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A. Pathophysiology 1 / Spring 2014 > miderm study guide > Flashcards

miderm study guide Flashcards

(105 cards)

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0
Q

MCHC is related to the _____ of RBCs

A

color

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1
Q

MCV is related to _____ of RBCs

A

size

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2
Q

RDW is related to the _____ of RBCs

A

shape

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3
Q

what do we call the percentage of a person’s blood that consists of RBCs

A

hematocrit

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4
Q

what are the borderline percentages for men and women as diagnostic criteria for anemia

A

men < 40

women < 37

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5
Q

why is hct count higher for men

A

because of the higher levels of androgen

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6
Q

how do we diagnose for inflammation

A

look at ESR rates for C-reactive protein

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7
Q

EPO comes from what organ

A

KD

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8
Q

if cells are small and pale, we call this

A

microcytic and hypochromic

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9
Q

what is the most common type of anemia

A

iron deficiency anemia

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10
Q

what do we suspect is going on inside the body if one has iron deficiency anemia

A

chronic bleeding (undiagnosed blood loss)

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11
Q

what are typical presentations of iron deficiency anemia

A

pica, pagophagia, koilonychia, bare tongue

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12
Q

how do we diagnose for iron deficiency anemia

A

TIBC test

test will come back low - rbcs are pale and small (micrcytic and hypocromic)

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13
Q

which two forms of anemia include macrocytic or megaloblastic cells

A

folate deficiency anemia & B12 deficiency anemia

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14
Q

which form of anemia will we see neurological difficulties

A

B12 deficiency

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15
Q

what happens if we mistake B12 deficiency anemia for folate deficiency anemia and treat with folate supplementation?

A

the anemia itself may improve but the neurological deficits in the patient due to the B12 deficiency will worsen and or become irreversible

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16
Q

when RBCs are large this is what kind of a problem

A

DNA problem

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17
Q

when RBCs are small, this is what kind of a problem

A

hemoglobin problem

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18
Q

what type of anemia is pernicious anemia

A

deficient formation B12 deficiency

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19
Q

what is the pathogenesis for pernicious anemia

A

auto-immune atrophic gastritis causing poor absorption of B12

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20
Q

if we suspect pernicious anemia, what would we suggest the patient do? what would we ask them?

A

Ask them about their digestion and send them to a GI specialist for an endoscopy. We can also use a hemogram and immunology exam as a diagnostic tool.

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21
Q

sickle cell anemia results in…

A

premature hemolysis of cells.

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22
Q

what is the pathogenesis of sickle cell anemia

A

hemolysis with thrombosis and ischemia

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23
Q

if we see a high level of reticulocytes, what does this indicate

A

there are not enough RBCs and the person is experiencing hypoxia
we also suspect chronic bleeding

