Lifespan 1 Health Differences

Question 1

Precordial leads:

Answer 1

V1-V6.

Horizontal plane.

Question 2

Myoglobin cardiac blood test?

Answer 2

Elevated - First marker of cardiac injury after acute MI

Question 3

CK-MB cardiac blood test?

Answer 3

Returns to normal quickly - Most reliable when reported as a percentage of total creatine kinase (CK) (relative index).

Question 4

Troponin I cardiac blood tests?

Answer 4

Isotypes of troponin found only in myocardium.

Elevated - Specific to myocardial damage.

Question 5

Troponin T cardiac blood test?

Answer 5

Isotype of troponin that’s less specific to myocardial damage (can indicate renal failure).

Elevated - Determined quickly at bedside.

Question 6

Homocysteine (tHcy) heart disease test?

Answer 6

Normal level: =13 μmol/L.

Excess levels:

• Irritate blood vessels, leading to atherosclerosis.
• Raise low-density lipoprotein (LDL) levels.
• Make blood clot more easily.

Question 7

High-sensitivity C-reactive protein (hs-CRP) heart disease test?

Answer 7

◗ Normal level: 0.2 to 0.8 mg/dl

◗ Excess levels: May indicate increased risk of coronary artery disease (CAD).

Question 8

Triglycerides heart disease test?

Answer 8

◗ Normal level: < 150 mg/dl

◗ Excess levels: Identification of hyperlipidemia in patients at risk for CAD.

Question 9

Total cholesterol heart disease test?

Answer 9

◗ Normal level: < 200 mg/dl for adults & less than 170 mg/dl for children & adolescent; borderline high up to 240 mg/dl; high if > 240 mg/dl.

◗ Excess levels: May indicate hereditary lipid disorders, CAD.

Question 10

Lipoprotein fractionation heart disease test?

Answer 10

◗ Isolates & measures high-density lipoproteins (HDLs), LDLs, & very low-density lipoproteins (VLDLs).

◗ Each of these particles composed of protein, cholesterol, & triglyceride in varying amounts.

Question 11

HDL heart disease test?

Answer 11

Primarily protein.

Test measures the actual amount in the blood.

The higher the level, the lower the risk of CAD (HDL should be HIGH).

Normal values for males: 37 to 70 mg/dl; for females, 40 to 85 mg/dl.

Question 12

LDL heart disease test?

Answer 12

◗ Mainly cholesterol.

◗ Equal to total cholesterol—HDL cholesterol minus VLDL cholesterol (when triglyceride level is < 400 mg/dl).

◗The higher the LDL level, the higher the incidence of CAD.

◗ Normal levels for individuals without CAD, < 130 mg/dl; borderline high, 130 to 159 mg/dl; high >160 mg/dl.

◗ Optimal levels for individuals who have CAD, < 100 mg/dl ( LDL should be LOW).

Question 13

VLDL heart disease test?

Answer 13

◗ Mainly triglycerides.

◗ Calculated as the triglyceride level divided by five.

◗ The higher the VLDL level, the higher the incidence of CAD.

◗ Can be measured with LDLs in blood with a more sensitive test when high-risk patients & those with triglycerides of 400 mg/dl or more require complex medical management.

Question 14

TESTS - HEART FAILURE neurohormones are?

Answer 14

Cardiac cells produce & store two neurohormones—A-type natriuretic peptide (ANP) & B-type natriuretic peptide (BNP)—that help ensure cardiac equilibrium. Disruptions in fluid balance within the circulatory system trigger release of these hormones, which act as natural diuretics & antihypertensives.

Question 15

ANP heart failure blood test?

Answer 15

• Found in atrial tissue; Normal value: 20 to 77 pg/ml.

Question 16

BNP heart failure blood test?

Answer 16

• Found in ventricular tissues; helps accurately diagnose & grade the severity of heart failure; Normal value: < 100 pg/ml.

Question 17

Potassium levels?

Answer 17

◗ Normal levels: 3.5 to 5 mEq/L.

◗ Most critical value.

◗ Has narrow therapeutic range.

◗ Imbalances causing life-threatening arrhythmias.

