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PATHO > EXAMS 2 > Flashcards

EXAMS 2 Flashcards

1
Q

Cardiac output

A

stroke volume X heart rate

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2
Q

stroke volume

A

preload, afterload, contractility

the volume of blood pumped during every contraction of the heart. anytime your heart beats, how much blood is pumped

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3
Q

Pulmonary

A

both ventilation and perfusion needed for gas exchange (a V/Q mismatch if either is inadequate)

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4
Q

Tissue oxygenation

A

need above plus normal capillary flow, acid-base, normal O2 content, electrolytes, temperature

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5
Q

what is V/Q mismatch

A

when part of your lungs receives oxygen without blood flow or blood flow without oxygen. eg choking

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6
Q

When the heart beats too rapidly,

A

it pumps less efficiently

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7
Q

systemic circulation

A

blood supply to all body functions

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8
Q

pulmonary circulation

A

circulation of blood between the heart and lungs

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9
Q

pressure between pulmonary and systemic circulation

A

pulmonary has lower pressure (18mmHg) than systemic circulation (90mmHg)

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10
Q

what happens to our aveolis when we breathe out

A

When we breathe in and out, our aveolis don’t completely close cus of surfactant. Babies are not born with this.

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11
Q

Primary gas exchange units

A

alveoli

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12
Q

alveolocapillary membrane

A

space between the aveoli and RBC.

aveoli has to be in close contact with the RBC.

fluid filling in those spaces due to infections like pneumonia will lead impairment f GAS EXCHANGE

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13
Q

what is hypercapnia

A

too much CO2 in bloodsteam by inadequate breathing

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14
Q

two types of insufficient exchange of gasses

A 
Hypoxemia = low oxygen content = 
Hypercapnia = too much CO2 in blood
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15
Q

neurological system

A

the cns and the respiratory center in the brain regulates how we breathe

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16
Q

how does Chronic hypoxemia adapt

A

Chronic hypoxemia adapt by having increased ventilation

chronic hypoxemia aslso lead to the increase in production of RBC

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17
Q

peripheral vasoconstriction?

A

mild hypoxemia

METABOLIC ACIDOS

= lack of oxygen can lead to conusion or mental problems

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18
Q

pulmonary vasoconstriction

A

chronic hypoxemia. example is chronic hypoxemia is cyanosis.

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19
Q

what is dyspnea

A

difficultiy breathin

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20
Q

what is Hyperventilation

A

fast breahting to compensate for the lost of oxygen

as a result, theres less CO2 = respiratory alkaylosis

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21
Q

difference between Hypoxema and hypoxia

A

hypoxemia is low oxygen content in the blood

hypoxia means low oxygen content in bodily tissues.

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22
Q

common portal of viruses

A

nasal mucosa and conjunctional surfaces of the eyes

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23
Q

types of influenza vaccinations

A

trivalent inactivated influenza (INJECTION)

  • live, attenuated influenza vaccine (INTRANASALY)
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24
Q

what is pneumonia

A

respiratory disorders involving inflammation of lung structures (ALVEOLI and BRONCHIOLES)

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25
Q

type A influenzas

A
  • most common
  • CAN AFFECT MULTIPLE PEOPLE
  • CAUSES MOST SEVERE DISEASES
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26
Q

subtypes of TYPE A influenza

A

hemagglutin (H) and neuraminidase (N)

SURFACE ANTIGENS

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27
Q

infectious agents causing pneumonia

A

bacteria and viruses

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28
Q

non infectious agents that causes pneumonia

A

gastric secretions that end up in the lungs

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29
Q

factors that facilitates development of pneumonia

A
  • exceedingly virulent organism
  • a large inoculum (culture)
  • impaired host defense. whether they are immunocompromised of immunocompetent
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30
Q

classifications of pneumonia

A
  • according to the source of the infection. where you get the infection from, hospial or community
  • according to the immune system of the host. weak immune system most likely to expericne severe reactions
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31
Q

what is tuberculosis

A

commonly affects the lungs. worlds foremost cause of death from a single infectious agent

CAN AFFECT BRAINS, KIDNEYS AND BONES AS WELL

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32
Q

myobacterium tuberculosis

A

virus that causes tuberculosis.

has a waxy capsule which makes it get harder to get rid off.

