Patho Final Flashcards
INNATE IMMUNITY is ___ and ___ response
early and rapid
4 cells of innate immunity
Phagocytic granulocytes
Macrophages
Dendritic cells
NKCs
1st line of defense against viral infection
NKCs
Dendritic cells
antigen-presenting cells
Phagocytic granulocytes examples
Neutrophils, Eosinophils, Basophils
Substances that elicit adaptive immune responses are called
ANTIGENS
help B-cells make antibodies & help phagocytic cells destroy ingested pathogens
helper T cells
kill intracellular microbes
Cytotoxic T-cells
Vaccinations depend on ___ immunity
Humoral
Cell-Mediated Immunity involves the use of __ to influence other cells
Cytokines
Defends against intracellular microbes such as viruses
Cell-Mediated Immunity
immunity that recognizes abnormal cells from cancers, viruses, infections, and transplanted tissues
Cell-Mediated Immunity
Innate or adaptive, general protection
Innate
Innate or adaptive, early phase of host response
Innate
Innate or adaptive, lag time between exposure and maximal response
Adaptive
Bones of the skeleton house __% of body’s calcium and __% phosphorus
99% of body’s calcium & 85% phosphorus
Osteopenia
Metabolic bone disease
Osteopenia is characterized by a
reduction in bone mineral density
Osteopenia occurs because of a decrease in ___ ___, inadequate ___ ___, or excessive bone ____
decrease in bone formation, inadequate bone mineralization, or excessive bone deossification
Osteopenia is not a diagnosis but a term used to describe an apparent loss of __ __ seen on x-ray studies
bone density
The 5 major causes of osteopenia are:
- Osteoporosis
- Osteomalacia
- Malignancies
- Multiple myeloma
- Hyperparathyroidism
Osteoporosis is a metabolic bone disease characterized by
decreased bone density (i.e., increased porosity)
In addition to decreased bone density, Osteoporosis is characterized by decreased
strength because the bone matrix and mineralization are decreased.
Osteoporosis risk factors
50yrs or older Female White or Asian Small bone structure/low body weight Postmenopausal Family history Sedentary Calcium/Vitamin D deficiency High-protein diet Smoking, drinking, caffeine
The cause of osteoporosis remains largely unknown, but most data suggest an
imbalance between bone resorption and formation.
___ factors play a significant role in the development of osteoporosis, particularly in postmenopausal women.
Hormonal
Postmenopausal osteoporosis is caused by an ___ deficiency.
estrogen
Postmenopausal osteoporosis: The loss of bone mass is greatest during
early menopause
decreased physical ___ that often accompanies aging may also contribute to the loss of bone mass in the elderly.
Activity
associated with many conditions, including endocrine disorders, malabsorption disorders, malignancies (multiple myeloma), alcoholism, and certain medications.
Secondary osteoporosis
___ use is the most common cause of drug-related osteoporosis
Corticosteroid
Several groups of children and adolescents are at particular risk for decreased bone mass, including ___ infants with low birth weight
premature
Children with ___ ___ often have impaired GI function that reduces the absorption of calcium and other nutrients, and many also require frequent corticosteroid drugs.
cystic fibrosis
Premature osteoporosis is increasingly being seen in female ___ due to increased prevalence of eating disorders and amenorrhea.
athletes
The female athlete ___ refers to a pattern of disordered eating that leads to amenorrhea and eventually osteoporosis
triad
Osteoporotic changes occur in the diaphysis and __ of bone.
Metaphysis
Osteoporosis is usually a silent disorder. Often, the first manifestations of the disorder accompany a skeletal
Fracture
Hip fractures occur mainly in persons over the age of
65
An important advance in diagnostic methods used for the identification of osteoporosis has been the use of ___ assessment
BMD assessment.
The clinical method of choice for BMD studies is dual energy x-ray absorptiometry (DEXA) of the
spine and hip.
Measurement of serial ___ in older adults is another simple way to screen for osteoporosis.
Heights
Studies have indicated that premenopausal women need more than 1000mg/day of calcium, and postmenopausal women need at least ____ of calcium daily.
1200mg
A daily intake of ___ IU of vitamin D is recommended for adults aged 50 years and older.
800-1000
Rheumatoid arthritis (RA) is a chronic ___ systemic disease
autoimmune
Rheumatoid arthritis (RA) is a chronic autoimmune systemic disease that affects all ethnic groups throughout the worlds, with
women being affected more frequently than men.
