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Pathopharmacology II > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Functions of the blood

A

Transport oxygen and nutrients for cell metabolism
Removal of cellular waste
Maintains homeostasis

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2
Q

Tunica intima

A

Endothelial layer (inner layer)

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3
Q

Tunica media

A

Layer of smooth muscle that controls the diameter of the blood vessel (middle layer)

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4
Q

Tunica Adventita

A

Outer CT layer and contains elastic and collagen fibers

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5
Q

Vasa Vasorum

A

Tiny blood vessels that supply blood to thewalls of arteries and veins

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6
Q

pH of blood

A

7.35-.45

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7
Q

How many liters of blood does the adult body contain

A

5

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8
Q

Hematocrit

A

Proportion of cells in blood (indicates viscosity)

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9
Q

Plasma

A

Clear yellowish fluid remaining after cells have been removed

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10
Q

Serum

A

Fluid and solutes remaining after cells and fibrinogen have been removed

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11
Q

Where do blood cells originate?

A

Red bone marrow

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12
Q

Dyscrasia

A

Disorders involving cellular components of blood

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13
Q

Erythrocytes

A

Biconcave, flexible discs that are non-nucleated when mature and contain hemoglobin

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14
Q

Erythropoietin

A

A hormone originating from kidneys that stimulate production of erythrocytes in red bone marrow in response to hypoxia

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15
Q

Hemoglobin consists of

A

Globin, two pairs of amino acid chains, four heme groups which contain iron atoms which oxygen can attach

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16
Q

Oxyhemglobin

A

Bright red; oxygenated

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17
Q

Deoxyhemoglobin

A

Dark or bluish red color and is found in venous blood

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18
Q

5 types of WBCs

A 
Lymphocytes
Neutrophils 
Basophils 
Eosinophils 
Monocytes
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19
Q

Lymphocytes

A

B and T lympocytes significant in the immune response

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20
Q

Neutrophils

A

Most common leukocytes. First response to any tissue damage and commence phagocytosis. Increase in numbers during bacterial infection

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21
Q

Basophils

A

Migrate from blood and enter tissue to become mast cells that can release histamine and heparin

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22
Q

Eosinophils

A

Combat the effects of histamine. Increased during allergic reactions and parasitic infections

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23
Q

Monocytes

A

Can enter tissue to become macrophages, which act as phagocytes when tissue damage occur

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24
Q

Thrombocytes

A

Also known as platelets

Not cells; small, irregularly shaped, non-nucleated fragments from large megakayocytes

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25
Q

Heparin

A

An anticoagulant that is released from basophils (or mast cells) in the tissues and exerts its major action by blocking thrombin. It does not dissolve clots, but will prevent further growth of the thrombus

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26
Q

O blood

A

No antigens

Anti-A and Anti-B antibodies

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27
Q

A blood

A

A antigens

Anti-B antibodies

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28
Q

B blood

A

B antigens

Anti-A antibodies

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29
Q

AB Blood

A

A and B antigens

No antibodies

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30
Q

Complete blood count (CBC)

A

Total red blood cells, white blood cells,and platelets

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31
Q

Leukocytosis

A

Increased WBCs

Associated with infection and inflammation

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32
Q

Leukopenia

A

Decreased WBCs

Associated with some viral infections, radiation, chemotherapy

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33
Q

Increased eosinophils

A

Common in allergic response

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34
Q

Reticulocyte count

A

Assessment of bone marrow function

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35
Q

Prothrombin time and partial thromboplastin time

A

Measures function of various factors in coagulation process

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36
Q

Underlying cause of anemias

A

Reduction in oxygen transport in the blood due to a decrease in hemoglobin content

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37
Q

Signs and symptoms of anemia

A

Fatigue, pallor, dyspnea, tachycardia, and high blood pressure

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38
Q

Causes of iron deficiency anemia

A

Dietary intake of iron below minimum requirement
Chronic blood loss
Impaired duodenal absorption of iron
Severe liver disease

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39
Q

Iron deficiency anemia most common in…

A

women of childbearing age and pregnant women

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40
Q

Pernicious Anemia

A

Lack of absorption of vitamin b12 because of lack of intrinsic factor (secreted by gastric mucosa and required for intenstinal absorption of b12)