CAN STAY ALIVE IN ANIMATED SUSPENSION FOR YEARS

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33
Q

forms of tuberculosis

A

mycotuberclosis horminis also known as human TB

  • congested areas
  • Airborne infection spread by minute droplet nuclei harbored in the respiratory secretions of persons with active tuberculosis

bovine tuberculosis

  • Acquired by drinking milk from infected cows; initially affects the gastrointestinal tract
  • has been virtually eradicated
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34
Q

respiratory disorders in children

A

upper airways infections

  • Viral croup
  • Spasmodic croup
  • Epiglottis

lower airways infections
- Acute bronchiolitis

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35
Q

Impending Respiratory Failure in Infants and Children

A
  • Rapid breathing
  • Exaggerated use of the accessory muscles
  • Retractions
  • Nasal flaring
  • Grunting during expiration
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36
Q

what is pleura effusion

A

abnormal accumulation of fluid in the pleural cavity

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37
Q

parietal pleura

A

lines the thoracic wall and superiror aspect of the diaghphram

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38
Q

visceral pleura

A

covers the lungs

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39
Q

pleura cavity

A

spaces between two layers and contains thing layer of seorus fluid

FLUID PREVENTS FRICTION

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40
Q

causes of lung cancer

A

primary: lung tumors 95%
secondary via mestastasis

smoking
asbestos = fibers from workplaces

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41
Q

treatment of tuberculosis

A

combination of drugs and can take up to 18 months.

positive tuberculin doesnt idifferentiate past, latent or active disease

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42
Q

what is chylothorax

A

lymphatic fluid formed in digestive system acummulates in the pleura

  • treat conservatively with meds, surgery or pleurodesis
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43
Q

what is atelectasis

A

partial collapse of the lung due to alveolis being surpressed

lung compression that occurs in pneumothroax or pleura effusion

atelectasis can also be incomplete expansion of the lungs

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44
Q

what is emyema

A

pus in the cavity

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45
Q

what is pneumothorax

A

collapse of the lung due to increase pressure of the pleura cavity

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46
Q

what is spontaneous pneumothorax

A

occurs when an airfilled blister on the lung surface raptures

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47
Q

what is traumatic pneumothorax

A
  • any trauma that penetrates the penetrates the lungs from outside. can be gunshot, blow

CAN BE PENETRATING (gunshot OR NON PENETRATING (blow)

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48
Q

what is tension pneumothorax

A

occurs when the intrapleural pressure exceeds atmospheric pressure. basicaaly when there is odee pressure in the lungs as compaired to outside

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49
Q

what is primary atelecatasis

A

failure of the lung to expand fully at birth

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50
Q

what is secondary atelectasis

A
  • develops in neontal period or later in life PNEUMOTHORAX
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51
Q

what is hemothorax

A

blood in the pleura space. can be drained with chest tube

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52
Q

types of fluids in pleural effusion

A

transudate = low proteins= high hydrostatic pressure/low oncotic pressure

exudates = high protein= inflammation and CAPILLARY PERMEABILITY

  • chyle
  • blood
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53
Q

what is thoracentesis

A

removal of fluid or air from around the lungs

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54
Q

what is asthma

A

affects the airways of the lungs not necessarily the lungs

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55
Q

what is dyspnea

A

difficulty breathing

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56
Q

majority cause of asthma

A
  • majority of asthma are due to environemental factors
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57
Q

what is status asthmaticus

A

BRONCHOSPAMS not reversed by unsual measures = life threatning

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58
Q

omnious signs of impending death

A

silent chest (no audible air movement) and PaCO2 greater than 70mmHg

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59
Q

Chronic Obstructive Airway Disease

A
  • Inflammation and fibrosis of the bronchial wall
  • Hypertrophy of the submucosal glands
  • Hypersecretion of mucus
  • Loss of elastic lung fibers
    Impairs the expiratory flow rate, increases air trapping, and predisposes to airway collapse
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60
Q