Rheumatoid arthritis: The onset of the disease can occur at any age, but its peak incidence is between
50 & 75 years of age.
Rheumatoid arthritis: Evidence points to a ___ predisposition and the development of joint inflammation that is immunologically mediated.
genetic
It has been suggested that the disease is initiated in a genetically predisposed individual by the activation of a ___-cell mediated response to an immunological trigger, such as a microbial agent.
T-cell-mediated
____ is a strong risk factor for the development of RA and may also influence the severity of the disease.
smoking
The pathogenesis of RA can be viewed as an aberrant immune response that leads to ____ inflammation and ____ of the joint architecture.
Synovial, destruction
RA has an insidious onset marked by systemic manifestations such as
fatigue, weakness, and generalized aching and stiffness.
The person may complain of joint pain and stiffness that lasts for 30 minutes and frequently for several hours.
RA
RA: The limitation of joint motion that occurs early in the disease is because of pain; later, it is because of
Fibrosis
In early disease, the wrists, metacarpophalangeal joints, proximal interphalangeal joints of the fingers, the thumbs, and hands are most commonly affected.
RA
RA: A ___ cyst may develop in the popliteal area behind the knee.
Baker
RA frequently has constitutional symptoms such as
fatigue, weakness, anorexia, and weight loss that are due to systemic inflammation.
Osteoarthritis aka
degenerative joint disease
Osteoarthritis most ___ type of joint disease
Prevalent
Osteoarthritis is characterized by degenerative changes of the ___ cartilage
articular
OA appears ____, without any apparent initiating cause, as an aging phenomenon.
Insidiously
Joint changes associated with OA include a gradual loss of articular cartilage, combined with ____ of bones.
thickening
OA is a multifactorial disease that has genetic and environmental risk factors.
- Age (strongest factor)
- Gender (Women)
- Race (Hand-White women) (Knees- Black women)
- Obesity
- Wear-and-tear arthritis
Wear-and-tear arthritis
OA
OA has audible
Crepitus
RBCs are derived from precursor cells called
Proerythroblasts
Most maturing RBCs enter blood as
Reticulocytes
__ to __ % of oxygen is bound to RBCs
95%-98%
Lack of iron= lack of ___ in RBC
Hemoglobin
__% iron is in hemoglobin
65%
When red blood cells age and are destroyed in the spleen, the iron from their hemoglobin is released into circulation & returned to the
bone marrow for incorporation into new RBCs or to the liver and other tissues for storage.
After 20yrs old, RBC production takes place in:
vertebrae, sternum, ribs, and pelvis
Maturation from reticulocyte to erythrocyte takes
24-48 hours
During maturation, RBC loses its
mitochondria, ribosomes, and ability to produce hemoglobin
Decreased O2 content is sensed by the ___, which in turn produce the hormone erythropoietin to produce more RBCs
KIDNEYS
Mature RBCs have a life span of
120 days
Mature RBCs do NOT have a nucleus, mitochondria, or endoplasmic reticulum, but do have cytoplasmic enzymes that metabolize
glucose and form ATP
Rate of RBC destruction=
rate of RBC production
When red blood cell destruction takes place in the circulation, as in hemolytic anemia, the hemoglobin remains in the plasma where it binds to a hemoglobin- binding protein called
haptoglobin
Anemia usually results from excessive loss (bleeding) or destruction (hemolysis) of RBC or
deficient RBC production due to lack of nutritional elements (iron) or bone marrow failure.
Anemias caused by premature destruction of the RBCs
hemolytic anemia
anemia associated with hyperbilirubinemia, jaundice, and gallstones.
hemolytic anemia
Chronic blood loss does not affect blood volume, but instead leads to
IRON-DEFIECNCIEY ANEMIA
Without adequate ___, the body cannot produce enough hemoglobin for red blood cells.
Iron
The result is iron-deficiency anemia. This type of anemia can be caused by: An iron-poor diet, especially in infants, children, teens,
vegans, and vegetarians
Iron balance is maintained by absorption of 0.5-1.5 mg daily to replace __mg lost in feces.
1mg
Persons are commonly asymptomatic until the hemoglobin level is less than __g/dL
8 g/dL
Iron can be derived from meat and is absorbed in the small intestine, especially the
duodenum
Hemolytic anemia is characterized by the premature destruction of RBCs, the retention of Iron and the other products of hemoglobin destruction, and the compensatory increase in
erythropoiesis
Extravascular hemolysis produces jaundice and
Gallstones
Intravascular hemolysis occurs as a result of
mechanical injury.
