Unit 2 - Diseases of blood, lymph, and endocrine systems Flashcards
Anemia of chronic disease
Compromised ability to produce red blood cells, including cancer, Crohn’s disease, HIV/AIDS, kidney failure, rheumatoid arthritis, and some chronic inflammatory diseases
True or false: Inhaled corticosteroid drugs are the most common cause of Cushing Syndrome related to drugs.
False. Inhaled steroids usually do not bring on Cushing syndrome unless high doses are taken.
What is the cause of Cushing disease?
Abnormally high cortisol levels
What are the characteristic features of Cushing syndrome?
A moon face and a fatty hump between the shoulders
Drugs that can cause Cushing syndrome
Use of corticosteroids over an extended amount of time can lead to development of Cushing
syndrome. Oral and injectable corticosteroids are the main causes; inhaled steroids usually do
not bring on Cushing syndrome unless high doses are taken.
How is hemophylia categorized?
Hemophilia is categorized as A, B, and C, with A being the most mild form and C being the most
serious
Treatment for von Willebrand disease
Mild forms do not require treatment. Patients should avoid drugs such as aspirin or ibuprofen that extend bleeding time.
More severe cases require medication to
control excessive bleeding. von Willebrand disease can cause menstrual bleeding to last longer than 7 days, contraceptives are often prescribed to control menstrual bleeding
Treatment for hemophilia
Clotting factor is infused into the blood stream to help prevent bleeding. The amount
depends on the severity of the condition
Why should patients with bleeding disorders wear medic alert bracelets?
Surgeries and serious injuries, like car accidents, can be especially dangerous to patients with
bleeding discords. For this reason, doctors recommend patients wear medical alert bracelets in
case of accident.
Complications of untreated hyperthyroidism
Eye problems: Graves’ disease can affect eye tissue, leading to red, swollen eyes;
bulging of the eyes; blurred or double vision; and/or sensitivity to light. Vision loss can
occur.
• Heart problems: Hyperthyroidism can seriously affect the heart, causing an abnormally
fast heart rate, atrial fibrillation, and possibly congestive heart failure. Treatment can
alleviate the symptoms.
• Osteoporosis: Extra thyroid hormone can interfere with the amount of calcium in the
bones.
• Skin redness and swelling: Graves’ dermopathy causes redness and swelling in the skins
and feet.
• Thyrotoxic crisis: When symptoms intensify suddenly, thyrotoxic crisis can result.
Symptoms become more acute, and a rapid pulse, fever, and possibly delirium can
result. Immediate medical attention is required.
Causes of iron deficiency anemia
Heavy
menstrual bleeding, cancer, ulcers, a polyp in the digestive system, or extended use of NSAIDs
can lead to iron deficiency anemia.
Causes of vitamin deficiency anemia
Folate or B12 deficiency
Aplastic anemia
Aplastic anemia is a rare, life- threatening form of anemia caused when the bone marrow is
unable to make red blood cells. Infections, autoimmune diseases, and drugs can cause aplastic
anemia.
Hemolytic Anemia
Hemolytic anemias can be inherited or can develop later in life. These anemias refer to the
condition whereby the body destroys red blood cells at a rate faster than the bone marrow can
produce.
Anemias Associated with Bone Marrow Disease
Conditions of the bone marrow like leukemia or myelodysplasia can reduce the bone marrow’s
ability to produce healthy red blood cells. Sometimes these conditions halt production entirely,
which is a life- threatening situation.
Sickle cell anemia
Sickle cell anemia is an inherited form of anemia resulting from defective hemoglobin where red
blood cells are formed in an abnormal, sickle shape. The blood cells die prematurely, causing a
continuous shortage of red blood cells. Sickle cell anemia is genetic condition most often found
in persons of African descent.
Diagnosis of anemia
A complete blood count (CBC) counts the number of blood cells within a sample of blood to
determine how many red blood cells are circulating in the body. Different forms of anemia
cause changes in the size, shape, and color of the red blood cells, so cells are examined for such
abnormalities. Other tests may be advised to find the underlying cause of the anemia, such as
polyps or bleeding ulcers that may be contributing to the condition. Sometimes samples of bone
marrow are tested.