Alveolar tissue

A

Decreases the surface area for gas exchange

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61
Q

Loss of elastic lung fibers

A

Impairs the expiratory flow rate, increases air trapping, and predisposes to airway collapse

EMPHYSEMA

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62
Q

atopy

A

genetic tendency to develop allergic reaction

63
Q

Pulsus paradoxus

A

when youre having an active attack of asthma and theres not pulses

64
Q

polycythemia

A

refers to an increase in RBC in the body

65
Q

what is Cystic Fibrosis

A

An autosomal recessive disorder involving fluid secretion in the exocrine glands and the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts = not just lungs. GI tract, respiratory tracts

66
Q

cause of cystic fibrosis

A

Mutations in a single gene on the long arm of chromosome 7 that encodes for the cystic fibrosis transmembrane regulator (CFTR), which functions as a chloride (Cl−) channel in epithelial cell

67
Q

manifestations of cystic fibrosis

A
  • Pancreatic exocrine deficiency
  • Pancreatitis
  • Elevation of sodium chloride in the sweat
  • Excessive loss of sodium in the sweat
  • Nasal polyps
  • Sinus infections
  • Cholelithiasis
68
Q

what are Diffuse Interstitial Lung Diseases

A

A diverse group of lung disorders that produce similar inflammatory and fibrotic changes in the interstitium or interalveolar septa of the lung

69
Q

types of Diffuse Interstitial Lung Diseases

A
  • Sarcoidosis
  • The occupational lung diseases
  • Hypersensitivity pneumonitis
  • Lung diseases caused by exposure to toxic drugs
70
Q

what is Pneumoconioses

A

The inhalation of inorganic dusts and particulate matter

71
Q

Occupational Lung Diseases

A
  • Pneumoconioses
  • Hypersensitivity diseases
  • Byssinosis
72
Q

Hypersensitivity diseases of occupational lung diseases

A

The inhalation of organic dusts and related occupational antigens

73
Q

what is byssinosis

A

cotton workers; has characteristics of the pneumoconioses and hypersensitivity lung disease

74
Q

development of pulmonary embolism

A

A blood-borne substance lodges in a branch of the pulmonary artery and obstructs the flow

75
Q

types of pulmonary embolism

A
  • Thrombus: arising from DVT
  • Fat: mobilized from the bone marrow after a fracture or from a traumatized fat depot
  • Amniotic fluid: enters the maternal circulation after rupture of the membranes at the time of delivery = after delivering a baby, amniotic fluid can end up in the blood. Rare but can occure
76
Q

Cor Pulmonale

A
  • Right heart failure resulting from primary lung disease and long-standing primary or secondary pulmonary hypertension
  • Involves hypertrophy and the eventual failure of the right ventricle
  • Manifestations include the signs and symptoms of the primary lung disease and the signs of right-sided heart failure.
77
Q

Acute Respiratory Distress Syndrome

A

A number of conditions that produces pathologic lung changes that include diffuse epithelial cell injury with increased permeability of the alveolar–capillary membrane

78
Q

causes of acute respiratory distress syndrome

A
  • Aspiration of gastric contents
  • Major trauma (with or without fat emboli)
  • Sepsis secondary to pulmonary or nonpulmonary infections
  • Acute pancreatitis
  • Hematologic disorders
  • Metabolic events
  • Reactions to drugs and toxins
79
Q

Impaired ventilation

A
  • Upper airway obstruction
  • Weakness of paralysis of respiratory muscles
  • Chest wall injury
80
Q

Impaired diffusion

A
  • Pulmonary edema

- Respiratory distress syndrome

81
Q

causes of respiratory failure

A
  • impaired ventilation
  • impaired matching or ventilation and perfusion
  • impaired diffusion
82
Q

Tracheostomy

A

Surgically created stoma (opening) used to

  • Establish a patent airway
  • Bypass an airway obstruction
  • Facilitate secretion removal
  • Permit long-term mechanical ventilation
  • Facilitate weaning from mechanical ventilation
83
Q