Sickle cell anemia: RBCs break down ___, so oxygen does not get to the body’s organs, causing anemia.
rapidly
The crescent-shaped red blood cells can also get stuck in tiny blood vessels, causing
pain
Sickle cell disease is an inherited disorder in which abnormal hemoglobin leads to chronic hemolytic anemia, pain, and
organ failure
Most infants with sickle cell disease do not begin to experience the effects until
8-10 wks of age.
2 most common probs of sickle cell disease:
Vasocclusive pain crisis
Acute chest syndrome (Pulmonary infarction)
an inhibitor of DNA synthesis, has been shown to reduce pain crisis and prevent the complications of sickle cell disease.
Hydroxyurea
May occur when vitamin B12 ( aka cobalamin) and folate are deficient.
Vitamin-deficiency anemia
These two vitamins are needed to make red blood cells.
vitamin B12 ( aka cobalamin) and folate
Megaloblastic (enlarged RBCs) anemia : Vitamin B12 or folate or both are
deficient
Dietary deficiency: Eating little or no meat, cereals and fruits may cause a lack of
vitamin B12
overcooking or eating too few vegetables may cause a
folate deficiency.
Lead exposure is toxic to the bone marrow, leading to fewer
red blood cells
Diabetes is a disorder of carbohydrate, protein, and fat metabolism resulting from a
lack of insulin availability or a reduction in the biologic effects of insulin.
After digestion, glucose passes into our bloodstream where it is available for body cells to use for growth and
Energy
For the glucose to get into the cells, ___ must be present
Insulin
Insulin is a hormone produced by the
pancreas
When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move the glucose from our blood into our cells. In people with diabetes, however, the pancreas either produces
little or no insulin, or the body cells do not respond to the insulin that is produced.
DM: glucose builds up in the blood, and overflows into the
Urine
DM: the body loses its main source of fuel even though the blood contains large amount of
glucose
Fasting plasma glucose (FGP) test measures plasma glucose levels after food has been withheld for at least
8 hours
Normal FGP
below 100mg/dL
Normal OGTT
below 140mg/dL
An elevated FPG or OGTT is classified as having impaired fasting plasma glucose (IFG) and/ or impaired glucose tolerance (IGT) → Persons with these are often referred to as being
prediabetic
known as insulin-dependent diabetes mellitus or juvenile diabetes
Type 1
In diabetes, the immune system attacks the insulin-producing
beta cells in the pancreas
One of the actions of insulin is the inhibition of ___ (fat breakdown) and release of free fatty acids from fat cells.
Lipolysis
In the absence of insulin, ___ develops when these fatty acids are released from fat cells and converted to ketones by the liver.
Ketosis
About 90 to 95 percent of people with diabetes have type __
2
form of diabetes usually develops in adults over the age of
40 and is most common among adults over age 55
In type 2 diabetes, the pancreas usually produces insulin, but for some reason,
the body cannot use the insulin effectively.
The end result of Type 2 is the same as for type 1 diabetes – an unhealthy buildup of
glucose in the blood and an inability of the body to make efficient use of it
Metabolic abnormalities involved in type 2 diabetes: Increased ___ production by the liver
Glucose
Gestational diabetes usually disappears when after
pregnancy
women who have had gestational diabetes have a greater risk of developing
type 2 diabetes later in their lives
greater risk of developing diabetes
African American, Hispanic, or Native American
Type 1 diabetes occurs equally among males and females, but is more common in
whites than in nonwhites.
A diet that is too high in sodium and too low in ___ puts you at risk for high blood pressure.
Potassium
Potassium is found in bananas,
potatoes, beans, and yogurt.
Men should have no more than __ drinks a day.
2
Tobacco use: carbon monoxide reduces the amount of
oxygen that your blood can carry.
Whole blood contains red cells, white cells, and platelets which are __% of total volume
45
refers to the acute or chronic inflammation of the liver
Hepatitis
-Hepatitis is caused by (4 things)
viruses
Chronic alcoholism
Drug toxicities
Autoimmune disorders
- Symptoms last for about 2 months
- Fever, nausea, anorexia, malaise, abdominal discomfort, dark urine and JAUNDICE.
