Chapter 3 Hemodynamic disorders Flashcards
Filariasis
a chronic mosquito-borne parasitic infection.
Chronic infection can lead to swelling of the extremities, hydroceles, and testicular masses.
caused by at least three species of nematode parasites (Wuchereria bancrofti, Brugia malayi, and Brugia timori)
transmitted to 5 genera of mosquitoes including Aedes, Anopheles, Culex, Mansonia, and Ochlerotatus
worldwide second-largest cause of permanent deformity and disability
Filariasis
First-largest cause of permanent deformity and disability worldwide
leprosy
Causes of Filariasis
Wuchereria bancrofti
Brugia malayi
Brugia timori
primary reservoir for Filariasis
Humans
most common condition of filariasis
hydrocele
Tropical pulmonary eosinophilia
an immune response to filarial infection. It causes pulmonary restrictive lung disease, wheezing, shortness of breath, and eosinophilia
Lymphedema - graded based on the extent of Filariasis
Grade I: Extremity pitting edema, reversible
Grade II: Extremity pitting or nonpitting edema, nonreversible
Grade III: Nonpitting, nonreversible edema, with skin thickening
Grade IV: Nonpitting, nonreversible, thickened and nodular appearance of the skin, classified as elephantiasis
preferred drug to use to treat lymphatic filariasis with associated Loa loa infection
Doxycycline
Lymphatic filariasis
a tropical disease found in undeveloped countries such as Africa and the South Asian Pacific.
“dance sign”
Ultrasound can directly confirm the presence of microfilariae. The “dance sign” can be observed and is highly sensitive for LF diagnosis.
Mazzotti reaction
most likely secondary to an inflammatory allergic response from microfilariae death.
onchocerciasis
has firm subcutaneous nodules with filarial worms found in the subcutaneous tissue and not peripheral blood.
Wuchereria bancrofti
a filarial (arthropod-borne) nematode (roundworm) that is the major cause of lymphatic filariasis.
primarily in Central Africa and the Nile delta, South and Central America, the tropical regions of Asia including southern China, and the Pacific islands.
Primary hyperaldosteronism is characterized by
low plasma renin concentrations, usually less than 1 ng/mL/h
elevated serum aldosterone levels, typically more than 20 ng/dL, due to inappropriate autonomous hypersecretion of adrenal aldosterone.
Secondary hyperaldosteronism results from
excessive renin production and activity due to various conditions, including renal artery stenosis, left heart failure, liver failure with ascites, cor pulmonale, pregnancy, renin-secreting tumors, excessive licorice ingestion, renal tubular acidosis, nutcracker syndrome, kidney failure, and genetic conditions such as Bartter and Gitelman syndromes.
nutcracker syndrome
results most commonly from the compression of the left renal vein (LRV) between the abdominal aorta (AA) and superior mesenteric artery (SMA)
Bartter syndromes
a rare inherited disease characterised by a defect in the thick ascending limb of the loop of Henle, which results in low potassium levels (hypokalemia), increased blood pH (alkalosis), and normal to low blood pressure.
Gitelman syndromes
autosomal recessive
a salt-losing tubulopathy caused by mutation of genes encoding sodium chloride (NCCT) and magnesium transporters in the thiazide-sensitive segments of the distal nephron. It is characterized by renal potassium wasting, hypokalemia, metabolic alkalosis, hypocalciuria, hypomagnesemia, and hyperreninemic hyperaldosteronism. Gitelman syndrome is also referred to as familial hypokalemia-hypomagnesemia.
Conn syndrome
Primary hyperaldosteronism was first described in 1956 and is caused by excessive autonomous aldosterone production by the adrenal gland, specifically the zona glomerulosa.
Endothelin
A potent endothelium-derived vasoconstriction
What do von Willebrand factor bind to?
GpIb on platelets
What do fibrinogen bind to on platelets?
GpIIb-IIIa complex
Platelet alpha- granules contain
P-selectin on their membranes
Coagulation factors (Fibrinogin, factor V and vWF).
Protein factors involved in wound healing (fibronectin, platelet factor 4, platelet-derived growth factor (PDGF), transforming growth factor-beta).
Platelet dense granules contain
Adenosine diphosphate (ADP), adenosine triphosphate (ATP), polyphosphate, ionized calcium, serotonin and epinephrine.
Bernard-Soulier syndrome
defect in GP Ib-IX. Autosomal recessive with a decreased platelet count.
Glanzmann’s thrombasthenia
defect in GP IIb/IIIa
defect in GP Ib-IX
Bernard-Soulier syndrome
defect in GP IIb/IIIa
Glanzmann’s thrombasthenia
Factor I
Fibrinogen
Factor II
Prothrombin
Factor III
Tissue thromboplastin
Factor IV
Calcium
Factor V
Proaccelerin
Factor VII
Proconvertin
Factor VIII
Antihemophilic factor A. Von Willebrand factor is the carrier for Factor VIII.
Factor IX
Antihemophilic factor B
Factor X
Stuart factor
Factor XI
Antihemophilic factor C
Factor XII
Hageman factor
Factor XIII
fibrin stabilizing factor
Fitzgerald factor
High molecular weight kininogen
Fletcher factor
Prekallikrein
Coumarin
moderately toxic to the liver and kidneys of rodents, with a median lethal dose (LD50) of 293 mg/kg in the rat,[25] a low toxicity compared to related compounds. Coumarin is hepatotoxic in rats, but less so in mice.
The most common inherited bleeding disorder
Von Willebrand disease, about 1 in 100 people globally.
Autosomal dominant
Von Willebrand disease
Usually autosomal dominant with normal platelet count.
compared to Bernard-Soulier disease autosomal recessive with decreased platelet count.
diseases with increased mean platelet volume (MPV).
Immune thrombocytopenic purpura
Bernard-Soulier disease
von Willebrand disease
Gray platelet syndrome
Platelet clumping due to platelet clumping with EDTA.
diseases with decreased mean platelet volume (MPV).
Aplastic anemia
Wiskott-Aldrich syndrome
Most common hemophilia
Hemophilia A (classic hemophilia) 85% of hemophilias.
X-linked recessive
Hemophilia B
Christmas disease. X-linked recessive. Factor IX deficiency.
Hemophilia C
Factor IX deficiency. Autosomal recessive.
