aerobic or resistance exercise
35
How do you modify or hold exercise based on hemoglobin above 10 g/dL
Exercise to patient tolerance
36
How do you modify or hold exercise based on hemoglobin between 8-10 g/dL
Light exercise and closely monitor vitals
37
How do you modify or hold exercise based on hemoglobin less than 8 g/dL
No aerobic or resistance exercise
38
What do platelets do
Initiate clotting to stop damaged blood vessels
39
What is a high amount of platelets called
Thrombocytosis
40
What is the cause of thrombocytosis (5)
1. Cardiac arrest
2. Anemia
3. RA
4. TB
5. Oral contraceptives
41
What is a low amount of platelets called
Thrombocytopenia
42
What is the cause of thrombocytopenia (4)
1. Lymphoma/leukemia
2. Sepsis
3. Chemo
4. Medication
43
How do you modify or hold exercise based on platelet levels between 50,000-150,000
Exercise to patient tolerance but not explosive exercises
44
How do you modify or hold exercise based on platelet levels between 30,000-50,000
AROM, cycling with no resistance, walking and monitoring vitals
45
How do you modify or hold exercise based on platelet levels between 20,000-30,000
No aerobic or resistance exercise, PROM and possibly AROM allowed
46
How do you modify or hold exercise based on platelet levels less than 20,000
ADLs or bed rest and PROM
47
True or False:
| For a patient with low platelet levels you should avoid vigorous manual techniques and do NOT perform debridement
True
48
What is erythrocyte sedimentation rate
Rate at which RBCs settle out of unclotted blood in 1 hour
49
What is a high ESR typically due to
Inflammation or tissue necrosis
50
How does the inflammation or tissue necrosis increase the ESR
Altering blood proteins and creates sticky RBCs that settle to the bottom faster
51
What happens to ESR as a condition gets worse
It increases
52
What happens to ESR as a condition gets better
It decreases
53
What is a cardiac enzyme profile
Blood test that determines the concentration of myocardial proteins
54
What is creatine kinase (CK)
Sensitive marker for MI
55
True or False:
| Any injury to skeletal muscle can elevate creatine kinase
True
56
What is creatine kinase-MB
Isoenzyme found specifically in the heart
57
True or False:
| Creatine kinase can also be broken down into CK-BB (brain) and CK-MM (muscle)
True
58
What is troponin
Cardiac enzyme involved in actin myosin interaction
59
What is troponin I
Marker for myocardial injury
60
What is troponin T
Predictor of cardiovascular mortality
61
What are the purposes of the cardiac enzyme profile (2)
1. Diagnose acute MI
| 2. Determine the amount of myocardial damage and prognosis after MI
62
True or False:
| Enzymes change in a predictable pattern after a cardiac event
True
63
When does CK/CK-MB appear in serum, peak, and decrease after an MI
Appears in 3-6 hours
Peaks in 18--24 hours
Decreases in 2-3 days
64
When does troponin I appear, peak, and decrease in serum after an MI
Appears in 3-6 hours
Peaks in 14-48 hours
Decreases in 7-14 days
65
When does troponin T appear, peak, and decrease in serum after an MI
Appears in 3-6 hours
Peaks in 14-48 hours
Decreases in 7-14 days
66
When does myoglobin appear, peak, and decrease in serum after an MI
Appears in 0-2 hours
Peaks in 3-5 days
Decreases in 18-24 days
67
What is myoglobin
Protein in cardiac and skeletal muscle that binds to oxygen
68
True or False:
| A PT may assess patient's intervention intensity based on degree of cardiac muscle damage
True
69
What should a PT monitor when a patient has elevated cardiac enzymes (2)
1. Exercise induced ischemia
| 2. Heart failure
70
True or False:
| Sometimes CK or myoglobin increase due to skeletal muscle damage so using troponin I or T is more specific
True
71
What is a chemistry profile
Blood test that assesses electrolyte and metabolite concentrations
72
What are electrolytes
