Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

test 2 > crit care test 2 > Flashcards

crit care test 2 Flashcards

win

1
Q

Microcytic MCV level

A

MCV less than 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of Microcytic Anemia (MCV <80 )

A

Iron defficiency- poor intake or blood loss (asymptomatic)

Tahlassemia minor
DX is unresponsive to iron supplemetation

Medeterranean- is beta
African American Alpha

Sideroblastic -primary 2nd or congential

Anemia of chronic disease- can have defficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

microcytic anemia DX/TX(MCV less than 80)

A

Check serum: ferritin, iron, TIBC, reticulocyte count
Ferritin >100 rules out dx

i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

in mircrocytic anemia of chronic disease - iron will be —— ferritin will be ——

A

iron low

ferritin is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tx of mircrocytic anemia

A

theraputic iron trial
eval for GIB
if not responsive to iron consider thalassemia dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anemia of chronic disease- trapping of iron is present

HGB level-
Serum Iron and IBC
retic count-

serum ferritin

A

anemia is moderate 7-11

Serum Iron and IBC both down

reticulocyte count is down

serum ferritin increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Macrocytic anemia MCV level

A

MCV >100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Macrocytic anemia MCV >100 types

A

B 12 deficiency-

Folate deficency

Hepatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Macrocytic anemia B 12 deficiency causes and notes

A

reduced production of intrinsic factor, poor intake, occurs i the 6th decade with neuro issues and cerebral dysfunciton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Macocytic anemia folate deficiency causes and notes

A

poor intake, meds, this has a role in arterial and venous thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

macrocytic anemia hepatic disease causes and notes

A

booze and diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Macrocytic anemia tx

A

give b12 and folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

normochromic and normocytic anemia

mcv level

A

80-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

causes of normochromic normocytic anemia

A 
Chronic disease
hemolytic
sickle cell
G6PD deficiency
Drug induced
aplastic
renal failure
hypothyroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

sickle cell disease with trait

A

Asymptomatic and no anemia, mild hematuria is usually present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

sickle cell signs of intravascular sickling

A

fever and leukocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

sickle cell tx

A

Hydration, pain control, (pca vs ketorolac)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

sickle cell tx when to give hydroxyurea

A

if 3 or more episodes in a year - kids get bone marrow transplant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

sickle cell complications

A

acute chest syndrome- can be caused bby infection or asthma, pulm edema, pneumonia, PE, priapism, retinoathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

g6pd deficiency episodic vs chronic notes

A

episodic - its sex linked
african americans
hemolysis after exposure to oxidant or infection- sulfonamides or antimalarials

chronic is Mediterranean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

g6pd treatment

A

avoid triggers - folic acid supplemtation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

drug induced hemolytic anemia will have a ——-test

caused by

tx

A

positive direct coombs test

caused by exposure to quinidine, PCN, or methyldopa

tx -avoid triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

autoimmune hemolytic anemia

IGG
IGM

A

IGG- against RH antign, Lymphomas, Lupus, UC, CLL- (warm antibodies)

IGM- Mycoplasma, Epstien bar, Cytomegalo virus, cold antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Aplastic anemia

is usually----
exposure to ---
idiosyncratic--
Viral-
onset is ------ and features
A

usually idopathic
marrow toxins like chemo or cytotoxic drugs

viral- HBV, Hep C, CMV, HIV parvo

gradual onset, fatigue bleeding and thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Renal failure anemia

RBCs-
Severity parralels -
Once GFR is less than –anemia is present

A

RBCs reduce and decrease survival

Severity parallels azotemia

GFR below 60 = anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

hypothyroid anemia is an——— response

A

autoimmune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

blood product admin

whole blood

A

Indications are rare
massive transfusion to correct hypovolemia (trauma or shock)

rare use- must be ABO identical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

PRBC- to treat ——anemia and ———

A

treat symptomatic anemia and routine blood loss during sx

29
Q

Platelets are used to

are prepared from

what about bacteria

theraputic dose for adults is —

some patients become —-

A

to prevent spontaneous bleeding or stop established bleeding in thrombocytopenic patients

prepared from a single unit of whole blood

due to storage this is most likley to be contaminated with bacteria
dose for adults is 6-10 units and some ptients become refractory

30
Q

FFP

A

used to replace labile and non labile coag factors in massively bleeders or tx things like coum overdoses

31
Q

DIC

excessive generation of -----
secondary activation of 
-------
Results in -----
Caused by -----
A

excessive generation of —–thrombin and formation of intravascular fibrin clots

secondary activation of
——-the fibrinolytic system

Results in —–consumption of platelets and coag factors

Caused by —–tissue injury, gram neg or positive sepsis, inflammatory disorders, endothelial sloughing secondary to acidosis, or obstetric disorders

32
Q

DIC dx

A

FDP will be up
D dimer is specific but not sensitive
PT/PTT not reliable
platelets are low

33
Q

DIC TX

A 
Tx underlying cause
Replace with whole blood
heparin
anti fibrinolytic factors
activated protein C
34
Q