◗ Affected by diuretics, penicillin G, & low insulin levels.

Question 18

Calcium electrolyte levels?

Answer 18

◗ Normal levels: 8.2 to 10.3 mg/dl.

◗ High levels causing cardiac toxicity & arrhythmias.

◗ Elevations commonly indicate cancer or hyperparathyroidism.

Question 19

Magnesium electrolyte levels?

Answer 19

◗ Normal levels: 1.3 to 2.1 mg/dl.

◗ High levels causing electrocardiogram (ECG) changes, ventricular tachycardia, & ventricular fibrillation, Low levels causing ECG changes, bradycardia, & hypotension.

Question 20

Sodium electrolyte levels?

Answer 20

◗ Normal levels: 135 to 145 mEq/L.

◗ Maintains osmotic pressure, acid-base balance, & nerve impulse transmission.

◗ Low levels indicating severe heart failure.

◗ Decreased levels caused by diuretics, high triglycerides, & low blood protein.

Question 21

Chloride electrolyte levels?

Answer 21

◗ Normal levels: 100 to 108 mEq/L.

◗ Partners with sodium to maintain fluid & acidbase balance.

◗ Low levels indicating heart failure & metabolic acidosis.

Question 22

Carbon dioxide levels?

Answer 22

◗ Normal levels: 23 to 30 mEq/L.

◗ Primarily made up of bicarbonate.

◗ Regulated by the kidneys.

◗ Reduced by thiazide diuretics.

Question 23

Coagulation tests?

Answer 23

Partial thromboplastin time, prothrombin time (PT), & activated clotting time are tests that measure clotting time. They’re used to measure response to treatment as well as to screen for clotting disorders.

International Normalized Ratio (INR):

Because PT measurements vary from laboratory to laboratory, International Normalized Ratio (INR) is generally viewed as the best standardized measurement of PT. Both are used for monitoring wafarin (Coumadin) treatment.

Guidelines for patients receiving warfarin recommend an INR of 2.9 to 3.0 except for patients with mechanical prosthetic heart valves. For those patients, an INR of 2.5 to 3.5 is recommended. Increased INR values may indicate disseminated intravascular coagulation, cirrhosis, hepatitis, vitamin K deficiency, salicylate intoxication, or uncontrolled oral anticoagulation.

Question 24

ANTIANGINALS

Antianginals relieve chest pain by reducing myocardial oxygen demand, increasing the supply of oxygen to the heart, or both. The three main types are:

Answer 24

Beta-adrenergic blockers:

◗ Reduce myocardial oxygen demands by slowing the heart rate & increasing the force of myocardial contractions

◗ Prescribed for long-term prevention of angina

◗ Examples: atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal)

Calcium channel blockers:

◗ Dilate coronary & peripheral arteries & prevent coronary vasospasm

◗ Used when other drugs fail to prevent angina

◗ Examples: amlodipine (Norvasc), diltiazem (Cardizem), nicardipine (Cardene), verapamil (Calan)

Nitrates:

◗ Produce vasodilation, decrease preload & afterload, & reduce myocardial oxygen consumption

◗ Used primarily to treat angina

◗ Examples: nitroglycerin (Nitro-Bid, Nitrostat, Nitrolingual), isosorbide dinitrate (Isordil)

Question 25

ANTIARRHYTHMICS

Antiarrhythmics are used to treat disturbances in the normal heart rhythm, & are grouped in one of four classes:

Answer 25

I (sodium channel blockers)

II (beta-adrenergic blockers),

III (potassium channel blockers)

IV (calcium channel blockers).

Question 26

ANTICOAGULANTS?

Answer 26

Anticoagulants reduce the blood’s ability to clot. They’re prescribed for mitral insufficiency & atrial fibrillation, or to prevent clots in an artery or vein.

Question 27

ANTIHYPERTENSIVES?

Answer 27

Treatment for hypertension begins with modifying diet, encouraging exercise and, if indicated,

counseling about weight loss. If these measures aren’t enough, drugs can help control blood pressure.

Question 28

Angiotensin-converting enzyme (ACE) inhibitors?