Types of Chronic Obstructive Pulmonary Disease

A
  • emphysema

- chronic obstructive bronchitis

84
Q

what is emphysema

A
  • Enlargement of air spaces and destruction of lung tissue

- Types: centriacinar and panacinar

85
Q

what is chronic obstructive bronchitis

A

Obstruction of small airways

86
Q

what is Bronchiectasis

A

Permanent dilation of the bronchi and bronchioles

  • secondary to persisting infection or obstruction
87
Q

manifestations of bronchiectasis

A
  • atelectasis = partial collapse of the lungs
  • Obstruction of the smaller airways
  • Diffuse bronchitis
  • Recurrent bronchopulmonary infection
  • Coughing; production of copious amounts of foul-smelling, purulent sputum; and hemoptysis
  • Weight loss and anemia are common.
88
Q

what is hemoptysis

A

spitting pf blood originated from lungs or bronchial tubes

89
Q

wha makes up the blood basics

A

Blood is composed of formed elements and plasma.

  • Formed elements
  • Plasma
  • Serum
  • Hematocrit
90
Q

Functions of the hematopoietic system include

A

transport, communication, temperature, defense, and clotting.

91
Q

Red cells are produced in the……….

A

red bone marrow after birth

Until 5 years of age, almost all bones produce red cells to meet growth needs; after 5 years, bone marrow activity gradually declines.
After 20 years, red cell production takes place mainly in the membranous bones of the vertebrae, sternum, ribs, and pelvis.

92
Q

The heme molecule is converted……

A

to bilirubin and transported to the liver.

93
Q

The red blood cell life span

A
  • The red blood cell has a life span of approximately 120 days.
  • It is broken down in the spleen.
  • The degradation products (iron and amino acids) are recycled
94
Q

Regulation of erythropoiesis

A

is through erythropoietin (EPO) that stimulates bone marrow to increase RBC production in response to low oxygen

95
Q

oxygen-binding component of hemoglobin.

A

iron

96
Q

Erythropoiesis requires

A
  • requires vitamin B12 (cobalamin), folate (folic acid) and iron.

Folate and Vitamin B12 are required for DNA synthesis.

97
Q

what is Thrombopoiesis

A
  • the process of forming platelets.

Platelets are derived from fragmentation of megakaryocytes and are important in hemostasis.

98
Q

what is Thrombopoietin

A

is a growth hormone released from the liver that stimulates thrombopoiesis

99
Q

thrombocytopenia may give rise to

A

purpura and petechiae (rash or spots due to bleeding).

100
Q

Exposure of these stem cells to environmental cues (hormones, growth factors)

A

may give rise to many types of cells

Lineages

101
Q

Bilirubin

A

The heme unit is converted to bilirubin.

Bilirubin is insoluble in plasma and attaches to plasma proteins for transport. ( UNCONJUGATED )

Removed from the blood by the liver and conjugated with glucuronide to render it water soluble
(Conjugated)

Jaundice

102
Q

Red blood cell count (RBC)

A

Measures the total number of red blood cells in 1 mm3 of blood

103
Q

Percentage of reticulocytes

A

normally approximately 1%)

104
Q

Hemoglobin

A

grams per 100 mL of blood

Measures the hemoglobin content of the blood

105
Q

Hematocrit TEST

A

Measures the volume of red cell mass in 100 mL of plasma volume

106
Q

Polycythemias

A

Too many RED BLOOD cells

107
Q

Normal number of cells with altered components

A

Sickle Cell

108
Q

Too few RED BLOOD cells

A

Anemias

109
Q

anemia size

A

Identified by terms that end in “-cytic”

Macrocytic, microcytic, normocytic

110
Q

Hemoglobin content

A
  • Identified by terms that end in “-chromic”

- Normochromic and hypochromic

111
Q

The classification of anemia usually based on?

A

the size of the rbc, mcv and MCH, normocytic, microcytic, and macrocytic, but it does not mean bigger size is better.

