PATHO: MODULE 6: BLOOD DISORDERS Flashcards
What does blood do?
-transports O2 & nutrients to body cells
-carries away CO2 & metabolic wastes
What do arteries do?
blood AWAY from the heart
What do veins do?
Return blood back to the heart
What do capillaries do?
microcirculation within tissues
What is systemic circulation?
carries oxygenated blood from the left ventricle to the arteries, to the capillaries and then to the tissues of the body
what is pulmonary circulation
carries de-oxygentaed blood from the heart to the lungs to be re-saturated with oxygen before being transported into the systemic circulation
What do erythrocytes do?
blood cell made produced by bone marrow + carries oxygen for the lungs to all parts of the body
What do leukocytes do?
WBC in charge of inflammation + immunity
What do platelets do?
help blood clot
What are some diagnostic tests that evaluate blood and lymphatic systems?
CBC, differential WBC, morphology, hematocrit, hemoglobin, reticulocyte count, chemical analysis, coagulation studies.
causes of iron deficiency ANEMIA?
insufficient IRON impairs hemoglobin synthesis
-diet intake
-chronic blood loss
-impaired absorption
-liver disease
What are the signs and symptoms of iron deficiency?
Pallor, fatigue, lethargy, cold intolerance, irritability, degenerative changes - brittle hair, spoon shaped & rigid nails, stomatitis and glossitis, menstrual irregularities, delayed healing, tachycardia, heart palpitations, dyspnea, syncope
What are the available treatment options for iron deficiency?
Fix underlying cause! Iron rich foods & supplements, ensure iron is taken with food
causes for pernicious ANEMIA?
-deficiency of vitamin b12
-most common, malabsorption
-gastric bypass, chronic gastris, autoimmune
What are the signs and symptoms for pernicious anemia?
-Tongue is red + FAT
-Decreased gastric acid = digestive discomfort.
- N/V
-Tingling or burning in extremities, loss of muscle control/coordination - ataxia
what does ATAXIA mean??
dizziness, restlessness, muscle weakness
Treatments for pernicious anemia?
-Microscopic exam
-bone marrow exam
-hypochlorhydria or achlorhydria
What is the usual course for pernicious anemia?
without B12, bone marrow produces megaloblastic RBC’s
-carry less hemoglobin
-shorter life span
-VERY large, immature, nucleated erythrocytes
CAUSE of aplastic anemia?
-impairment of failure of bone marrow
-LOW with all cell (RBC, WBC and platelets)
What are the signs and symptoms of aplastic anemia?
Anemia
pallor
weakness,
dyspnea,
leukopenia, thrombocytopenia,
Treatment for aplastic anemia?
-Blood transfusion
-Bone marrow transplant
-Chemotherapy
-radiation
-Stem cell therapy.
Course for aplastic anemia?
Blood counts =pancytopenia
bone marrow biopsy required
Causes of sickle cell anemia?
“Hemolytic Anemias”
-Abnormal hemoglobin, shape has changed from disc to crescent “sickle”
-Cell membrane is damaged, leading to hemolysis.
signs and symptoms for sickle cell anemia?
Pallor
weakness,
dyspnea,
tachycardia
, jaundice (hyperbilirubinemia),
splenomegaly,
***HIgh rate of hemolysis of RBC’s, hemoglobin->heme->can lead to hyperbilirubinemia->jaundice, gallstones
treatment for sickle cell anemia?
-Use of hydroxyurea reduces frequency of crisis.
-Dietary supplements of folic acid
-Penicillin
What is the usual course for sickle cell anemia?
Dominant in Africa and middle east. Sickle cell crisis
What is sickle cell crisis?
-oxygen levels =lowered
-RBCs block blood flow through tiny blood vessels to your chest, abdomen and joints = HIGH PAIN
What is sickle cell crisis?
sudden pain throughout body, result from sickle cells clumping in blood stream. Block the blood flow through blood vessels in limbs and organs. Increased hemolysis and bilirubin.
What are the causes of hemophilia A?
Deficit or abnormality of clotting factor VIII. Most common inherited clotting disorder
What are the signs and symptoms of hemophilia A?
Prolonged or severe hemorrhage following minor trauma, persistent oozing of blood & hematomas are common, spontaneous hemorrhage into joints, eventually causing painful and crippling deformities resulting from recurrent inflammation, blood may appear in urine or feces.
What are the available treatments for hemophilia A?
Proper precautions! Desmopressin medication can raise clotting factor levels, replacement therapy.
What is the usual course of hemophilia A?
Bleeding and PT are normal, but PTT and aPTT and coagulation time are prolonged
*Rarer in women
What is the cause of Von Willebrand Disease?
Hereditary blood clotting & bleeding disorder.
*Deficiency of von Willebrand factor that helps platelets clump and stick to the walls of blood vessels where damage has occurred
What are the signs and symptoms of Von Willebrand Disease?
Skin rashes, frequent nosebleeds, easy bruising, bleeding gums, abnormal menstruation.
What are the available treatments/diagnostic tests for Von Willebrand Disease?
T: Based on type and severity. Surgery, tooth extraction, accident trauma, desmopressin.
*Women = birth control
Dx: bleeding time, blood typing, platelet count and aggregation test
What causes disseminated intravascular coagulation?
life threatening condition, excessive bleeding with excessive clotting. blood counts may be normal or abnormal, usually caused by chronic infection and thromboembolism.
What are the signs and symptoms of disseminated intravascular coagulation?
Low plasma fibrinogen present, thrombocytopenia occurs, prolonged bleeding time, PT, aPTT, and thrombin time are noted
low blood pressure and shock, bloody nose, hematuria, infarcts on brain or other organs, respiratory impairment - dyspnea and cyanosis, neurologic = seizures & decreased responsiveness, acute renal failure with oliguria - accompanies shock
What are the available treatments for disseminated intravascular coagulation?
Underlying cause needs to be treated first - infection needs to be treated successfully and the major current problem (excessive clotting or hemorrhage).
Causes of polycythemia? primary and secondary)
1) Primary polycythemia-polycthemia vera:
2) Secondary polycythemia-erythrocytosis:
1) Primary polycythemia-polycthemia vera:
-increased production of Erythrocytes and other cells in bone marrow
-Neoplastic disorder
-Serum erythropoietin levels =LOW
-increased Blood volume and viscosity
2) secondary polycythemia-erythrocytosis:
-increased in RBCs in response to prolonged hypoxia
-increased erythropoietin secretion
-increased oxygen transport
signs and symptoms of polycythemia?
-heahaches
-blurred vision
-red skin
-HIGH BP
-confusion
Treatments for polycythemia?
-Drugs
-radiation
-periodic (phlebotomy) using a needle in the vein
cause of acute lymphatic &myelogenous leukemia?
when a bone marrow cell develops changes (mutations) in its genetic material or DNA.
signs and symptoms of acute lymphatic & myelogenous leukemia?
-Bleeding from the gums.
-Bone pain.
-Fever.
-Frequent infections.
-nosebleeds.
treatments for acute lymphatic &myelogenous leukemia?
Chemotherapy.
Targeted therapy. …
Radiation therapy. …
Bone marrow transplant. …
What is the usual course of acute lymphatic &myelogenous leukemia?
Peripheral blood smears, immature leukocytes & altered numbers of WBCs, number of RBCs and platelets decreased, bone marrow biopsy.
cause of CHRONIC lymphocytic &myelogenous leukemia?
genetic mutations that affect the way your body produces blood cells
S/S of CHRONIC lymphocytic &myelogenous leukemia?
-weightloss
-bleeding
-bruising
-large lymph nodes
What are the available treatments of chronic lymphocytic &myelogenous leukemia?
*Same as acute
chemotherapy &biologic therapy
What are some complications of leukemia?
opportunistic infections, sepsis, CHF, hemorrhage, liver failure, renal failure, CNS depression & coma
CAUSE of hodgkin lymphomas?
a change (mutation) in the DNA of a type of white blood cell called B lymphocytes
s/s of hodgkin lymphomas?
-Painless swelling of lymph nodes in your neck, armpits or groin.
-always tired
-Fever/Night sweats.
-weightloss
treatments of hodgkin & non-hodgkin lymphomas?
Radiation, chemotherapy, surgery
What is the usual course of hodgkin lymphomas?
Spreads in sequence. Staging and prognosis is dependant on # of nodes, and location.
cause of non-hodgkin lymphomas?
a change (mutation) in the DNA of a type of white blood cell called lymphocytes
-infection w/ certain viruses and bacteria: ulcer-causing Helicobacter pylori
What are the signs and symptoms of non-hodgkin lymphomas?
Enlarged, painless, lymph node. General signs of cancer.
What is the usual course of non-hodgkin lymphomas?
Less predictable spread, reed-stenberg cells not present, wide spread, 5th most common
What are the causes of multiple myeloma?
Neoplastic disease that involves increased production of blood plasma cells in bone marrow.
impaired production of blood cells, loss of bone, severe bone pain
What are the signs and symptoms of multiple myeloma?
frequent infections related to antibodies, pathologic fractures, anemia and bleeding
*kidneys are affected
What are the available treatments of multiple myeloma?
Chemotherapy, analgesics for bone pain
What is the usual course of multiple myeloma?
Pathogenic or spontaneous fractures at weakened sites. Poor prognosis, short life expectancy.
Causes of lymphedma?
Obstructed lymph vessels - edema due to accumulation of lymph
-can be caused by cancer treatments that damage or remove lymph nodes
What are the signs and symptoms of lymphedma?
Swelling in extremities.
*Initially: soft, progression: firm, painful, unresponsive to treatment.
**Chronic lymphedema may lead to infections, high fever, chills.
treatments of lymphedma?
Diuretics
bed rest
elevation.
Severe = removal of affected tissue and surrounding fascia
describe the blood smear test
characteristic of individual cells, different types of ANEMIAS distinguished this way
describe the blood smear test?
Describe what HEMATOCRIT blood work is
% of blood volume composed of RBC’s and indicates fluid and cell content
LOW RBC’s= anemia
describe bone marrow function?
Reticulocyte count (immature non nucleated RBC)
-aspiration and biopsy
describe chemical analysis blood work
-serum levels on iron
-vit b12
folic acid
-cholesterol
-urea
-glucose
-bilirubin
describe bleeding time (blood work)
measures platelet formation,prothrombin time OR INR AND PTT
Primary polycythemia- polycythemia vera
Electrocardiography test
Useful in the initial diagnosis and monitoring of dysrhythmias, myocardial infarction, infection, pericarditis
Auscultation
Determination of valvular abnormalities or abnormal shunts of blood that cause murmurs
Detected by listening through a stethoscope
Blood test, Troponin
Blood test is used to measure the levels of blood proteins called troponins.
These proteins are released when cardiac muscle has been damaged
Chest x-ray films
Used to show shape and size of the heart
Nuclear imaging
Tomographic studies
Cardiac catheterization
Measures pressure and assesses valve and heart function
Determines central venous pressure and pulmonary capillary wedge pressure
Angiography
Visualization of blood flow in the coronary arteries
Doppler studies
Assess blood flow in peripheral vessels
Record sounds of blood flow or obstruction
Blood tests
Assess levels of troponin, serum triglycerides, cholesterol, sodium, potassium, calcium, other electrolytes
Arterial blood gas determination
Checks the current oxygen level and acid-base balance
