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Pathophysiology - Diseases > Diseases and Disorders of the blood > Flashcards

Diseases and Disorders of the blood Flashcards

1
Q

what does the blood transport?

A

oxygen, carbon dioxide, water, nutrients, proteins, hormones, & cells

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2
Q

What is the blood made of?

A

plasma, and formed elements, which include red
blood cells, white blood cells, and platelets.

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3
Q

What is plasma?

A

mostly water, carries nuyrtients, wastes, ions, hormones, clotting factors, albumin (promtoes blood’s ability t ohold water and maintain pressure insdie the bv) and antibodies

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4
Q

What are erythrocytes?

A

aka red blood cells (RBCs), make up 1/2 of bloods volumes, most abundant cell in the human body, have no nucleus

carries oxygen w/ iron-rich oxygen carrying protein called hemoglobin

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5
Q

how many erythrocyes in human body?

A

5 million/mm^3 in males and about 4.5 million/ mm^3 in females

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6
Q

What is hemoglobin?

A

protein in RBC composed of a protein called glovin and iron containing heme molecule

turns into oxyhemoglobin when binded to oxygen and turns into carbhemoglobin when binded with carbon dioxide

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7
Q

What is sepcial abt RBC?

A

no nucleus so cant grow or repair themselves = only alive for 120 days

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8
Q

how to RBC get removed and recreated?

A

removed from body by liver and spleen
made in red marrow of bones such as vertebrae and body of sternum

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9
Q

What is erythoropoeisis?

A

red blood cell formation - regulated by hormone erythropoietin

begins as large nucleated stem cells before emerging as mature red blood cell (hemoglobin accumulates cytoplasm and nucleus disappear)

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10
Q

what r reticulocytes?

A

mature red blood cells emerging from the bone marrow `

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10
Q

what r reticulocytes?

A

mature red blood cells emerging from the bone marrow ``

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11
Q

What are leukocytes?

A

white blood cells including neutrophils, eosinophils, basophils, monocyes, and lymphocytes

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12
Q

what are platelets?

A

produced in bone marrow and r essential for blood clotting

Various clotting factors are formed in the liver, enter the blood, and become active in response to injury

during injury platelets become sticky and trigger the deposition of an insoluble clotting protein called fibrin that forms a dnese mesh at wound

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12
Q

what are platelets?

A

produced in bone marrow and r essential for blood clotting

Various clotting factors are formed in the liver, enter the blood, and become active in response to injury

during injury platelets become sticky and trigger the deposition of an insoluble clotting protein called fibrin that forms a dnese mesh at wound

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13
Q

what vitamin is required for synthesis of the prothrombin and thrombin clotting factors

A

vitamin k

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14
Q

What are some ofthe diagnostic test and procedures for the blood?

A

blood tests- measure total blood countrs (RBC, WBC, platelents), hemoglobin, hematocrit, serum chemsitry and enzyme and hormone levels in the body

Differential blood analysis - qualitive info such as sieze, shape and ratio of one cell to another

bone marrow smear - used to diagnose malignant blood disorders and increases/decreases in blood count by obtaining bone marrow smaples from needle aspiration fo the bone marrow from bone marrow cavity

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15
Q

What is anemia?

A

abnormally low number of red blood cells that leads to reduced delivery of oxygen and nutrients to the tissues

caused by hemorrhage, excessive destruction of red blood cells, nurtitioanl deficiency and chronic disease, impaired prodcuton of RBCs, anorexia nervosa, hemolytic-hemoglobin disorders

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16
Q

s/s of anemia

A
  • tissue hypoxia (lack of o2)
  • acute hemorrhage, fatigue
  • decreased tolerance for exercise
  • dyspnea
  • palpitations
  • pallor
  • jaundice and enlargement of the spleen caused by hemolysis (RBC death)
  • tachycardia
  • heart murmurs
  • weakness
  • listlessness
  • cardiac enlrgement
  • mental sluggishness
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17
Q

How to diagnose anemia?

A

Diagnose - microscopic examination, analysis of
red blood cells, complete history on dietary habits, family history of anemia

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18
Q

what is iron-deficiency anemia?

A

anemia in which there is evidence of iron deficiency (iron deficiency is the leading cause of anemia)

prevalence of iron-deficiency anemia is greatest amongst preschool children and adolescent and adult females

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19
Q

what are the risk factors and treatment for iron-deficient anemia?