112
Q

what is Pernicious anemia

A
  • Caused by a lack of intrinsic factor made by the gastric parietal cells and is required for vitamin B12 absorption
  • Results in vitamin B12 deficiency
113
Q

Pernicious anemia neurological manifestations due to nerve demyelination

A

Weakness, paresthesias of feet and hands, ↓ vibratory and position senses, ataxia, muscle weakness, and impaired thought processes

114
Q

increasing dietary cobalamin (vitamin B12) pernicious anemia

A

Increasing dietary cobalamin does not correct this anemia if intrinsic factor is lacking or if there is impaired absorption in the ileum

115
Q

what is folic acid?

A
  • Folic acid is required for DNA synthesis

- RBC formation and maturation

116
Q

Folic Acid Deficiency

A

Common causes are Dietary deficiency

  • Malabsorption syndromes
  • Increased requirement (i.e., pregnancy)
  • Alcohol abuse and anorexia
    Loss during hemodialysis

Gluten is a protein found in wheat, rye, and barley. It may also be in other products like vitamins and supplements, hair and skin products, toothpastes, and lip balm.

117
Q

what is celiac disease (genetic)

A

Celiac disease is an immune disease in which people can’t eat gluten because it will damage their small intestine. If you have celiac disease and eat foods with gluten, your immune system responds by damaging the small intestine.

Treatment is a diet free of gluten.

118
Q

folic acid deficiency serum folate level

A

Serum folate level is low but vit b12 is normal

We can treat them by replacement therapy or eat the food with larger amount of folic acid

119
Q

most common type of anemia

A

Iron Deficiency Anemia

Nutritional iron deficiency
Metabolic or functional deficiency
Progression of iron deficiency causes:
Brittle, thin, coarsely ridged, spoon-shaped nails
A red, sore, painful tongue
120
Q

Normocytic anemia:

A

Acute and chronic Blood Loss

Anemia resulting from blood loss may be caused by either acute or chronic problems

Acute blood loss occurs as a result of sudden hemorrhage

121
Q

When acute blood loss is more gradual

A
  • the body maintains its blood volume by slowly increasing the plasma volume, but then the number of RBCs is significantly diminished

Consequently, blood transfusions (packed RBCs) may be needed if the blood loss is significant.

122
Q

When anemia exists after acute blood loss…

A

When anemia exists after acute blood loss, dietary sources of iron will probably not be adequate to maintain iron stores.
Therefore oral or parenteral iron preparations are administered

123
Q

Some causes of chronic blood loss:

A
  • Bleeding ulcer
  • Hemorrhoids
  • Menstrual and postmenopausal blood loss
124
Q

Blood Transfusion complications

A

Not linked into one baseline hemoglobin level but recommended for HCT < 30

  • Fluid overload
  • Blood-borne infection
  • Exposure to donor leukocytes
125
Q

Acute hemolytic transfusion reaction

A

Incompatibility

Hypothermia – ventricular dysrhythmias

126
Q

what is Sickle Cell Disease

A

Inherited structural abnormality in the hemoglobin

  • Crystal-like, elongated, rigid cell causes occlusion in the microcirculation
  • Sickling in response to cold, dehydration, hypoxia, infection, and acidosis
127
Q

Treatment of Sickle Cell Crisis

A
  • Oxygen administration
  • Aggressive intravenous fluid hydration
  • Prompt treatment of infection with broad-spectrum antibiotics
    RBC transfusions are not usually required
  • Pain control with around-the-clock narcotics
  • Folic acid supplementation
  • Hydroxyurea
  • Hematopoietic stem cell transplantation (HSCT) is promising towards finding a cure for Sickle Cell Disease
128
Q

Polycythemia Vera

A

A condition in which the red blood cell mass is increased.

129
Q

Relative polycythemia

A

results from a loss of vascular fluid and is corrected by replacing the fluid

130
Q

Primary polycythemia

A

a proliferative disease of the bone marrow with an absolute increase in total red blood cell mass accompanied by elevated white cell and platelet counts

131
Q

Secondary polycythemia

A

is caused by other disease processes that induce hypoxia. For these, the underlying cause is treated. These include: chronic heart and lung disease, living at high altitude, sleep apnea

132
Q

RBCs and platelets are formed

A

in the marrow and released into circulation.