- Children younger that 6 years are asymptomatic
- Jaundice usually occurs in 70% of cases
- Does not cause chronic hepatitis
- Rarely causes acute fulminant hepatitis
Hepatitis A
Associated with the Delta virus • Longer incubation period • More serious health problems • Worldwide perinatal transmission • In the U.S. intravenous drug use and unprotected sex is the main routes of transmission • Can cause acute and chronic hepatitis • Causes hepatic failure • Participates in the development of Hepatitis D
Hepatitis B
- Most common cause of chronic hepatitis, cirrhosis, and hepatocellular cancer in the world.
- Currently the most common mode of transmission is recreational injection drug use.
- Other risks include needle stick injuries in the health care settings and birth by an HCV infected mother.
- Children and adults are usually asymptomatic
- Nonspecific including fatigue, malaise, anorexia, and weight loss.
- Most serious are progressive liver fibrosis leading to cirrhosis and hepatocellular cancer.
Hepatitis C
Fecal-oral route
Acute hepatitis
Signs and symptoms are similar to Hepatitis A
Fever, nausea, anorexia, malaise, and abdominal discomfort
Does not cause chronic hepatitis
Very high morality rate among pregnant women
Hepatitis E
Chronic viral hepatitis: defined as a chronic inflammatory reaction of the liver, positive viral serology for more than ___ months.
6
Chronic viral hepatitis is the main reason for
liver transplantation in adults
Hepatic insufficiency that progresses from onset of hepatitis symptoms to hepatic encephalopathy within 2 to 3 weeks in patients that do not have chronic liver disease.
Acute Fulminant Hepatitis (Hepatic Failure)
Leading cause of Acute Fulminant Hepatitis (Hepatic Failure):
Acetaminophen (Tylenol) toxicity
Intracellular Fluids (ICF):
2/3 of body water (40%) of body weight
Extracellular Fluids (ECF):
1/3 of body water (20%) of body weight
Kidney function includes:
Helps to maintain RBC levels
➢ Kidneys produce urine at about 50 to __ ml per hour
60
➢ Kidneys produce urine at about ___ ml per day.
1500
➢ People usually void about __ times per day.
8
Bladder can store
500 ml
Urethra sizes in men and women
Women: 3 to 4 cm (1.5 in)
Men: Extends about 20 cm (8 in)
Pyelonephritis is a renal disease affecting the
tubules, instertitium, and pelvis of the kidney.
Acute Pyelonephritis: Defined as acute inflammation of the kidney caused by
bacterial infection.
Uncomplicated acute pyelonephritis: Most commonly occurs in young women without
structural or urinary tract obstructions.
• Complicated acute pyelonephritis: Occurs in adults and children with
structural or functional urinary tract abnormalities or predisposing medical conditions.
2 ways bacteria can gain access to the kidneys:
- Ascending infection from the lower urinary tract is the most common.
- Hematogenous spread from the bloodstream
• ADH is synthesized in the
Hypothalamus
• ADH is stored in the
• pituitary gland
➢ Syndrome of Inappropriate Antidiuretic Hormone (SIADH): Results from a failure of the
negative feedback system
Bronchial Asthma: Represents an acute and reversible form of airway disease caused by narrowing of the airways due to bronchospasm, inflammation, and increased
airway secretions
There are two categories of asthma:
Extrinsic and intrinsic
Extrinsic asthma (Allergic or Atopic) is caused by
type I hypersensitivity reaction.
Asthma can be triggered by
exercise, ingestion of aspirin, emotional upset, cigarette smoke.
Atopic Asthma onset is usually during
early childhood or adolescence
• Late response develops 4 to _ hours after the exposure
8
Leading cause of morbidity and mortality worldwide. The fourth leading cause of death in the United States.
COPD
Most common cause of COPD is
Smoking
Two types of airway obstructive disease are
emphysema and chronic obstructive bronchitis
loss of lung elasticity and abnormal enlargement of the air spaces distal to the terminal bronchioles, with destruction of the alveolar walls and the capillary beds.
emphysema
___ emphysema: Affects the bronchioles in the central part of the respiratory lobule, initially preserves the alveolar ducts and sacs. Most commonly seen in make smokers.
Centriacinar
____ emphysema: Produces initial involvement of the peripheral alveoli and later extends to the more central bronchioles.
Panacinar
Chronic Bronchitis:
Airway obstruction of the major and small airways.