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24
if we see bandemia, what does this indicate
acute bacterial infection unless proven otherwise. | could also be from burns, pregnancy, etc...but have to diagnose
25
red bone marrow can be found within which type of bones
flat bones of axial skeleton - skull, ribs, sternum, pelvis, spine
26
what is the #1, 2, & 3 reasons for lymphocytosis
``` #1 acute viral infection #2 auto immune disorder #3 cancers (will see signs of fatigue, sudden nose bleeds, rashes, bruises...etc) ```
27
dehydration, profuse diaphoresis, emesis, diarrhea, heat exhaustion, burns and vomiting are all related to which kind of polycythemia
relative
28
renal cell carcinoma is related to which kind of polycythemia
absolute - secondary
29
polycythemia rubra vera is associated with which kind of polycythemia
absolute - primary
30
bone marrow malignancy is associated with which type of polycythemia
absolute - primary
31
smoking, chronic CO or CO2 poisoning are associated with which kind of polycythemia
absolute - secondary
32
what is the most common hemophilia
hemophilia A
33
hemophilia A is a deficiency of...
factor XIII
34
hemophilia B is a deficiency of...
factor IX | christmas
35
how do we diagnose hemophilia or other bleeding disorders
with plasmaelectrophoesis
36
what is the most common genetic bleeding disorder
von willebrand disease
37
which type of leukemia is responsible for 80% of all childhood leukemias
Acute lymphocytic leukemia (ALL)
38
which form of leukemia is associated with the Philadelphia chromosome
chronic myelogenous leukemia (CML)
39
Reed-Sternberg cells are found in what kind of lymphoma
Hodgkin's
40
how do we diagnose for Non-Hogkin's and Hogkin's
Non-Hogkins: CBC & Hemogram; this lymphoma is in blood | Hogkins: biopsy of lymph node or bone marrow; can't do a blood test because this is a solid cancer
41
what is the most common cause of L CHF
systemic arterial HTN
42
what is the most common cause of R CHF
#1 left CHF, followed by cor pulmonale
43
what is the pathogenesis of portal HTN
chronic smoking --> COPD --> pulmonary HTN = stagnation in RT HT = cor pulmonale --> LV is compromised --> portal HTN
44
cor pulmonale
R CHF due to COPD
45
when there is no medical cause found to explain one's high blood pressure, we call this:
essential/primary/idiopathic hypertension
46
when high blood pressure is a result of another condition, we call this:
secondary hypertension
47
what is the most common cause of secondary hypertension
KD pathology
48
If we have a young patient with HTN, would we suspect primary or secondary HTN?
We would suspect secondary HTN. We would have to investigate the underlying cause because most of the time young people who develop HTN have an underlying pathology.
49
what are major risk factors for ischemic heart disease
``` male age family history htn high LDL smoking diabetes mellitus ```
50
if a person feels squeezing, crushing and heavy chest pain, we suspect...
stable angina pectoris
51
sudden chest pain (spasm-like) is related to which type of ischemic heart diease
prinzmetal angina
52
what are the 3 diagnostic tools for MI
ECG cardiac enzymes: troponin, creatine, MB clinical presentation
53
what is the most common complication after an MI
reactive preicarditis - due to POST MI; inflammation spills into pericardium
54
if a patient experiences sharp, stabbing pain worse when lying down, we suspect:
pericardial pathology
55
a chronic auto-immune disease due to/triggered by streptococcal infection is...
rheumatic fever
56
what type of shock: | low volume of blood/failure of fluids
hypovolemic
57
what type of shock: | heart cannot pump due to pericarditis, myocarditis, or MI; failure of the pump
cardiogenic
58
what type of shock: | blood being redistributed and returned to HT is sluggish; failure of the tubes
distributive
59
what category of shock are septic and anaphylactic
distributive
60
what are the causes of atherosclerosis
high levels of LDL and endothelial inflammation
61
how do we diagnose atherosclerosis
angiogram
62
how do we remove blood or fluids due to pericardial effusion
pericardiocentesis
63
pulse pressure =
systolic - diastolic
64
128/85 vs 140/90
``` 128/85 = prehypertensive 140/90 = beginning of HTN ```
65
S1 is sound of...
closure of atrioventricular valves - systole
66
S2 is sound of...
closure of semilunar valves - diastole
67
the amount if time it takes for the atria to depolarize
P wave
68
wave of depolarization going through the ventricles
QRS wave
69
repolarization of ventricles
T wave
70
Arrhythmia Blocks: 1st 2nd 3rd
1st: PR interval is extended 2nd: 1 QRS complex will be randomly missed 3rd: several QRS complexes will be missed in a row
71
serious, chaotic beating of ventricles
ventricular fibrillations
72
irregularly-irregular rhythm, common in geriatric patients, can lead to stroke and MI
atrial fibrillations
73
what is the most common type of cardiomyopathy
dilated
74
is preload increased or decreased in the following types of cardiomyopathy: dilated hypertrophic restrictive
dilated - increased hypertrophic - decreased restrictive - decreased
75
why do people have ectopic arrythmias
because of hypoxia
76
what are the causes of dilated cardiomyopathy
40% we do not know; the other 60% is familial, increased where there is alcoholism, diabetes, pregnancy, and those on anti-cancer meds
77
narrowing of the root of the pulmonary artery as it departs from the right ventricle
pulmonary stenosis
78
the root of the aorta is positioned over the septal inter-ventricular defect
dextra-position of the aorta (aka: overriding aorta)
79
what are the 4 heart malformations associated with tetralogy of fallot
pulmonary stenosis hypertrophy of the right ventricle inter-ventricular foramen (right to left shunt) dextra-position of the aorta
80
inter-ventricular foramen (right to left shunt) - what kind of blood is moving in what direction?
deoxygenated blood is moving from the right side of the heart into the left side circulation
81
what is the major source of pulmonary embolism
DVT (deep venous thrombosis)
82
what is this disease? recurring inflammation and thrombosis of small and medium arteries and veins of the hands and feet? strongly associated with smoking
Buerger's disease AKA thromboangitis obliterans
83
#1,2, 3, 4 site of aneurysms
``` # 1 circle of willis # 2 abdominal aorta # 3 thoracic aorta # 4 popliteal artery ```
84
what conditions are likely to put someone in danger of rupture or infection associated with aneurysms
systemic arterial hypertension & adult polycystic kidney disease
85
decrease in BP upon changing from supine to upright position
orthostatic hypotension
86
what is the difference between portal HTN and systemic arterial HTN?
portal - amongst the system of portal veins: GI tract and lower extremities (venous circulation) systemic - arterial circulation
87
location of KDs
retroperitoneal and extend anywhere from T12-L3 (L4 on right side bc of liver)
88
filtering unit of the KD
glomerulus
89
part of the KD where electrolytes and minerals are reabsorbed
proximal convoluted tubule | REMEMBER ALDOSTERONE HERE
90
in what part of the KD is urine concentrated and diluted
loop of henle
91
which parts of the KD reabsorb water
distal convoluted tubule and collecting duct | REMEMBER ADH HERE FOR DCT
92
what is the best index of GFR
serum creatinine
93
specific gravity
concentration of urine / concentration of plasma | measures how well the tubules are concentrating urine
94
what should the normal urinary output be
700mL - 2L per 24 hours
95
which hormone makes tubules able to absorb more sodium in proximal convoluted tubule by sodium potassium pump
aldosterone
96
what are normal constituents of urine
bilirubin, electrolytes, ammonia, hormones, creatinine, epithelium
97
what are abnormal constituents in urine
proteins, glucose, formed elements of blood, albumins
98
adult polycystic kidney disease is classified as:
an autosomal dominant disorder
99
what are the most common kinds of KD stones
calcium oxalate stones
100
what are the #1 and #2 causes of calcium oxalate stones
``` #1 hypercaliurea --> too much Ca+ in urine (unexplained by bio-med) #2 hypercalcemia --> too much Ca+ in blood - (caused by: hyperfunction of parathyroid gland or cancer) ```
101
struvite stones are produced by and contain
urea-splitting bacteria | magnesium, ammonium, phosphate stones
102
difference in appearance between calcium stones and struvite stones
calcium stones are opaque | struvite stones are translucent and mushy
103
what is the major cause of UTIs
obstruction of stones in urinary tract
104
what are the clinical presentations of acute nephrolithiasis
renal colic - colicky pain; "loin to groin" | stones are moving with obstruction to urinary tract

A. Pathophysiology 1 / Spring 2014 (4 decks)

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