Treatment of anemia
Changes in diet • Dietary supplements • Medications • Blood transfusions • Bone marrow transplant • Chemotherapy • Plasmapheresis In cases of inherited anemia, genetic counseling may be in order to discuss the risks of passing the condition on to offspring.
Polycythemia vera
Polycythemia vera occurs when the bone marrow produces too many red blood cells. A rare
condition, polycythemia vera develops slowly, allowing the extra red blood cells to thicken the
blood.
What mutation is responsible for polycythemia vera?
JAK2. This mutation is likely not inherited
Most common age of onset and affected demographic for polycythemia vera
The condition generally does not occur until older adulthood and is more
common in adults over age 60. Polycythemia is more prevalent in men than in women and is
often associated with a family history of the condition.
Symptoms of polycythemia vera
Early disease causes no symptoms
Headache
• Dizziness
• Skin itchiness
• Skin redness
• Shortness of breath
• Breathing difficulty, particularly when lying down
• Numbness, weakness, tingling, or burning of the hands, feet, arms, or legs
Fatigue
• Fullness or bloating in the left upper abdomen due to an enlarged spleen
Complications associated with polycythemia vera
Blood clots: Thick blood flows slower than normal, so increased blood thickness coupled
with decreased blood flow can lead to blood clots. Blood clots are associated with
stroke, heart attack, pulmonary embolism, or deep vein thrombosis.
• Splenomegaly: The increased number of blood cells causes the spleen to become
overtaxed, leading to an enlargement of the spleen.
• Skin problems: Itching, burning, and/or tingling in the arms, legs, hands, or feet,
especially after sleeping in a warm bed or taking a warm shower are common. The skin
on the face may also appear red.
• Open sores: Particularly in the inside lining of the stomach, upper small intestines, or
esophagus
• Inflammation of the joints
• Other blood disorders: Polycythemia vera may lead to myelofibrosis (scar tissue
replaces bone marrow); myelodysplastic syndrome (stem cells don’t function properly
or mature correctly); or leukemia.
Hyperglycemic hyperosmolar nonketotic
syndrome (HHNS
A life-threatening condition that results when a diabetic patient’s blood glucose rises over 600 mg/dL
Blood test results that confirm a diagnosis of polycythemia vera
Increased number of red blood cells
• Elevated hematocrit measurements
• Elevated hemoglobin levels
• Low levels of erythropoietin (EPO)
Additional tests for polycythemia vera
A bone marrow aspiration or biopsy may be performed to collect a sample to test for
abnormally high levels of blood cells. Additional analysis of the bone marrow and blood may
reveal the gene mutation associated with the condition.
Treatment for polycythemia vera
Polycythemia vera is incurable, but must be managed to control the signs and symptoms and
prevent complications. Drawing blood from the veins reduces the amount of blood cells and
blood volume circulating in the body. This is known as phlebotomy. The severity of the condition
dictates how frequently phlebotomy is performed. Medications can also be prescribed to limit
the production of red blood cells and stimulate the immune system to rid the body of excess re d blood cells. Low- dose aspirin can help guard against blood clots, and antihistamines or
ultraviolet light therapy can reduce itching.
Moreover, stretching and exercise can help improve blood circulation throughout the body.
Tobacco causes the blood vessels to narrow and should be avoided. Moreover, poor circulation
causes sores to take longer to heal, which can lead to infection. The hands and feet are
particularly vulnerable.
Leukemia
Cancer of the blood- forming tissues, such as the bone marrow and lymphatic system
Acute leukemia
Abnormal blood cells are immature and multiply quickly
Chronic leukemia
Mature blood cells reproduce incorrectly and gradually build up over
time.
Lymphocytic leukemia
The lymphoid cells are affected.
Myelogenous leukemia
• Myelogenous leukemia:
What is the most common form of leukemia in children?
Acute lymphocytic leukemia
What are the four major types of leukemia?
Acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myelogenous leukemia, and chronic myelogenous leukemia
Acute lymphocytic leukemia (ALL)
Abnormal blood cells are immature and multiply
quickly. The lymphoid cells are affected. ALL is the most common form of leukemia in
children.