ITP

autoimmune disorder where —– is formed and binds to ——

A

IGG- platelets

35
Q

ITP and the role of the spleen-

A

ITP in adults presents with bleeding and splenomeagly

36
Q

ITP thrombocytes

peripheral smear will have —-

A

<10,000 may be with anemia and normal CBC,

Megathrobocytes

37
Q

ITP can be seen with

-------- anemia
hematologic -----
myleodysplasia
megaloblastic anemia 
chronic ---------
and can be induced by
A

aplastic anemia
hematologic malignancies
chronic etoh
and induced by drugs or transfusion

38
Q

Drug most common to cause ITP

A

Heparin

39
Q

ITP tx

A

Prednisone 1-2 mg/kg/day increases the platelet count, and include high dose dexamethasone, slenectomy and high dose IVIG or danazol

40
Q

HIT
——antibody reacts with platelets on the surface

rises after —– days

initially asymptomatic thrombocytopenia

dx is

TX is

A

IGG antibody

after four days

+ hit panel

stop heparin

41
Q

TTP

is common or uncommon

A

uncommon

42
Q

TTP - seen in ages with M/F predominance

A

20-50 with female prodominance

43
Q

TTP causes

A

pregnancy, drugs or infection

44
Q

TTP treatment

A

emergent large volume plasmapheresis, prednison and antiplatelets, splenectoy, immunosuppression

45
Q

HUS

causes

labs

A

hemolytic uremic syndrome

caused by estrogen use, post partum state,familial

coumbs negative

46
Q

AML - definition

A

neoplastic disease which clonal undifferentiated cells infiltrate the blood, bone marro and tissues

47
Q

AML cuase

symptoms

A
  • Caused by genetics, radiation, medications, chemical and occupational exposures but not viral
  • S/S: nonspecific, general complaints, could have
48
Q

AML- Exam

A

• PE: fever, organomeglia, lymphadenopathy, sternal tenderness, infection, hemorrhage

49
Q

AML Treatment

A
  • Treatment: Once diagnosis is made functional integrity of major organ systems need to be done, treat symptoms and blood disorders
    1. Induction chemotherapy
    1. Post remission therapy
50
Q

CML definition

A

• Clonal hematopoietic stem cell disorder driven by genetics and the Philadelphia chromosome

51
Q

CML S&S and Exam

A
  • S/S: symptoms of anemia, fatigue, malaise,weight loss, early satiety, LUQ pain or mass, organomeglia, vasoocclusive events
  • PE: splenomegaly, lymphadenopathy, complications of tumor burden on major organs
52
Q

Treatment

complications

A
  • Treatment: Once the Phila. Chromosome is identified, TKI therapy is initiated, can have stem cell transplant, splenectomy
  • Complications: do not give TKI during pregnancy
53
Q

Neutropenia

A
  • Neutropenia: low neutrophils (susceptible to infection <1000, loss of control of endogenous flora <500, loss of local inflammatory process <200
  • Causes: chemo, antibiotics
54
Q

Thrombocytopenia

definition and causes

A

Thrombocytopenia: low platelets

• Causes: decreased bone marrow production, enlarged spleen, or platelet destruction (infection or drug induced)

55
Q

Pancytopenia

A
  • Pancytopenia: anemia, leukopenia, and thrombocytopenia
  • Causes: aplastic anemia, myelodysplasia, leukemia, lymphoma, secondary to systemic diseases such as alcohol use, TB, sarcoidosis, infection, SLE
56
Q

Imunosuppressive therapy

A

• Immunosuppressive therapy: suppresses all immune responses to bacteria, fungi, malignant tumors
• Used post-transplant and in some oncologic disorders
• Induction therapy: reduces the risk of acute rejection and
minimizes/eliminates the use of steroids
• Maintenance therapy: given once acute rejection timeframe over
• Complications: opportunistic infections

57
Q

Tumor Lysis Syndrome

A

Oncological emergency
• Caused by a large number of rapidly proliferating neoplastic cells
• Hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia
• Treatment
• Recognize early, • Prevent with allopurinol, urinary alkalization and aggressive hydration

58
Q

Rheumatoid arthritis:

A

antibodies attach to the linings of the joints causing inflammation, swelling and pain. Treated with anti-inflammatories.

59
Q

• SLE:

A

antibodies attach to tissues (joints, lungs, blood cells, nerve endings, kidneys). Treated with steroids

60
Q

• MS:

A

immune system attacks nerve cells causing pain, blindness, weakness, poor coordination, muscle spasms.

61
Q

Type I DM:

A

antibodies attack insulin producing cells from the pancreas.

62
Q

Guillian-Barre Syndrome:

A

immune system attacks nerves that control the muscles in the legs, arms and upper body. Treated with plasmapheresis.

63
Q

• Psoriasis:

A

overactive T cells in the skin

64
Q

Chronic inflammatory demyelinating polyneuropathy:

A

similar to GBS

65
Q

Grave’s Disease:

A

antibodies overstimulate the thyroid gland

66
Q

Hashimotos thyroiditis:

A

antibodies attack the thyroid gland

67
Q

Myasthenia Gravis

A

antibodies bind to the nerves and slow them down causing weakness

68
Q

Vasculitis:

A

immune system attacks and damages the blood vessels

test 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions