pericardial disorders

Question 1

what is pericarditis?

Answer 1

inflammation of the pericardium (lining around outside of heart)

• vasodilation, swelling, cellular respiration
• due to infection or any other form of injury

Question 2

inflammation leads to….

Answer 2

increased capillary permeability—> fluid fills pericardium—-> moves into pericardial space when full—> exudate in pericardial space

Question 3

fibronous or fluid exudate?

Answer 3

-fluid exudate easier to remove, fluid can be displaced throughout chambers, fibrinous= WORSE, fixed plaque
BOTH restrict cardiac function

Question 4

constrictive pericarditis?

Answer 4

fibrinous scar tissue

Question 5

manifestations (pericarditis triad)

Answer 5

1. chest pain aggravated by movement and breathing
2. pericardial rub heard on auscultation of heart (friction rub)
3. changes in ECG (constantly changing)

Question 6

diagnosis of pericarditis?

Answer 6

-mfts, ECG, x-ray, echocardiogram

Question 7

treatment of pericarditis?

Answer 7

-based on cause, but usually anti-inflammatories and antibiotics

Question 8

what is cardiac tamponade?

Answer 8

• external pressure on the heart (compression), develops secondary to pericarditis (pressure from fluid accumulation)
• can also be caused by other things

Question 9

cardiac tamponade is due to?

Answer 9

-accumulation of fluid, pus (bacterial infection) or air in the pericardial space

Question 10

obstructive shock?

Answer 10

cardiac tamponade–> impacts filling and emptying, life threatening

Question 11

manifestations of cardiac tamponade?

Answer 11

• decreased CO, decreased arterial pressure

- hypoxia and hyperperfusion—> shock responses induce tachycardia (only temporary bc there is an obstruction)

Question 12

treatment of cardiac tamponade?

Answer 12

-pericardiocentesis (removal of fluid within pericardial space)

Question 13

lymphoid stem cell gives rise to…

Answer 13

t & b lymphocytes, NK cells

Question 14

myeloid stem cell gives rise to…

Answer 14

monocytes, granulocytes, platelets and rbcs

Question 15

leukemia=

Answer 15

proliferation of WBCs that are present in the circulation

Question 16

leukemia has increased prevalence in?

Answer 16

children and young adults

Question 17

lymphocytic leukemia=

Answer 17

cancer of the lymphoid stem cell line

Question 18

myelogenous leukemia=

Answer 18

aka granulocytic leukemia, cancer of the myeloid stem cell line

Question 19

higher up in the stem cell line being affected means…

Answer 19

WORSE prognosis because it is in the less mature cells, less differentiated

Question 20

leukemia can be…

Answer 20

ACUTE or CHRONIC lymphocytic or myelogenous

Question 21

acute is…

Answer 21

more aggressive, blast cells are impacted (immature cells, higher up)

Question 22

chronic is…

Answer 22

surviving longer term, treatment to control

• less aggressive
• mature less impacted (lower down)

Question 23

etiology of leukemia?

Answer 23

-idiopathic= mutated genes, cause hard to identify

Question 24

risk factors for leukemia?

Answer 24

-smoking
-genetic predisposition
-immunodeficiency
-radiation exposure–>forms free radicals that impact normal cells DNA
-t-cell leukemia virus (gets inside T cells and takes genetic info)
….this impacts other cells (RBCs challenged for space, decrease number, less O2 carrying capacity) impaired IR

Question 25

manifestations of leukemia?

Answer 25

• anemia, thrombocytopenia, leukopenia
• bleeding d/t decreased platelets
• generalized pain
• infections d/t impaired IR—> fever
• fatigue and weakness from decreased O2

Question 26

diagnosis for leukemia?

Answer 26

simple! blood and bone marrow evaluation

Question 27

treatment for leukemia?

Answer 27

• radiation and treatment
• antimicrobials
• colony stimulating factors (substance regularly secreted by the bone marrow that promotes growth and differentiation of stem cells into colonies of specific blood cells (used to increase production of blood cells)
• marrow or stem cell transplant—> must be typed and matched—> SEVERE

Question 28

how does radiation work?

Answer 28

1. induction (induce remission)
2. consolidation (aka intensification, decrease number of leukemia cells still in body)
3. maintenance (decrease dosage and maintain normal function for a few years)

Question 29

intrathecal chemo is?

Answer 29

receiving drugs via lumbar puncture into spinal cord to kill any cells that may have spread to brain or spinal cord
-if CA cells get into CNS, pt normal fx will decrease, no space!!!