133
Q

lifespan of WBC

A

The life span of WBCs is relatively short; constant renewal is necessary to maintain normal blood levels.

Conditions that decrease availability of stem cells or hematopoietic growth factors produce a decrease in WBCs.

134
Q

Leukopenia deficiency of leukocytes

A

Neutropenia

Granulocytopenia

135
Q

Aplastic anemia

A

Anemia, thrombocytopenia, and agranulocytosis

136
Q

RBCs and platelets are formed in the

A

the marrow and released into circulation.

137
Q

whats is Infectious Mononucleosis

A

Self-limited lymphoproliferative disorder

138
Q

Causes and Characteristics

of infectious mononucleosis

A
  • Caused by the B-lymphocytotropic EBV, a member of the herpes virus family; transmitted in saliva
  • Characterized by fever, generalized lymphadenopathy, sore throat, and the appearance in the blood of atypical lymphocytes and several antibodies
  • Highest incidence in adolescents and young adults
    Treatment is symptomatic and supportive.
139
Q

Neoplastic Disorder of Hematopoietic and Lymphoid Origin

A

Represent the most important of the white cell disorders

140
Q

Hodgkin disease

A

Reed-Sternberg cells are present.

141
Q

Reed-Sternberg cells are derived

A

from B lymphocytes

142
Q

Non-Hodgkin disease

A

Reed-Sternberg cells are not present.

143
Q

Symptoms of Hodgkin Disease

A
  • Stage A
    Lack constitutional symptoms
  • Stage B (40% of persons with Hodgkin disease)
    Significant weight loss, fevers, pruritus, or night sweats

ADVANCED STAGES

  • Fatigue and anemia
  • Liver, lungs, digestive tract, and CNS may be involved.
144
Q

Categories of Non-Hodgkin Lymphomas

A
  • Low-grade lymphomas
    Predominantly B-cell tumors
  • Intermediate-grade lymphomas
    Include B-cell and some T-cell lymphomas
- High-grade lymphomas
Largely immunoblastic (B cell), lymphoblastic (T cell), Burkitt, and non-Burkitt lymphomas
145
Q

what are Leukemias

A

Malignant neoplasms arising from the transformation of a single blood cell line derived from hematopoietic stem cells

146
Q

Lymphocytic leukemias

A

lymphocytes

147
Q

Myelocytic leukemias

A

granulocytes

monocytes

148
Q

chronic leukemias

A

Malignancies involving the proliferation of well-differentiated myeloid and lymphoid cells

149
Q

Types of chronic leukemia

A
  • Chronic lymphocytic leukemia (CLL)

- Chronic myelogenous leukemia (CML)

150
Q 
Acute lymphocytic (lymphoblastic) leukemia (ALL)
Chronic lymphocytic leukemia (CLL)
A
  • Both involve immature lymphocytes and their progenitors in the bone marrow, the spleen, lymph nodes, CNS, and other tissue.
151
Q

Acute myelogenous (myeloblastic) leukemia (AML)

Chronic myelogenous leukemia (CML)

A

Both involve the pluripotent myeloid stem cells in bone marrow and interfere with the maturation of all blood cells.

152
Q

Factors Affecting the Likelihood of Achieving Remission

A
  • Age (most significant prognostic variable)
  • Type of leukemia
  • Stage of the disease at time of presentation
153
Q

Multiple Myeloma definiation

A

A plasma cell dyscrasia characterized by expansion of a single clone of immunoglobulin-producing plasma cells and a resultant increase in serum levels of a single monoclonal immunoglobulin or its fragments

154
Q

Main sites involved

in multiple myeoma

A
  • The bones and bone marrow
  • Proliferation and activation of osteoclasts that lead to bone resorption and destruction
  • Pathologic fractures
  • Hypercalcemia

PATHO (6 decks)

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