Environmental & Hematology/Oncology Flashcards
Define Radiation
Lost to air
Define convection
Lost to air with wind
Define conduction
Lost to and object
Define evaporation
Lost to air through water
Heat elimination is affected by
Vasodilation, Perspiration, Increased CO, increased RR
Heat Preservation is affected by
Vasoconstriction, Shivering, Piloerection, Decreased RR, Increased BMR (Basal Metabolic Rate)
Heat cramps SS
SS include, Painful cramps, Tachycardia, hot and sweaty skin, has a normal core temp.
Heat Exhaustion SS
SS include: History of working in the heat, decreased urine output, positive tilt test, Tachy, Nausea Vomiting, Cool to warm, wet, pale tissues, Dizziness and syncope, Headache, muscle cramps, normal to low BP, Usually normal core temp
Heat stroke from Progression of heat exhaustion SS
Dehydration, electrolyte imbalance, Metabolic acidosis, elevated core temp, tachy if early, brady if late, hypotension, rapid shallow RR, Confusion, Seizures/Coma
Heat stroke from isolated activity without exertion SS
Dry Skin, Full bounding pulse, elevated core temp, tachy if early, brady if late, hypotension, rapid shallow RR, Confusion, Seizures/Coma
Hypothermia levels
Mild 34c - 36c (94f- 97f)
Moderate 30c-34c (86f-94f)
Severe less than 30c (86f)
Causes of hypothermia
Wet clothing, wind, Cold water, Shock, AMI, Hypothyroidism, Diabetic Coma, Drugs, Sepsis
SS of mild to moderate Hypothermia
Temp 30c- 36c, Shivering, lethargy, loss of coordination
SS of Severe Hypothermia
Temp less than 30c, confusion, coma, loss of shivering, stiff muscles, ECG changes, and arrhythmias
CPR with Hypothermia
Start CPR with active warming
If VFib shock once, then resume CPR
Intubate, and ventilate with warm oxygen or mouth to mask, Warm IV fluids
If temp above 30c, give meds as indicated with longer intervals, Defib as normal
If temp below 30c, No meds, and 1 shock only
SS of frost bite
Described as Cold, then pins and needles, pain, then numb
Appears irritated, then white, blue gray, then blue black
Feels Doughy then hard
Management of frostbite
Do not allow to thaw if refreezing is possible
Do not massage or rub
Begin IV
Treat pain
Thaw by warm water immersion 37.7c- 41.1c
Cover with loose and dry dressing
Do not rewarm feet if walking is required
Treatment for drowning
Remove pt from water, attempt rescue only if properly trained to do so
Suspect head and neck injury
Protect pt from heat loss
Evaluate ABCs
Begin CPR and defibrillation if indicated
Boyle’s Law
Volume of gas is inversely proportional to the pressure if temperature is kept constant
VP=k
Daltons Law
Total pressure of mixture of gases is equal to sum of partial pressure of individual gases
P=p(1)+p(2)+….+p(n)
Henrys Law
Amount of gas dissolved in given volume of liquid is proportional to pressure of gas above it
Nitrogen Narcosis
At depth usually deeper that 100’ nitrogen becomes narcotic
Effect is reversed with ascent
Injurie of Ascent
From to rapid ascent
*Over expansion injuries
-Arterial Gas Embolism(AGE)
-Pneumothorax
-Mediastinal emphysema
From improper decompression
-decompression sickness
Decompression Sickness
Type 1
Muscle and joint pain, Rash, Pitting edema
Type 2
Parethesia, Paralysis, chokes, CNS disturbances
Acute Mountain sickness
Mild- Lightheadedness, breathlessness, weakness, headache, nausea and vomiting
Severe- weakness, severe vomiting, decreased urine output, SoB, Altered level of consciousness
Blood volume %s
Plasma 55%
-Water 90-92%
-Proteins 6-7%
-other 2-3%
Formed elements 45%
2,3 DPG affects
Affects hemoglobins affinity for oxygen
Bohr Effect
To cause hemoglobin to give up more oxygen
-Increase Co2
-Decrease pH (more acid)
To cause hemoglobin to bind more oxygen
-Decrease CO2
-Increase pH(less pH)
Transfusion Reactions Hemolytic
SS- Facial flushing, hyper ventilation, tachycardia, hives, chest pain, wheezing, fever, chills, and cyanosis
Treatment- Stop transfusion, change all IV tubing, and initiate crystalloid IV therapy. Consider furosemide, dopamine, and diphenhydramine.