Chronic Bronchitis: Most commonly seen in middle aged me and in associated with irritation from
smoking
Chronic Bronchitis: Associated with ____ of the submucosal glands in the trachea and bronchi.
hypertrophy
Late stages of COPD:
Recurrent respiratory infections
Permanent dilation of bronchi caused by destruction of the bronchial tissue wall and elastic supporting tissue.
Bronchiectasis
Bronchiectasis is commonly associated with
TB
Major cause of severe chronic respiratory disease in children and young adults. Autosomal recessive genetic disorder manifested by:
• Chronic lung disease
• pancreatic exocrine deficiency
• elevation of sodium chloride in the sweat.
Cystic Fibrosis
Cystic Fibrosis causes exocrine gland secretions to become exceedingly
Viscid
promotes colonization of the respiratory tract with P. areuginosa and other organisms such as S. aureus.
Cystic Fibrosis
Signs and Symptoms: Steatorrhea, diarrhea, and abdominal pain is common
Cystic Fibrosis
Refers to the presence of air in the pleural space.
Pneumothorax
Pneumothorax causes partial or complete
collapse of the affected lung
- Ipsilateral chest pain
- Increased respiratory rate
- Dyspnea
- Assymetry of the chest
- Breath sounds may be decreased or absent over the affected
Pneumothorax symptoms
change in cell number
Hyperplasia
change in cell type (reversible, cells switch jobs)
Metaplasia
change in cell shape & organization (deranged growth, cancer)
Dysplasia
autosomal recessive single-gene disorder that causes lung and pancreatic disease
Cystic Fibrosis
ICF is ___ of the water in our body (which makes it 40% of total body weight)
2/3
Hyperkalemia & hypocalcemia
raise resting potential toward threshold (it takes less of a stimulus for cells to fire)
hypokalemia & hypercalcemia
decrease resting potential
Hodgkin’s Lympoma
involves malignant B cells (Reed-Sternberg cells)
Non-Hodgkin lymphoma
involves B & T cells malignancies (therefore worse prognosis)
Leukemia
neoplasm arising in bone marrow
Lymphocytic leukemia
affecting lymphocytes
Myelocytic leukemia
affecting granulocytes, monocytes, RBC’s, platelets
Lymphoma
neoplasm arising in lymphoid organs
Myeloma
malignant tumor of bone marrow
abnormal condition esp. imbalance of the constituents of blood
Dyscrasia
AML more common than
ALL
ALL – most common in
pediatric
ALL is associated with having more
B cells than T cells
CML - associated with
Philadelphia chromosome (translocation of chromosomes 9 & 22)
CLL- immature
lymphocytes are released, unable to ward off infection
Kostmans Syndrome
congenital neutropenia (low WBC)
In each type, overproduction of abnormal cells of that line occur, crowding out the normal cells.
Leukemia (blood cancer)
Antigen presenting cells eat the invading antigen, break it down into pieces called
Epitopes
T helpers (CD4) attach to MHC __, start an immune response (activate B cells)
2
T cytotoxic (CD8) attach to MHC __, kill infected cells
1
Primary immune response can take __ weeks
2-3
In secondary immune response B cells respond
immediately (booster shots cause 2nd immune response)
Passive immunity is much ___ than active because you already have the antibodies
Faster
Ig – most common; found in blood, lymph, CSF; involved in phagocytosis of pathogens
G
Ig – first immunoglobulin built during immune response; involved in agglutination
M
Ig – found in body secretions; involved in neutralization of pathogens
A
Ig – found on surface of B lymphocytes
D
Ig__ – involved in allergic reactions, parasitic infections
E
fibrous scar tissue makes pericardium stick to heart
Constrictive pericarditis
serous exudate fills the pericardial cavity, restricting heart expansion
Pericardial effusion
rapid accumulation of exudate compresses the heart
Cardiac tamponade
friction rub, adhesions
Fibrous exudate
pain when heart’s oxygen demand increases
Stable angina
ventricles too stiff to stretch
Restrictive cardiomyopathy
ventricles too weak to pump blood
Dilated cardiomyopathy
heart hypertrophies because it must work harder to achieve oxygenation
Hypertrophic cardiomyopathy
LV dysfunction in late pregnancy or postpartum
Peripartum cardiomyopathy
artery wall weakens and stretches into an outpouching; risk of rupture & clot formation
Aneurysm
crackles, frothy pink sputum
Pulmonary edema
heart fails to pump blood adequately (MI most common cause)
Cardiogenic shock
vasodilatory, not enough blood to circulate
Distributive shock
specialized form of lymphoma that features the presence of an abnormal cell called a Reed- Sternberg cell
Hodgkin’s Lymphoma
Hodgkin’s Lymphoma: Occurs in early adulthood (15-40 years old) and in
older adulthood (55 years or older)
Hodgkin’s Lymphoma: Characterized by the presence of large, atypical, mononuclear
tumor cells called Reed- Sternberg cells
Hodgkin’s Lymphoma: Individuals with a history of infectious
mononucleosis
Hodgkin’s Lymphoma: Most patients are present with painless enlargement of
a single node or group of nodes
Hodgkin’s Lymphoma: There may be complaints of
chest discomfort with cough or dyspnea
Hodgkin’s Lymphoma: Fatigue and ___ are often present when the disease has spread.