A

excessive blood loss, menstruation, pregnancy,
and rapid growth during adolescence

treat by taking a dietary intake or supplementary iron (require 1.0-1.4 mg of iron per day)

20
Q

what are is the first stage of developing an iron deficiency anemia?

A
  1. negative iron balance (demand for iron exceeds body’s ability to absorb iron from diet) (can result from blood loss, pregnancy, rapid growth spurts, and inadequate dietary intake)
21
Q

what are is the second stage of developing an iron deficiency anemia?

A

when the iron store in the body become depleted (synthesis of hemoglobin becomes impaired, RBC loos shape and appear cigar/ pencil shaped under microscopic analysis on a peripheral blood smear)

22
Q

What are the s/s of iron deficiency?

A

weakness, fatigue, can affect cognitive performance, behavior and growth in preschool and school-age children, during pregnancy it can lead to infant mortality or death

23
Q

what is the most frequent cause of iron deficiency in each group (men and postmenopausal women, premenopausal women, young children)?

A

men and postmenopausal women - GI bleeding
premenopausal women - menstruation and during pregnancy
young children - in intake of iron does not keep pace with rapid growth and development

24
Q

What is anemia of chronic diseases?

A

anemia that occurs in pt as a result of chronic inflammatory, infectious and autoimmune diseases which is usually bc of a defect in erythropoiesis

25
Q

What is the severity of anemia of chronic diseases associated with?

A

severe anemia - rheumatoid arthritis or tuberculosis ((bc depletion of iron stores)
moderate anemia - associated w/ cardiac conditions like angina pectoris and exercise intolerance

26
Q

How to treat anemia of chronic disease?

A

treating underlying diseases or using erythropoietin, a hormone secreted by the kidney that stimulates synthesis of RBC

27
Q

What is anemia of renal diseases?

A

chronic kidney failure results in moderate to severe anemia

caused by kidney’s failure to produce adequate amounts of erythropoietin

ppl with anemia of renal disease usually have normal serum iron

28
Q

What is megaloblastic anemia?

A

caused by impaired DNA synthesis megaloblastic red blood cells r large, have an increased ratio of RNA to DNA

underlying cause of impaired erythropoiesis in megaloblastic anemia is a vitamin B12 deficiency and/or folic acid deficiency

29
Q

What is vitamin B12 Deficiency Anemia?

A

aka as pernicious anemia
inadequate absorption or intake of B12 or a deficiency in a protein called intrinsic factors (produced in stomach and is essential for the absorption of vitamin B12 from small intestine)
considered macrocytic anemia
immature RBCs r larger than normal
hemoglobin volume is reduced w/ subsequent reduction in oxyfen-carryinf capacity

30
Q

Where is vitamin B12 stored?

A

Vitamin B12 can only be taken in by diet (min rec is 2.5 micrograms)

2 micrograms r in liver and 2 micrograms r stored else where

takes 3-6 yrs for a normal individual to become deficient in vitamin B12

31
Q

What happens when RBC dont have B12 or intrinsic factor??

A

RBC rupture easily within blood = anemia and reduced o2 carrying capacity

32
Q

What are causes of pernicious anemia?

A

inadequate diet, impaired absorption, increased requirement or increased excretion of vitamin B12

vegetarians develop pernicious anemia bc vitamin b12 is found in animal food products

bacteria growth in small intestines and bowel disorders can = pathological changes that either impair or increase the elimination of vitamin b12

90% of pt with pernicious anemia have anti-parietal cell antibodies which can be cytotoxic to the parietal cells

anti-intrinsic factor antibodies

33
Q

s/s of pernicious anemia?

A

abd distress
nausea and vomiting
burning of the tongue
numbness
weakness
yellow and blue color blindness
sore tongue
tingling and numbness in extremities
lips, tongue, and gums appear pale
sclera and skin appear slightly jaundiced
distrurbances in digestion (anorexia, nausea, vomiting, diarrhea, constipation, flatulence and wt.loss)
vulnerable to infection
demyelination of perippheral nerves and eventually the spinal (neuritis, peripheral weakness, numbness, and paresthesia
ataxia
light-headedness
altered vision
tinnitus
optic muscle atrophy
fatigue
palpitations
dyspnea
tachycardia
premature ventricular contractions
congestive heart failure

34
Q

Where to find folic acid?

A

found in many diff types of plants bacterias (mainly fruits and vegetables)

min requirement of folic acid is abt 50 micrograms (body stores abt 5-20 mcg in body, 1/2 of which is in the liver)

35
Q

Where is folic acid deficiency common?