Answer 28

Decrease vasoconstriction & re-uptake of fluids by preventing angiotensin I from converting to angiotensin II.

Examples: captopril (Capoten), enalapril (Vasotec)

Question 29

Angiotensin II receptor blockers (ARBs)?

Answer 29

Inhibit vasoconstriction, protect against renal failure in patients with type 2 diabetes.

Examples: losartan (Cozaar), olmesartan (Benicar)

Question 30

Beta-adrenergic blockers?

Answer 30

Block catecholamine-induced increase in blood pressure.

Examples: metoprolol (Lopressor), nadolol (Corgard)

Question 31

Calcium channel blockers?

Answer 31

Dilate the arteries to lower blood pressure & decrease cardiac contractility.

Examples: amlodipine (Norvasc), diltiazem (Cardizem).

Question 32

Diuretics?

Answer 32

◗ Help kidneys excrete water & electrolytes, which lowers blood pressure.

◗ Thiazide example: hydrochlorothiazide (HydroDIURIL).

◗ Loop example: furosemide (Lasix).

◗ Potassium-sparing example: spironolactone (Aldactone).

Question 33

Selective aldosterone receptor antagonists?

Answer 33

Used as a second-line treatment when other drugs fail.

Only example: eplerenone (Inspra).

Question 34

Sympatholytics?

Answer 34

Decrease peripheral vascular resistance by inhibiting the sympathetic nervous system.

clonidine (Catapres), doxazosin (Cardura), carvedilol (Coreg)

Question 35

Vasodilators?

Answer 35

◗ Relax arteries, veins, or both.

◗ Examples: hydralazine (Apresoline), I.V. nitroprusside (Nitropress), diazoxide (Hyperstat I.V.)

Question 36

ANTILIPEMICS?

Answer 36

Antilipemics lower cholesterol, triglyceride, & phospholipid levels. They’re used in combination with lifestyle changes to decrease the risk of coronary artery disease.

Question 37

ANTILIPEMICS:

Bile-sequestering drugs?

Answer 37

◗ Remove excess bile acids from fat deposits

◗ Lower low-density lipoprotein (LDL) levels

◗ Example: cholestyramine (Questran)

Question 38

ANTILIPEMICS:

Cholesterol absorption inhibitors?

Answer 38

◗ Lower total cholesterol levels

◗ Example: ezetimibe (Zetia)

Question 39

ANTILIPEMICS:

Fibric-acid derivatives?

Answer 39

◗ Lower triglyceride levels

◗ Minimally increase high-density lipoprotein (HDL) levels

◗ Examples: fenofibrate (TriCor), gemfibrozil (Lopid)

Question 40

ANTILIPEMICS:

HMG-CoA reductase inhibitors?

Answer 40

◗ Also known as statins

◗ Lower total cholesterol & LDL levels

◗ Minimally increase HDL levels

◗ Examples: atorvastatin (Lipitor), simvastatin (Zocor)

Question 41

ANTILIPEMICS:
Nicotinic acid (niacin)?

Answer 41

◗ Water-soluble vitamin

◗ Lowers triglyceride levels

◗ Increases HDL levels

Question 42

INOTROPICS?

Answer 42

Inotropics increase the force of the heart’s contractions. The two types are cardiac glycoside & phosphodiesterase inhibitors.

Cardiac glycoside - Slows the heart rate & electrical impulse conduction through the sinoatrial & the atrioventricular nodes Example: digoxin (Lanoxin).

Phosphodiesterase (PDE) inhibitors - Provide short-term management of heart failure or long-term management for patients awaiting heart transplant surgery. Examples: inamrinone (Amrinone), milrinone (Primacor).

Question 43

FIBRINOLYTICS?

Answer 43

Fibrinolytics can dissolve a clot or thrombus that has caused acute MI, ischemic stroke or peripheral artery occlusion, or pulmonary embolus. They can also dissolve thrombi & reestablish blood flow in arteriovenous cannulas, grafts, & I.V. catheters. In an acute or emergency situation, they must be administered within 3 to 6 hours after the onset of symptoms. Fibrinolytics include alteplase (Activase), reteplase (Retavase), & urokinase (Abbokinase).