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41
Q

Pernicious Anemia characterized by

A

Very large, immature nucleated erythrocytes that carry less hemoglobin and have a shorter lifespan

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42
Q

s/s of pernicious anemia

A

Tongue is enlarged, red, sore, and shiny
Digestive discomfort, often with nausea and diarrhea
Feeling of pins, needles, and tingling in limbs

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43
Q

Hemolytic anemia

A

Excessive destruction of RBCs, or hemolysis leading to low erythorcyte count and low hemoglobin

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44
Q

Pathology of sickle cell

A

It occurs whenever oxygen levels are lowered. The altered hemoglobin is unstable and changes shape in hypoxemia. Sickle-cell shaped cells are too large to pass through the microcirculation and leads to multiple infarctions and areas of necrosis

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45
Q

Thalassemia

A

Genetic defect in which one or more genes for hemoglobin are missing or variant. This interferes with the production of globin chains, and the amount of hemoglobin synthesized and the number of RBCs is reduced

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46
Q

Two forms of thalassemia

A

Thalassemia Beta (autosomal dominant) and Thalassemia Alpha

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47
Q

Signs and Symptoms of Thalassemia

A

Child’s growth and development are impaired directly by the hypoxia and indirectly by fatigue and inactivity
Hyperactivity in the bone marrow leads to invasion of bone and impairs normal skeletal development
Heart failure develops as a result of the compensation mechanism increasing cardiac work load

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48
Q

Treatment for thalassemia

A

Blood transfusions
Iron chelation
Folate supplement

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49
Q

Pathology of hemophilia A

A

Deficit or abnormality of factor
X-linked recessive trait
Manifested in men, carried by women

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50
Q

S/S of hemophilia A

A

Prolonged bleeding after minor tissue trauma
Spontaneous bleeding into joints
Blood in feces

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51
Q

Diagnostic tests for hemophilia A

A

Bleeding time and PT normal
PTT, activated (PTT), coagulation time prolonged
Serum levels of factor VII are low

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52
Q

S/S of VonWillebrand Disease

A 
Skin rashes
Frequent nose bleeds
Easy bruising 
Bleeding of gums 
Abnormal menstrual bleeding
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53
Q

Most common inherited clotting disorder

A

Hemophilia A

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54
Q

Most common hereditary clotting disorder

A

Von Willebrand

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55
Q

Disseminated Intravascular Coagulation

A

Involves both excessive bleeding and clotting
Excessive clotting in circulation
Clotting factors are reduced to a dangerous level and widespread uncontrollable hemorrhage results

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56
Q

Complications of disseminated intravascular coagulation

A

Obstetrical complications (abruptio placentae)
Infections
Carcinomas
Major trauma

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57
Q

Myelodisplastic syndrome

A

Diseases that involve inadequate production of cells by the bone marrow

58
Q

Primary polycythemia (polycythemia vera)

A

Increased marrow production of erythrocytes and other cells in the bone marrow
Serum erythropoietin levels are low

59
Q

Secondary polycythemia (erythrocytosis)

A

Increase in RBCs in response to prolonged hypoxia
Increased erythropoietin secretion
Compensation mechanism to provide increased oxygen support

60
Q

Acute lympocytic leukemia (ALL)

A

Malignant cell - B lymphocytes

Age group - Young children

61
Q

Acute myelogenous leukemia (AML)

A

Malignant cell - granulocytic stem cells

Age group - Adults

62
Q

Chronic lymphocytic leukemia

A

Malignant cell - B lymphocytes

Age group - Adults greater than 50 degrees

63
Q

Chronic myelogenous leukemia (CML)

A

Malignant cell - granulocytic stem cells

Age group - adults 3-50

64
Q

Acute monocytic leukemia

A

Malignant cell - monocytes

Age group - adults

65
Q

Hairy cell leukemia

A

Malignant cell - B lymphocytes

Age group - males greater than 50 years

66
Q

Acute leukemias

A

High proportion of immature nonfucntional cells in bone marrow and peripheral circulation
Onset usually abrupt
Occurs in children and young adults

67
Q

Chronic leukemias

A

Higher proportion of mature cells
Insidious onset
Common in older adults

68
Q

Function of the lymphatic system

A

Returns excess interstitial fluid and protein to the blood
Filters and destroys unwanted material from body fluids
Initiates immune response (lymph nodes) by sensitizing B and T lymphocytes