A

western world bc consumption of raw fruits and veggies r low

also folic acid absorption can be impaired by inflammation of the bowel as in Crohn’s disease, meds, preg and lactating females who abuse alc and indv. with kidney diseases

35
Q

Where is folic acid deficiency common?

A

western world bc consumption of raw fruits and veggies r low

also folic acid absorption can be impaired by inflammation of the bowel as in Crohn’s disease, meds, preg and lactating females who abuse alc and indv. with kidney diseases

36
Q

How to detect + treat folic acid deficiency anemia?

A

detect : measurement of serum folic acid levels

treat : oral folic acid supplementation

37
Q

What is hemolytic anemia + etiology?

A

reduction in circulating red blood cells caused by accelerated destruction of RBC

may be bc …
hemoglobin defects
enzyme defects
membrane defects
Infectious agents
certain medications
immune disorders

38
Q

S/s of hemolytic anemia

A

similar symptoms to other anemias, main diff is hemolytic anemia produces incrased serum levels oof bilirubin that results from degradation of heme in destroyed RBCs = haundicied appearance in tissue, urine and feces

39
Q

How to treat hemolytic anemia

A

depends on etiology

inherited hemolytic anemia - spleenectomy (decreases risk of gallstones, sever episodes of hemolysis and pathological hanges to the bone marrow)

severe blood loos such as trauma - blood transfusions

infectious - antibodies

immune disorders - immunosuppressive therapies

40
Q

how to diagnose and treat pernicious anemia

A

diagnose - clinical findings, lab testing, Schilling test for presence of anti-parietal cell or anti-intrinsic factor antibodies, decrease in Hgb level, RBC count and increased mean cell volume (MCV), RBCs and platelets r large and malformed, hypersegmented neutrophils on peripheral blood smear

treat - intramuscular injections of vitamin B12 bc ppl with pernicious anemia cant absorb vitamin b12

41
Q

What is blood dyscrasias?

A

deviation or malfunction of blood production = blood dyscrasis, either bc of impairement in formation of blood composnents or bc of unsual destruction of cells

42
Q

What are anemias classified as (other than causative factor)

A

color of RBC (hypochromic, normochromic, or hyperchromic (spherocytosis)
and
by size as microcytic, normocytic, or macrocytic

43
Q

What is folic acid deficinecy anemia?

A
  • insufficient amounts of folic acid r available for DNA synthesis, thus preventing maturation of blood cells
  • can be consequence of dietary deficiency and is clinically similar to pernicious anemia
44
Q

What is aplastic anemia?

A
  • result from an insult to hematopoietic cells (stem cells)
  • RBC, WBC, platelet production is reduced bc of exposure to myelotxins, certain drugs and instectides, and radiation
45
Q

How to diagnose and treat anemia?

A
  • reduced Bc numbers, reduced hemoglobin levels and hematocrit, changes in morphology of corpuscles, bone marrow studies

treat - based on cause, dietary or supplemental iron administration, treat slow insidious bleed, folic acid replacement, vitamin B12, causative factors must be uncovered in hemolytc and aplastic anemias, rest, increased fluid intake, analgesics, O2 administration, IV therpay, narcotic analgesics, transfusion of packed RBCs

46
Q

What is transfusion incompatibility reaction?

A

results when blood or blood product transfused has antibodies to recipient’s RBCs or recipitient has antibodies to the donor’s EBCs
- caused by ABO and Rh-incompatible blood and antigens that screening doesnt revela cause antigen-antiobody reaction that produce hemolysis or aglutiatnion

47
Q

s/s of transfusion incompatibility reaction?

A
  • hemolysis or agglutination
  • bacterial, allergic and circulatory-overload transfusion reactions
  • severity of reaction depends on amt of incompatible blood
  • chills, ever, tachycardia
  • severe back pain, vomiting, dharrhea, hives or rash, substernal tightness, dyspnea
  • hypotensive and progresses to state of circulatory collapse
  • bleeding from punture sitre, blood in urine and eventually renal failure
48
Q

diagnose and treat transfusion incompatibility reaction?

A

diagnose - any signs of chills, fever, hives, back pain, dyspnea during transfuion

treat- observe pt closely durign first 15 min, stop blood transision at sigh of reaction, blood and urine samples, antihistamines, anaphylaxis

Pathophysiology - Diseases (22 decks)

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