Question 44

Rheumatic fever - which bacteria and how many weeks present before mitral valve damage?

Answer 44

Rheumatic fever presents 2 to 6 weeks following an untreated or partially treated group A beta-hemolytic streptococcal infection of the upper respiratory tract.

Question 45

Rheumatic fever?

Answer 45

Rheumatic fever is an inflammatory autoimmune disease that affects the connective tissues of the heart, joints, subcutaneous tissues, & blood vessels of the central nervous system.

Question 46

Kawasaki disease?

Answer 46

Kawasaki disease causes inflammation in the walls of medium-sized arteries throughout the body. It primarily affects children. The inflammation tends to affect the coronary arteries, which supply blood to the heart muscle.

Question 47

CARDIOMYOPATHY - DILATED?

Answer 47

Dilated cardiomyopathy results from extensively
damaged myocardial muscle fibers. This disorder interferes with myocardial metabolism & grossly dilates all four chambers of the heart, giving the heart a globular appearance & shape. It usually isn’t diagnosed until it has reached an advanced stage, & the prognosis is generally poor.

Question 48

CARDIOMYOPATHY - RESTRICTIVE?

Answer 48

Restrictive cardiomyopathy is characterized by
restricted ventricular filling (the result of left ventricular hypertrophy) & endocardial fibrosis & thickening. It’s severe & irreversible, & the average survival after diagnosis is 9 years.

Question 49

Six classifications of viruses are known to cause the common cold?

Answer 49

1. Rhinovirus
2. Coronavirus
3. Influenza
4. Parainfluenza
5. Respiratory syncytial virus (RSV)
6. Adenovirus

Colds are extremely contagious because the virus begins to shed approximately 24 to 72 hours before the onset of symptoms.

Question 50

Allergic Rhinitis meds?

Answer 50

Numerous randomized controlled trials (RCTs) have shown that the oral antihistamines cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra) improve the symptoms of seasonal allergic rhinitis compared with placebo.

• Eight RCTs have shown that pseudoephedrine (Sudafed), in combination with a second-generation antihistamine, gives better symptom control than pseudoephedrine alone, an antihistamine alone, or placebo.
• There is no convincing evidence for the efficacy of intranasal azelastine (Astelin) in improving symptoms in seasonal allergic rhinitis.
• There is evidence that montelukast (Singulair) alone or in combination with loratadine is significantly better at improving nasal symptoms compared with placebo.

Question 51

Pharyngitis/Tonsillitis?

Answer 51

Tonsillitis, sometimes referred to as pharyngitis, is inflammation of the pharyngeal tonsils that may also extend to the adenoids. The condition can be acute, recurrent, or chronic. The uncomplicated acute form, which often follows an upper respiratory infection, usually lasts 4 to 6 days & affects children between ages 5 & 10. Tonsillitis is considered recurrent if the patient experiences seven episodes in 1 year, five episodes in 2 consecutive years, or three episodes yearly for 3 consecutive years. Chronic tonsillitis is persistent infection of the tonsils. Tonsillitis generally results from infection with beta-hemolytic streptococci but can also result from other bacteria or viruses, such as herpesvirus, cytomegalovirus, or adenovirus. Chronic tonsillitis may result in chronic upper airway obstruction, causing sleep apnea or sleep disturbances, cor pulmonale, failure to thrive, eating or swallowing disorders, & speech abnormalities. Febrile seizures, otitis media, cardiac valvular disease, abscesses, glomerulonephritis, subacute bacterial endocarditis, & abscessed cervical lymph nodes may also be noted. Scarlet fever, rheumatic fever, & heart disease may also occur, but these conditions are not as common as they were before the widespread use of antibiotics.

Question 52

Cor Pulmonale?

Answer 52

Right ventricular hypertrophy or failure, secondary to disease of the lungs, pulmonary vessels, or chest wall

• Occurs when there is increased pressure and pulmonary hypertension
• There is destruction of the pulmonary capillaries, increased resistance of the pulmonary capillary bed, and shunting of unaerated blood across the collapsed alveoli.
• Initially, the right heart fails, then the left heart fails because of decreased cardiac output.

