Refined Notes Deck Exam 2

Question 1

Development pathway of an RBC

Answer 1

Pluripotential hematopoietic stem cell -> CFU-S (committed to the myeloid line) -> CFU-B -> CFU-E -> proerythrocyte -> reticulocyte -> erythrocyte

Question 2

Ferritin

Answer 2

The storage form of iron in the liver

Question 3

Apotransferrin and transferrin

Answer 3

The transporter molecule of iron in the blood stream, apotransferrin lacks bound Fe and becomes transferrin upon binding Fe.

Question 4

RBC metabolism

Answer 4

Free hemoglobin from lysed rbc’s that have become too old are digested by macrophages into porphyrin (able to be broken down) and bilirubin (unable to be broken down, continues to circulate thru the blood stream, liver should remove)

Question 5

Megaloblastic anemia

Answer 5

Caused by vitamin B9 or B12 deficiency, cannot form proper biconcave disk shape of RBC and thus have large, nonfunctional cells

Question 6

Microcytic/hypochromatic anemia

Answer 6

Caused by iron deficiency, small pale RBC’s that cannot carry enough hemoglobin

Question 7

Aplastic anemia

Answer 7

Anemia brought on by death of bone marrow cells that produce RBC’s, often due to toxin or chemo exposure

Question 8

Pernicious anemia

Answer 8

Anemia brought on by conditions such as gastric bypass which prohibit a patient from being able to absorb enough B12 and thus are deficient

Question 9

Hemolytic anemia

Answer 9

Anemia brought on by the lysing of RBC’s either by mechanical action or because of underlying disease

Question 10

Polycthemia vera

Answer 10

Primary polycthemia, unregulated RBC production resulting in high hematocrit and viscous blood

Question 11

secondary polycthemia

Answer 11

Excess RBC in blood brought on by a secondary condition such as high altitude, COPD, etc.

Question 12

Inflammation fibrinogen mechanism

Answer 12

Fibrinogen forms clots at the site of infection walling off the area and preventing fluid drainage after vascular leakiness has occurred, resulting in sustained tissue edema for prolonged period of time during infection

Question 13

D antigen

Answer 13

The most immunogenic antigen on the surface of certain people’s RBC’s, form the basis of the rhesus factor Rh with individuals being Rh positive (they have the D antigen and thus no antibodies against it) or Rh negative (they lack the D antigen and thus have antibodies against it)

Question 14

Tomograms

Answer 14

3D generated panoramic images from x ray radiation

Question 15

Radiograph

Answer 15

2D generated image from x ray radiation, used to see bone or foreign objects in body

Question 16

Ultrasound

Answer 16

Imaging technique using soundwaves and their densities, useful for visualizing vasculature, fluid filled structure

Question 17

IV enteral contrast dye

Answer 17

Injection of a contrast dye to visualize different aspects of the enteric system, useful for seeing hollow organs

Question 18

Angiogram

Answer 18

Inserting contrast dye into vessels to pick up occlusion

Question 19

CT

Answer 19

Fancy computerized radiograph that plots millions of points together simultaneously to create a highly detailed image, used to see bone or organs

Question 20

MRI

Answer 20

No radiation magnetic imaging technique good for visualizing soft tissue

Question 21

PET scan

Answer 21

Scan that detects metabolic activity of tissues, often used in cancer screening

Question 22

The issue with interpreting lab tests

Answer 22

Some people that fall into the sick category of a test are not sick, just have physiological variation. And vise vers

Question 23

Sensitivity

Answer 23

Measure of a test’s ability to pick up a positive value (regardless of false positives), a sensitive test with a negative diagnosis rules out a condition

Question 24

Specificity

Answer 24

Measure of a test’s ability to determine negative values (regardless of false negatives), a specific test with a positive diagnosis rules in a condition

Question 25

Positive predictive value

Answer 25

Proportion of patients with a positve test who truly have the disease

Question 26

Type 1 error

Answer 26

false positive

Question 27

Type 2 error

Answer 27

false negative

Question 28

Negative predictive value

Answer 28

Proportion of patients with a negative test who truly do not have the disease

Question 29

PPV=

Answer 29

(true positives/(true positives+false positives))

Question 30

NPV

Answer 30

(True negatives/(true negatives+false negatives))

Question 31

5 components to be discussed in the patient treatment plan

Answer 31

1) Pending studies (stuff we are waiting results on that we will reach out to the patient about if the results are normal or if we need to discuss) 2) Treatment plans (medications, physical activities, diets, behavioral changes, patient education, preventative issues) 3) Follow ups (both in the event of an emergency what to do and when we need to follow up weeks or months) 4) Referrals (to specialists, PT, nutritionists) 5) Provider notes (notes to self for future reference or things to keep in mind)

Question 32

Informed consent

Answer 32

Informed consent is the legal and ethical responsibility of the provider to inform the patient of the various risks and benefits associated with a treatment plan in terms that they can understand so they can make educated and informed decisions regarding their course of treatment.

Question 33

List 4 mandatory questions to ask every time you order a medication

Answer 33

Any prior drug allergies? Any chance you could be pregnant? Any other medications? Any prior reactions to any medications in the past