Patho Quiz 4 Flashcards
Why might a splenectomy be used to treat anemia?
Because the spleen is where destruction of RBCs occur so removing it may help conserve them.
What is a major complication of a splenectomy?
Hemolytic anemia (bleed to death), and infection.
What is a clinical manifestation of Sickle Cell Anemia?
Elevated Bilirubin.
Why are Sickle Cell Anemia patients often mistaken for drug seekers?
They often only visit the hospital during major exacerbations and are often familiar with what pain medications work.
What does the Oxygen-Hemoglobin Dissociation Curve represent?
Represents the proportion between hemoglobin (Oxygen carrier) to absorbed Oxygen.
What is absolute anemia?
Actual decrease in red cells.
What has to be activated for prothrombin to be converted to thrombin?
Factor Xa
Why might a D-Dimer be drawn?
To identify if a clot is present (DVT, PE, etc.)
Disseminated Intravascular Coagulation (DIC) can occur as a result of what triggering events?
Malignancy, sepsis, snake bite, trauma, severe liver disease.
Why does DIC occur?
The coagulation factors are quickly used up.
How is DIC treated?
Treat initial cause (ie. sepsis) and clotting factors.
Your patient on coumadin therapy will need to have routine evaluations of their?
PT, INR
The conversion of the prothrombin to thrombin is the start of which pathway?
Common final pathway.
What organ secretes erythropoietin?
The kidneys.
What organs reabsorb red blood cells?
In the liver and spleen.
What is the cause of anemia in patients with chronic renal failure?
Failure of renal function impairs erythropoietin production (which stimulates the production of RBCs, which causes the cessation of production).
What happens to RBCs in Thalassemias anemia?
Increased RBC destruction resulting in decreased RBC survival rates
What are two things that patients with Sickle Cell Anemia should avoid?
Extreme cold temperatures and high altitudes.
When would you hear a bruit?
Fistulas, partial Carotid blockage, when taking a blood pressure manually.
What skin temperature would you expect to find in a venous clot? For an arterial clot?
Warm skin, cool/cold skin
What are the 6 P’s (S&S) or an acute arterial occlusion?
Pallor, paralysis, polar, paresthesia, pain, and pulselessness
How does blood flow?
From high pressure to low pressure (right atrium has the lowest pressure)
What is the relationship in length of diastole and systole?
Diastole is twice as long as systole.
What does the flat line between P and R on an EKG?
It represents the time from the start of atrial depolarization to the start of ventricular depolarization. It includes the delay in conduction that occurs at the AV node.
The which nodes supply the right coronary artery?
AV node and Bundle of His
What the human body’s backup pacemaker when the SA node does not work?
AV node.
How is our heart rate determined?
By the autonomic nervous system.
How is a pulse determined?
Cardiac output-amount of blood pumped out of the heart each minute.
How is cardiac output determined?
Stroke volume X heart rate.
What are ways to manage heart contractility?
Calcium, Potassium, Phosphate, Magnesium, Inotropic agents (Digoxin).
What are the functions of ANP and BNP and what can they be used to indicate?
Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) are hormones secreted to enhance the excretion of sodium and water by the kidneys to lower cardiac output. BNP can be used to diagnose heart failure (higher the BNP, worse the heart failure).
What is the difference between aginal and MI chest pain?
Angina chest pain is exertional while MI chest pain is not.
Left main coronary artery occlusion blocks flow from where?
Through the left circumflex and left anterior descending.
What kind of patients are most likely to have a silent MI?
DM and very elderly patients (impaired nervous system).
What is Beck’s Triad and what does it indicate?
Distended neck veins, narrowing pulse pressure, muffled heart tones–Cardiac Tamponade.
What are the two main causes of diastolic dysfunction?
Coronary artery disease and HTN
What is the cardinal symptom of left heart failure?
Dyspnea.
Which two types of heart failure present with the same symptoms?
Right sided forward HF and left sided forward HF
What are the differences between Venous and Arterial Thrombosis (clot)?
Arterial- Cool, cyanotic, diminished peripheral pulse. Venous- calf tenderness, edema, warm, red
Differences between Arterio/Atherosclerosis?
Athero- plaque build up. Arterio- hardening
What does the P-wave on an EKG symbolize?
The Atrial “kick”
What effects Stroke Volume?
Preload, Contractility, and Afterload.
Where is ANP and BNP produced and secreted?
ANP -Atrium. BNP- Ventricles
What are the three different patterns of angina pectoris?
Stable (typical), prinzmetal (variant), crescendo (unstable)
What qualifies as prinzmetal angina?
Vasospasm (or closing) of non-obstructed veins.
What qualifies as crescendo angina?
Worsening state of stable angina.
What qualifies as stable angina?
Pain on increased cardiac workload, onset is predictable and relieved with rest and NTG (nitroglycerin)
What are the three diagnostic indicators of a MI?
EKG, Biomarkers (troponin, creatinine, & myoglobin), S/S (pain in the area between shoulder blades, chest, jaw, left arm, or upper abdomen, feeling of impending doom, chest pressure)
What is the area of a muscle called that can not be reinfused and restarted after an occlusion?
Zone of Infarction
What are the two biggest complications with MI?
Cardiac Dysrhythmias, HF
What are the two valve diseases to know and an explanation of them?
Stenosis-failure of the valve to open completely results in extra pressure work for the heart
Regurgitation- inability of a valve to close completely results in extra volume work for the heart
What are two myocardial diseases to know and an explanation?
Myocarditis: inflammatory disorder of the heart muscle characterized by necrosis and degeneration of myocytes
Cardiomyopathy: may be genetic or acquired and is noninflammatory
What is myocardial tamponade?
External compression of the heart chambers such that filling is impaired
What are the three main causes of HF?
In order it is MI, HTN, DM T2
What is the biggest problem with HF?
Reduced CO.
What are S/S of Left sided HF?
Leads to a backup of fluid in the lungs (pulmonary edema)
What are S/S of Right sided HF?
Leads to a backup of fluid in the lower extremities (such as pedal edema)