Question 53

DECONGESTANTS: Several adrenergic drugs, for example, phenylephrine (Neo-Synephrine) or pseudoephedrine (Sudafed), act as decongestants.

What do they do and Why should they not be used long-term?

Answer 53

These drugs constrict blood vessels in the respiratory tract, resulting in shrinkage of swollen mucous membranes and helping to open nasal airway passages.

However, these drugs, both oral and nasal, should be used only on a short-term basis because rebound congestion may occur within a few days.

Question 54

Xanthines?

Answer 54

The xanthine derivative theophylline relaxes the smooth muscle of the bronchial airways and pulmonary blood vessels, and may possess anti-inflammatory actions.

Question 55

ASTHMA PROPHYLAXIS

Leukotriene Inhibitors?

Answer 55

Zafirlukast (Accolate) and montelukast (Singulair) are oral leukotriene receptor antagonists for asthma

prophylaxis and treatment of chronic asthma. Leukotriene receptor antagonists primarily help to control the inflammatory process of asthma caused by leukotriene production, thus helping to prevent asthma symptoms and acute attacks. Montelukast can be used in children as young as two years old and has fewer drug interactions compared to zafirlukast.

Question 56

END-TIDAL CARBON DIOXIDE MONITORING - what is correlation between PaC02?

Answer 56

Although the values are similar, the ETCO2 values are usually 2 to 5 mm Hg lower than the partial pressure of arterial carbon dioxide value. Capnograms & ETCO2 monitoring reduce the need for frequent arterial blood gas sampling.

Question 57

MIXED VENOUS OXYGEN SATURATION MONITORING?

Answer 57

SvO2 reflects the oxygen saturation level of venous blood. It’s determined by measuring the amount of

oxygen extracted & used or consumed by the body’s tissues. SvO2 monitoring uses a fiber-optic thermodilution pulmonary artery catheter to continuously monitor oxygen delivery to tissues & oxygen consumption by tissues. Monitoring of SvO2 allows rapid detection of impaired oxygen delivery, as from decreased cardiac output, hemoglobin level, or arterial oxygen saturation. It also helps evaluate a patient’s response to drug therapy, ET tube suctioning, ventilator setting changes, positive-end-expiratory pressure, & fraction of inspired oxygen (FIO2).

Question 58

Flora commonly found in the respiratory tract include what?

Answer 58

alpha-hemolytic streptococci, Neisseria species, diphtheroids, some Haemophilus species, pneumococci, staphylococci, & yeasts such as Candida.

Question 59

Pathogenic organisms most commonly found in sputum include what?

Answer 59

Streptococcus pneumoniae, Mycobacterium tuberculosis, Klebsiella pneumoniae (and other Enterobacteriaceae), H. influenzae, Staphylococcus aureus, and Pseudomonas aeruginosa.

Question 60

Flora commonly found in the nasopharynx include what?

Answer 60

nonhemolytic streptococci, alpha-hemolytic streptococci, Neisseria species (except N. meningitidis and N. gonorrhoeae), Staphylococcus epidermidis and, methicillin-resistant S. aureus.

Question 61

THROAT CULTURE pathogens include what?

Answer 61

Possible pathogens cultured include group A beta-hemolytic streptococci (Streptococcus pyogenes), which can cause scarlet fever or pharyngitis; Candida albicans, which can cause thrush; Corynebacterium diphtheriae, which can cause diphtheria; & Bordetella pertussis, which can cause whooping cough. Other cultured bacteria include Legionella species, Mycoplasma pneumoniae, Staphylococcus aureus, Streptococcus pneumoniae, and H. influenzae. Cultured bacteria are also used to screen for carriers of N. meningitidis. Fungi include Histoplasma capsulatum, Coccidioides immitis, and Blastomyces dermatitidis. Viruses include adenovirus, enterovirus, herpesvirus, rhinovirus, influenza virus, & parainfluenza virus.