69
Q

Parts of lymphatic system

A 
Lymphatic vessels (capillaries, branches, trunks, ducts, subclavian vein) 
Lympohid tissue (palantine and pharyngeal tonsils, spleen, and thymus gland)
70
Q

Palatine and pharyngeal tonsils

A

Protection against bacterial infection in opening between nasal and oral cavities
First line of defense from external organisms

71
Q

Functions of spleen

A

Defense
Hematopoiesis
RBC and platelet destruction
Reservoir for blood

72
Q

Function of thymus gland

A

Final site of lymphocyte development before birth

Secretes hormones after birth to enable lymphocytes to develop into mature T cells

73
Q

Vessels from R upper quadrant empty where

A

Into R lymphatic duct and returns lymph to general circulation via R subclavian vein

74
Q

Most vessels in lymph system empty where

A

Into the thoracic duct in upper abdomen and thoracic cavity which drains into L subclavian vein

75
Q

Multiple myeloma

A

Neoplastic disease of unknown etiology occurring in older adults involving the plasma cells (mature B lymphocytes)

76
Q

Castleman Disease

A

Rare illness involving the overgrowth of lymphoid tissue

77
Q

Parietal pericardium

A

Outer fibrous pericardium that anchors the heart to the diaphragm

78
Q

Epicardium

A

Serous membrane that provides small amount of lubricating fluid within the pericardial cavity between the two pericardial membranes

79
Q

Myocardium

A

Middle layer of the heart. Composed of specialized cardiac muscle cells that contract rhythmically and forcefully to pump blood throughout the organs.

80
Q

Endocardium

A

Inner layer of the heart. Forms the four heart valves that separate the chambers of the heart and ensure one way flow of blood

81
Q

Atrioventricular valves

A

R side (tricuspid) and L side (mitral or bicuspid)

82
Q

Semilunar valves

A

aortic and pulmonary

83
Q

Intercalated discs

A

Contain desmosomes which prevent muscle cells from separating during contraction

84
Q

Gap junctions

A

Permit ions to pass from cell to cell to facilitate rapid transmission of impulses

85
Q

SA Node

A

Usually initiates impulses (pacemaker of heart)

Location in wall of R atrium

86
Q

Sinus Rhythm

A

Basic rate of impulses generated by SA node (70 bpm)

Can be altered by ANS fibers and circulating homrones

87
Q

AV Node

A

Location in floor of R atrium

Only anatomical connection between the atrial and ventrical portions of the conduction system

88
Q

P wave

A

Depolarization of atria

89
Q

QRS wave

A

Depolarization of ventricles, Wave masks effect of atrial repolarization

90
Q

T wave

A

Repolarization of ventricles (recovery phase)

91
Q

Baroreceptors

A

Detect changes in BP, the cardiac center then responds through stimulation of SNS or PNS to alter rate/force of cardiac contractions
Located in aorta or internal carotid arteries

92
Q

Sympathetic stimulation

A

Cardiac accelerator nerve
Increases HR (tachycardia) and contractility
Beta adrenergic receptors

93
Q

Purpose of beta blockers

A

Block the increase in rate/force of contractions after heart has been damaged

94
Q

Parasmypathetic stimulation

A 
Vagus nerve 
Decreases HR (bradycardia)
95
Q

Left anterior descending artery

A

Follows anterior interventricular sulcus downward over the surface of the heart. Supplies anterior wall of ventricles, anterior septum, and bundle branches

96
Q

Left circumflex artery

A

Circles the exterior of the heart in L atrioventricular sulcus
Supplies L atrium and lateral/posterior walls of L ventricle

97
Q

Right coronary artery

A

follows R AV sulcus on posterior surface of the heart. Supplies the R side of the heart and inferior portion of L ventricle and posterior interventricular septum. Also supplies SA and AV node

98
Q

Diastole

A

Relaxation of myocardium required for filling chambers

99
Q

Systole

A

Contraction of myocardium provides increase in pressure to eject blood

100
Q

Lubb

A

Closure of AV valves at beginning of ventricular systole

101
Q

Dubb

A

Closure of semilunar valves with ventricular diastole

102
Q

Cardiac output

A

Blood ejected by a ventricle in 1 minute

103
Q

Equation for cardiac output

A

CO=SVxHR

104
Q

Stroke volume

A

volume of blood pumped out of 1 ventricle in 1 contraction

105
Q

Preload

A

Mechanical state of heart at end of diastole with ventricles at their maximum volume