Anemia
The main difference between Hodgkin’s and non-Hodgkin’s lymphoma is in the specific
lymphocyte each involves
Leukemia that involves immature lymphocytes and their pregenitors that originate in the bone marrow but enter the spleen, lymph nodes, CNS, and other tissues.
Lymphocytic
Pathway: recognizes complement- fixing antibodies (IgG and IgM) of adaptive immunity bound to the surface of a microbe or another structure
Classical
Pathway: uses a plasma protein called the mannose- binding ligand (MNL) that binds to mannose residues on microbial glycoproteins or glycolipids
Lectin
Pathway: recognizes certain microbial molecules in the absence of antibody
Alternative
- Most abundant antibody (80%)
- Readily enters tissues
- ONLY immunoglobulin that crosses placenta & can transfer immunity from mother to fetus
IgG (“googoo”)→
- 1st circulating immunoglobulin to appear in response to an antigen in a NEWBORN
- Suggests a current infection in babies because sometimes inflammation & fever cannot be known.
IgM
a large bone marrow cell responsible for the production of blood thrombocytes (platelets), which are necessary for normal blood clotting.
Megakaryocyte
first Phil to show up
Neutrophils
- Highly toxic to parasitic worms
* Involved in allergic reactions & interact with basophils
Eosinophils
Prominent in allergic reactions
• Release histamine!!
Basophils
o CLL- tests show an increase in WBC greater than
20,000
o AML- normally fatal with in
o weeks if untreated. More Dangerous
o CML- Tests show WBC around
o 150,000
Kostmanns Syndrome is an inherited autosomal ____ disease
recessive
Neutrophil less than 500 chronically normally less than 200
Kostmanns Syndrome
o Fever, nausea, anorexia, ab. Discomfort, dark urine, jaundice
o RNA last 2 months
o Feces, sexual contact, water contamination Eating Food
• Hep A
o Fecal oral route
o Acute
o High mortality in pregnant women
• Hep E
o Long incubation period
o DNA
o Blood, bodily fluids, Needles drug users, sex
o Chronic Hepatitis
• Hep B
o Blood
o Drug users BLOOD TRANSFUSIONS
o Most common cause of Cirrhosis liver cancer
o Chronic Hepatitis
• Hep C
Caused by Hep B
o Drug users
o Chronic Hepatitis
• Hep D
How many liters should you urinate per day
Less than 2
the term “Leukemia” describes a reverse in the ratio of ___ to ___
RBCs to WBCs
Malignant neoplasms of cells originally derived from precursor myeloid or lymphoid tissue
Leukemia
Leukemias are classified according to whether they are acute or chronic and according to their predominant cell type (___ or ___)
lymphocytic or myelocytic
Which kind of leukemia involves immature lymphocytes
lymphocytic leukemia
Which kind leukemia has an interference with the maturation of all blood cells including granulocytes, erythrocytes, and thrombocytes
myelogenous leukemia
exposure to ___ increases risk for Leukemia
radiation
it appears that leukemia results, at least in part, from disruption in the activity of ___ that normally regulate blood cell development
genes
Acute leukemias are cancers of the hematopoietic ___ cells
progenitor cells (immature cells)
In contrast to acute leukemias, Chronic leukemias are cancers of more ___ cells
mature/developed
Acute or Chronic leukemia- depressed bone marrow function
Acute
AML is mainly a disease of __ adults
older adults
leukemia that encompasses a group of neoplasms composed of precursor B or precursor T lymphocytes
ALL
A diverse group of neoplasms affecting myeloid precursor cells in the bone marrow
AML
leukemia where normal marrow elements are replaced by an accumulation of relatively undifferentiated blast cells
AML
term for when the circulating blast count is extremely high
Leukostasis
Diagnosis of what disease requires finding leukemic cells in the peripheral blood, bone marrow, or extramedullary tissue
Acute Leukemia
Besides chemotherapy, what can be used to treat acute leukemia
stem cell or bone marrow transplant
Bone marrow transplant is contraindicated for which patients?