Question 62

Iron Drug Therapy. Oral iron should be used whenever possible because it is inexpensive & convenient. Many iron preparations are available. When administering iron, consider the following five factors:

Answer 62

1. Iron is absorbed best from the duodenum & proximal jejunum. Therefore enteric-coated or sustained-release capsules, which release iron farther down in the GI tract, are counterproductive & expensive.
2. The daily dose should provide 150 to 200 mg of elemental iron. This can be ingested in three or four daily doses, with each tablet or capsule of the iron preparation containing between 50 & 100 mg of iron (e.g., a 300-mg tablet of ferrous sulfate contains 60 mg of elemental iron).
3. Iron is best absorbed as ferrous sulfate (Fe2+) in an acidic environment. For this reason & to avoid binding the iron with food, iron should be taken about an hour before meals, when the duodenal mucosa is most acidic. Taking iron with vitamin C (ascorbic acid) or orange juice, which contains ascorbic acid, enhances iron absorption. Gastric side effects, however, may necessitate ingesting iron with meals.
4. Undiluted liquid iron may stain the patient’s teeth. Therefore it should be diluted & ingested through a straw.
5. GI side effects of iron administration may occur, including heartburn, constipation, & diarrhea. If side effects develop, the dose & type of iron supplement may be adjusted. For example, many individuals who need supplemental iron cannot tolerate ferrous sulfate because of the effects of the sulfate base. However, ferrous gluconate may be an acceptable substitute. Tell patients that the use of iron preparations will cause their stools to become black because the GI tract excretes excess iron. Constipation is common, & the patient should be started on stool softeners & laxatives, if needed, when started on iron.

Question 63

Thalassemia?

Answer 63

Thalassemia is a group of diseases involving inadequate production of normal hemoglobin, & therefore decreased erythrocyte production. Thalassemia is due to an absent or reduced globulin protein. αGlobin chains are absent or reduced in α-thalassemia, & β-globin chains are absent or reduced in βthalassemia. Hemolysis also occurs in thalassemia, but insufficient production of normal hemoglobin is the predominant problem.

Question 64

Megaloblastic anemias?

Answer 64

Megaloblastic anemias are a group of disorders caused by impaired DNA synthesis & characterized by

the presence of large RBCs. When DNA synthesis is impaired, defective RBC maturation results. The RBCs are large (macrocytic) & abnormal & are referred to as megaloblasts. Macrocytic RBCs are easily destroyed because they have fragile cell membranes. Although the overwhelming majority of megaloblastic anemias result from cobalamin (vitamin B12) & folic acid deficiencies, this type of RBC
deformity can also occur from suppression of DNA synthesis by drugs, inborn errors of cobalamin & folic acid metabolism, & erythroleukemia (malignant blood disorder characterized by a proliferation of erythropoietic cells in bone marrow).

Question 65

dyspepsia is?

Answer 65

Indigestion.

Question 66

Aplastic anemia?

Answer 66

Aplastic anemia is a disease in which the patient has peripheral blood pancytopenia (decrease of all blood cell types—RBCs, white blood cells [WBCs], & platelets) & hypocellular bone marrow. The spectrum of the anemia can range from a chronic condition managed with erythropoietin or blood transfusions to a critical condition with hemorrhage & sepsis. The incidence of aplastic anemia is low, affecting approximately 2 of every 1 million persons per year.

Aplastic anemia has various etiologic classifications, but is divided into two major groups: congenital or acquired. Approximately 75% of the acquired aplastic anemias are idiopathic & thought to have an autoimmune basis.

Question 67

Sickle cell disease (SCD)?

Answer 67

Sickle cell disease (SCD) is a group of inherited, autosomal recessive disorders characterized by an abnormal form of hemoglobin in the RBC.

Question 68

HEMOCHROMATOSIS?

Answer 68

Hemochromatosis is an iron overload disorder.

The genetic disorder (hereditary hemochromatosis) is an autosomal recessive disorder characterized by increased intestinal iron absorption and, as a result, increased tissue iron deposition. It is the most common genetic disorder among whites, with an incidence of about 5 per 1000 whites of European ancestry. The normal range for total body iron is 2 to 6 g. Individuals with hemochromatosis accumulate iron at a rate of 0.5 to 1.0 g/yr & may exceed total iron concentrations of 50 g. Symptoms of hemochromatosis usually develop between 40 & 60 years of age.