Charged particles needed for cell function and metabolism
73
What are the 6 key electrolytes
1. Sodium
2. Potassium
3. Chloride
4. Calcium
5. Magnesium
6. Bicarbonate
74
What does sodium do
Causes cells to shrink/swell (brain)
75
What does potassium do
Neuromuscular function (muscles and hear)
76
What does chloride do
With Na+ can affect cell permeability
77
What does calcium do
Involved in multiple systems in the body
78
What does magnesium do
Involved in multiple systems in the body
79
What does bicarbonate do
Involved in acid-base balance
80
What are the important metabolites (6)
1. CO2
2. Blood urea nitrogen (BUN)
3. Creatinine
4. Albumin
5. Bilirubin
6. Glucose
81
What does CO2
Affected in metabolic acid-base disturbances
82
What does BUN do
Detects renal disorders or hydration levels
83
What does creatinine do
Indicator of kidney functioning
84
What does albumin do
Indicator of liver function
85
How is bilirubin formed
Formed from the breakdown of hemoglobin
86
How is a chemistry profile done
5-10 mL of venous blood is collected in a heparinized needle and syringe
87
What is the purpose of a chemistry profile (3)
1. Detect decreased or excess circulating electrolytes or metabilites
2. Differential diagnosis
3. Monitors response to therapeutic intervention
88
What can cause hypernaturemia (5)
1. Decrease H2) intake
2. Increased Na+
3. Too many IVs
4. Vomiting
5. Cushing's syndrome
89
What are the symptoms of hypernaturemia (6)
1. Tachycardia
2. Irritable
3. Hypotension
4. Decreased urine output
5. Seizures
6. Coma
90
What can cause hyponaturemia (2)
1. Hypovolemia
| 2. Hypervolemia
91
What could cause the hypovolemia that causes hyponaturemia (3)
1. Diuretics
2. Diarrhea
3. Burns
92
What could cause the hypervolemia that causes hyponaturemia (2)
1. Renal failure
| 2. IV fluids
93
What are the symptoms of hyponaturemia cause by hypovolemia (6)
1. Headache
2. Lethargy
3. Decreased skin turgor
4. Dry mucous membrane
5. Orthostatic hypotension
6. Tachycardia
94
What are the symptoms of hyponaturemia caused by hypervolemia (3)
1. Hypertension
2. Tachycardia
3. Pitting edema
95
What is affected with any condition with naturemia
Na+
96
What is affect with any condistion with kalemia
K+
97
What could cause hypekalemia (3)
1. Renal failure
2. NSAIDs
3. Too much IV K+
98
What are the symptoms of hyperkalemia (3)
1. Muscle weakness
2. Parathesias
3. Bradycardia
99
What could cause hypokalemia (5)
1. Diarrhea/vomiting
2. Diuretics
3. Increased steroid use
4. Malnutrition
5. ETOH abuse
100
What are the symptoms of hyperkalemia (5)
1. Weakness
2. Hyporeflexia
3. EKG changes
4. Dysarrythmias
5. Hypotension
101
What is affected with any condition with calcemia
Ca++
102
What could cause hypercalcemia (2)
1. Excessive intake of Ca++ (antacids TUMS)
| 2. Increased release (bone cancer)
103
What are the symptoms of hypercalemia (3)
1. Weakness
2. Hyporeflexia
3. Muscle weakness
104
What could cause hypocalcemia (4)
1. ETOH abuse
2. Poor diet
3. Renal failure
4. Excessive use of laxitives
105
What are the symptoms of hypocalcemia (3)
1. Irritability
2. Muscle spasm/cramps
3. Seizures
106
What are the symptoms of hyperchloremia (3)
1. Weakness
2. Lethargy
3. Hypotension
107
What are the symptoms of hypochloremia (1)
Muscle tetany (spasms)
108
What is affected with any condition ending in chloremia
Cl-
109
When should dehydration be considered in a patient (3)
1. Hypotension
2. Tachycardia
3. Dry mucous membranes
110
When should over hydration be considered in a patient (4)
1. Pulmoanry edema
2. Ascites
3. Peripheral edema
4. Juvenile diabetes
111
When should protien deficiency be considered in a patient (2)
1. Muscle weakness/atrophy
| 2. Slow/poor wound healing
112
When should anemia, abnormal bilirubin/creatinine/BUN be considered in a patient (1)
1. Impaired exercise tolerance