older than 50 years old
CLL and CML are mainly a diseases of what age group
older adults
A clonal malignancy of B lymphocytes. It’s the most common form of leukemia in adults in the western world
CLL
disease where the WBC is usually greater than 20,000
CLL
Sometimes clinicians choose not to treat CLL, but high-risk CLL is treated with
combination chemotherapy
In younger patients with high-risk ____, destroying bone marrow or non-myeloablative stem cell transplant is an option
CLL
disease characterized by excessive amount of granulocytes, erythroid precursors, and megakaryocytes
CML
The Philadelphia chromosome is associated with which leukemia
CML
disease treated with allogenic bone marrow transplant, stem cell transplant, or an inhibitor of the BCR-ABL tyrosine kinase (imatinib mesylate)
CML
Can result from decreased production of erythrocytes by the bone marrow
anemia
Deficient amount of iron leads to decreased ___ synthesis
hemoglobin
Iron in the body is used
repeatedly (not always excreted)
The most common cause of iron deficiency is
blood loss
what happens to the heart rate during anemia
tachycardia
what causes spoon shaped deformity of the finger nails
iron deficiency
smooth tongue, brittle hair and nails, eating abnormal substances
iron deficiency
B12 is needed for DNA synthesis, which is needed for __ ___ maturation
red cell maturation
B12 is needed to prevent ____ breakdown which would lead to neurologic complications
myelin
An important cause of B12 deficiency is ___ anemia
pernicious
___ anemia results from autoimmune destruction of gastric mucosa
pernicious anemia
the hallmark of B12 deficiency is _____ anemia
megaloblastic anemia (I think this means increased cell size)
When B12 is deficient, red cells are abnormally ___ in size
large
condition where the RBCs have immature nuclei and the membrane is oval shaped instead of biconcave
pernicious anemia
pernicious anemia can be reversed by
oral dose or injection of B12
Anemia is defined as an abnormally low number of ___, or low level of ___, or both
RBCs or hemoglobin
Anemias caused by premature destruction of RBC
hemolytic anemia
Anemias that result from ineffective hematopoises (premature death of RBCs in the bone marrow) are associated with inappropriately high levels of
iron absorption from the gut
Iron deficiency and B12 deficiency both cause deficient number of
RBCs
Kind of hypertension where the cause is unknown
primary hypertension
Kind of hypertension where the cause is related to a specific illness
secondary hypertension
Between primary and secondary, the most common hypertension is
primary
Family history, race, and age are ___ risk factors in hypertension
Constitutional risk factors (part of primary hypertension)
primary hypertension is aka
essential hypertension
An infant’s BP is much ____ than an adult’s
lower
The goal of treating hypertension for diabetic patients is to reduce BP to
less than 130/80
the goal of treating hypertension is to reduce BP below
140/90
Most MIs are caused by
CAD (coronary artery disease)
MI often involves the rupture of ___ which leads to blockage of an artery
plaque
If the the sickled cell hasn’t been repeatedly damaged, it can return to its normal shape with _____ in the lungs
oxidation
The abnormal hemoglobin in sickle cell anemia is called
HbS
The 2 major consequences of RBC sickling
hemolytic anemia and blood vessel occlusion
during sickle cell, RBCs are destroyed prematurely (since they’re deformed). This decrease in the number of RBC causes ___ ___
hemolytic anemia
Lifespan of RBC in sickle cell anemia is __ days
20 days
In sickle cell, pain and tissue ischemia is caused by blood vessel ____
occlusion
___ reduces the affinity of hemoglobin of oxygen, increasing sickling
acidosis
During sickle cell, damage to what organ makes the person vulnerable to infections
spleen
an inhibitor of DNA synthesis that has been shown to reduce pain crises and prevent complications of sickle cell anemia
hydroxyurea
Which leukemia is most common among children/adolescents?
ALL (acute lymphocytic leukemia)
Treatment includes giving the patient G-CSF
Kostmann syndrome