Transfusion Reactions Febrile Nonhemolytic Reaction
SS- Headache, Fever, Chills
Treatment- Stop transfusion, change all IV tubing, initiate crystalloid IV therapy
Consider diphenhydramine and a antipyretic
Anemias: Aplastic
-Failure to produce red blood cells
-often from chemotherapy or radiation
Anemias: Iron Deficiency
-Greater demand for stored iron than is available
-Hemoglobin may be more effected than RBCs
May have Pagophagia
-Pica for ice
Anemias: Pernacious
-inability of stomach to absorb B12
-Found mostly in 40-80 yo Northern Europeans
-Results in enlarged/ misshapen red blood cells
Anemias :Sickle Cell
Found mainly in Blacks and Jews
Effects
-Vaso-occlusive
-Hematological
-infectious
Severe symptoms- fatigue, paleness, tachycardia, respiratory distress, jaundice, priapism, strokes, infections
Anemias:Polycythemia
Over production of erythrocytes
Results in bleeding abnormalities
-Epistaxis, spontaneous bruising, Gi bleed
Leukopenia/ Neutropenia
Too few white blood cells or neutrophils
Leukocytosis
An increase number of circulating white blood cells, often due to infection
Leukemia
Cancer of hematopoietic cells
Initial presentation
-Acutely ill, fatigued, febrile and weak
-often a secondary infection
Lymphomas
Cancers of the lymphatic system
-Abnormal B or T lymphocytes divide faster than normal
Hodgkin’s Lymphoma
Has the Reed-Sternberg Cell
Enlarged lymph nodes in neck head and armpits
Good prognosis
Non- Hodgkin’s Lymphoma
More common, not specific
2x as common for men than women
Immune-suppressive medication increases risk 100x
Presents with
- Swelling of lymph nodes
-Fever, night sweats, anorexia,, weight loss, fatigue, and pruritis
Thrombocytosis
Abnormal increase in thrombocytes
Thrombocytopenia
Abnormal decrease of thrombocytes
Multiple types
-Thrombotic thrombocytopenic purpura
*rare disorder o extensive microclots
* Damage many organs
-idiopathic thrombocytopenic purpura
*low platelet count with normal bone marrow / absence
*increased bleeding
Hemophilia
Deficiency in clotting factor
Type A: deficient in VIII
Type B : deficient in IX
Von Willebrand’s disease: deficient in Von Willebrand’s factor
Neoplasia
Uncontrolled growth of cells whose proliferation cannot be adequately controlled by normal regulatory mechanisms operating in normal tissues
Types on Neoplasms
Benign
Malignant
-Leukemias
-Connective (sarcomas)
-Epithelial (carcinomas)
General Terminology
/ oma = tumor
-Adenoma - tumor of epithelial cells
-Lipoma - tumor fat cells
Hemangioma - blood vessels
- Osteoma - tumor of bone cells
General Terminology
/sarcoma = malignant tumor of mesenchymal cells
-Fibrosarcoma
-liposarcoma
/carcinoma= malignant tumor of epithelial cells
-adenocarcinoma
-Squamous cell carcinoma
Metastasis
Movement of cells from one site to another
Risk factors for cancer
Age
Sex
Family medial history
Tobacco use
chemical exposer
Race
Obesity
Early warning signs for cancer
Change in bowl or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty in swallowing
Obvious change in wart or mole
Nagging cough or hoarseness