Question 69

Myelodysplastic syndrome (MDS)?

Answer 69

Myelodysplastic syndrome (MDS) is a group of related hematologic disorders characterized by peripheral blood cytopenias (from ineffective blood cell production) & changes in the cellularity of the bone marrow with dysplastic changes. In MDS, hematopoiesis is disorderly & ineffective.

Question 70

Leukemia?

Answer 70

Leukemia is the general term used to describe a group of malignant disorders affecting the blood and blood-forming tissues of the bone marrow, lymph system, & spleen.

It results in an accumulation of dysfunctional cells because of a loss of regulation in cell division.

By combining the acute & chronic categories with the cell type involved, one can identify four major types of leukemia: acute lymphocytic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelogenous (granulocytic) leukemia (CML), & chronic lymphocytic leukemia (CLL).

Question 71

Lymphomas?

Answer 71

Lymphomas are malignant neoplasms originating in the bone marrow & lymphatic structures resulting in the proliferation of lymphocytes. Lymphomas are the fifth most common type of cancer in the US. Two major types of lymphoma are Hodgkin’s lymphoma & non-Hodgkin’s lymphoma (NHL).

Question 72

HODGKIN’S LYMPHOMA?

Answer 72

Hodgkin’s lymphoma, also called Hodgkin’s disease, makes up about 11% of all lymphomas. It is a malignant condition characterized by proliferation of abnormal giant, multinucleated cells, called Reed-Sternberg cells, which are located in lymph nodes.

Question 73

NON-HODGKIN’S LYMPHOMA?

Answer 73

Non-Hodgkin’s lymphomas (NHLs) are a heterogeneous group of malignant neoplasms of primarily B-, T-, or natural killer (NK) cell origin affecting all ages.

Question 74

MULTIPLE MYELOMA?

Answer 74

Multiple myeloma, or plasma cell myeloma, is a condition in which neoplastic plasma cells infiltrate the bone marrow & destroy bone.

Question 75

Thrombocytopenia?

Answer 75

Thrombocytopenia is a reduction of platelets below 150,000/μL (150 × 109/L).

Question 76

Hemophilia?

Answer 76

Hemophilia is an X-linked recessive genetic disorder caused by a defective or deficient coagulation factor.

Question 77

Disseminated intravascular coagulation (DIC)?

Answer 77

Disseminated intravascular coagulation (DIC) is a serious bleeding & thrombotic disorder that results from abnormally initiated & accelerated clotting.

Subsequent decreases in clotting factors & platelets ensue, which may lead to uncontrollable hemorrhage. The term disseminated intravascular coagulation can be misleading because it suggests that blood is clotting. However, this condition is characterized by the profuse bleeding that results from the depletion of platelets & clotting factors. DIC is always caused by an underlying disease or condition. The underlying problem must be treated for the DIC to resolve.

Question 78

D-dimer test?

Answer 78

D-dimer test measures a specific fibrin monomer fragment of fibrin degradation products (FDPs) to determine whether FDPs are caused by normal mechanisms or by excessive fibrinolysis. The fibrin monomer fragments are present in severe clotting disorders such as DIC.

Question 79

Erythrocyte sedimentation rate?

Answer 79

Erythrocyte sedimentation rate measures the rate of RBC settling out of plasma. It may detect infection or inflammation.

Question 80

Schilling test?

Answer 80

Schilling test is used to determine absorption of vitamin B12 (necessary for erythropoiesis) by measuring excretion of radioactive B12 in the urine.

Question 81

Neutropenia?

Answer 81

Neutropenia is a condition in which the absolute neutrophil count (ANC) is less than 1000 cells/μL; severe neutropenia is associated with an ANC of less than 500 cells/μL.

Question 82

Platelet Count?

Answer 82

Platelet Count - The platelet count is the number of platelets per microliter of blood. Normal platelet counts are between 150,000 & 400,000/μL. Counts below 100,000/μL signify a condition termed thrombocytopenia.

Question 83

Radiation therapy?

Answer 83

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.