106
Q

Afterload

A

Force required to ejected blood from ventricles. Determined by peripheral resistance to opening of the semilunar valves to arteries

107
Q

Pulse pressure

A

difference between systolic & diastolic pressure

108
Q

Peripheral resistance

A

Force opposing blood flow or amount of friction with the vessel walls encountered by the blood

109
Q

Increases SNS output

A

Vasoconstriction and increased BP

110
Q

Decreases SNS output

A

Vasodilation and decreased BP

111
Q

Antidiuretic hormone

A

Increased BP

112
Q

Aldosterone

A

Increased blood volume and blood pressure

113
Q

Renin-angiotensin aldosterone

A

Vasoconstriction and increased BP

114
Q

Low density lipoprotein

A

Transports chloesterol from liver to cells

115
Q

High density lipoprotein

A

Transports cholesterol from cells to liver

116
Q

Bradycardia

A

regular, but slow HR (less than 60 bpm)

Affected by vagal nerve or parasympathetic NS

117
Q

Tachycardia

A

Regular rapid HR (100-160)

Normal response to sympathetic NS

118
Q

Sick sinus syndrome

A

Marked by altering bradycardia and tachycardia

119
Q

Premature atrial contractions or beat

A 
Extra contraction (ectopic beats) 
Arise from a focus of irritable atrial muscle cells outside the conduction pathway (interfere with timing of next beat)
120
Q

Atrial flutter

A

Atrial HR of 160 to 350 bpm

AV node delays conduction - ventricular rate slower

121
Q

Atrial fibrillation

A

Rate over 350 BPM
Causes pooling of blood in atria
Thrombus formation is a risk

122
Q

Heart blocks

A

Conduction excessively delayed or stopped at AV node of bundle of His

123
Q

First degree block

A

Conduction delay between atrial and ventricular contractions (PR interval)

124
Q

Second degree block

A

Every second to third atrial beat dropped at AV node

Longer delay leads to missed ventricular contraction

125
Q

Third degree block

A

No transmission from atria to ventricles

Ventricles contract spontaneously at a slower rate (30-40 bpm) totally independent of atrial contraction

126
Q

Bundle branch block

A

Interference with conduction in one of the bundle branches

Does not alter CO, but does show a wide QRS complex

127
Q

Ventricular tachycardia

A

Reduce cardiac output as reduce diastole occurs

128
Q

Ventricular fibrillation

A

Muscle fibers contract independently and rapidly

Cardiac standstill occurs if not treated immediately

129
Q

Premature ventricular contractions

A

Additional beats from ventricular muscle or ectopic pacemaker
May lead to ventricullar fibrillation

130
Q

L ventricle affected first (with CHF) when..

A

MI in L ventricle or essential HTN

131
Q

R ventricle affected first (with CHF) when…

A

Pulmonary valve stenosis or pulmonary disease

132
Q

Valvular defects

A

Interfere with normal flow of blood

133
Q

Septal defects

A

Allow for mixing oxygenated blood with unoxygenated blood

134
Q

L to R shunt

A

Blood from L side of heart recycled tot he right side and to the lungs
Results in increased blood volume in pulmonary circulation, a decreased CO, and inefficient system

135
Q

R to L shunt

A

Unoxygenated blood from R side bypasses the lungs and enters the left side of the heart

136
Q

Ventricular septal defect

A

Opening in the interventricular septum
Pressure usually higher in L therefore L to R shunt
Acyanotic condition unless respiratory condition increases pressure in R ventricle

137
Q

Tetralogy of Fallot includes

A

Pulmonary valve stenosis
VSD
Detroposition of the aorta (to right over the VSD)
Right ventricular hypertrophy

138
Q

Most common sites for PVD

A

Areas of bifurcation (abdominal aorta, carotid arteries, femoral and iliac arteries)

139
Q

Thrombophlebitis

A

Development of a thrombus in an inflamed vein

140
Q

Phlebothrombosis

A

Thrombus forms spontaneously without prior inflammation

Pathopharmacology II (1 decks)

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