Most common form of acute leukemia in adults
Acute myelogenous leukemia (AML)
Acute myelogenous leukemia (AML)
Myeloid cells are affected. The immature cells
cannot carry out their work and multiply quickly. AML is the most common form of
acute leukemia and the most common form in adults.
Chronic lymphocytic leukemia (CLL):
Mature cells within the lymphatic system form
incorrectly and build up in the body over time. CLL is commonly diagnosed in adults. A
person with CLL may feel fine for years before needing treatment.
Chronic myelogenous leukemia (CML):
CML produces few or no symptoms for months
or years before leukemia cells begin to grow rapidly. An abnormal chromosome known as the Philadelphia chromosome (Ph chromosome) is associated with this form of
leukemia. CML is most prevalent in adults.
What form of leukemia is associated with the Philadelphia chromosome?
CML.
Risk factors for leukemia
Family history of leukemia • Previous cancer treatment • Genetic abnormalities, such as Down syndrome • Some blood disorders • Exposure to certain chemicals • Exposure to high levels of radiation • Smoking
What do early symptoms of leukemia resemble?
Influenza
Symptoms of leukemia
Easy bleeding or bruising • Fever or chills • Continuous fatigue • Weakness • Swollen lymph nodes • Enlarged liver or spleen • Frequent infections • Unexplained weight loss • Petechiae (red spots on the skin) • Night sweats • Bone tenderness or pain
Diagnosis of leukemia
Chronic forms of leukemia can be found via routine blood tests before symptoms appear.
Unusual levels of white blood cells or platelets can indicate the presence of leukemia. If
leukemia is suspected, a bone marrow test is ordered to look for leukemia cells within the bone
marrow.
Treatment of leukemia
Treatment of leukemia is based on type, severity, stage, patient’s age, patient’s health, and
whether or not the leukemia has spread to other parts of the body. Radiation and
chemotherapy are often used to treat leukemia. Other treatments include medication, biological
therapy to encourage the immune system to attack leukemia cells, and stem cell transplants.
Two most common types of lymphoma
Hodgkin lymphoma and non- Hodgkin lymphoma.
Lymphoma
Lymphoma is a cancer affecting cells within the lymphatic system, specifically lymph node cells
or lymphocytes. There are many kinds of lymphomas; the most common are Hodgkin lymphoma
and non- Hodgkin lymphoma. The difference between the kinds of lymphomas results in which
particular lymphocyte, a type of white blood cell, the cancer affects.
Most common type of lymphoma
Non-Hodgekin
Non-Hodgkin lymphoma
For unknown reasons,
abnormal lymphocytes are produced. These lymphocytes continue to grow and divide, but do
not die as normal cells do. The abnormal lymphocytes build up in the lymph nodes, causing the
nodes to swell. Cancerous lymphocytes are usually present in the lymph nodes and can spread
to other areas of the lymphatic system, like the spleen, tonsils, adenoids, and bone marrow. In
rare occasions, the cancer is spread to other organs beyond the lymphatic system.
Hodgkin lymphoma
While the absolute cause of Hodgkin lymphoma is unclear, most Hodgkin lymphomas occur as a
result of a mutation in the DNA of a B cell. The mutation causes rapid division of the cells, which
result in larger than normal cells that do not die as they should. The cells accumulate in the
lymphatic system, overcrowding healthy cells. While classical Hodgkin lymphoma is the most
common form, subtypes exist, including nodular sclerosis Hodgkin lymphoma and mixed
cellularity Hodgkin lymphoma. Treatment depends on the kind of lymphoma.
Symptoms of lymphoma
Swollen lymph nodes • Chest pain • Coughing • Trouble breathing • Abdominal pain or swelling Loss of appetite • Fatigue • Fever • Night sweats • Weight loss
Diagnosis of lymphoma
A physical exam, blood and urine test, and imaging tests are used to diagnose lymphoma. If
lymphoma is suspected, a swollen lymph node may be removed for analysis. Bone marrow may
also be collected to test for signs of cancer. If cancer is found, the stage of cancer will be
determined to help ascertain a prognosis and course of treatment.
Treatment of non-Hodgkin lymphoma
Non- Hodgkin lymphoma does not always necessitate treatment. If the lymphoma is slow
growing, a doctor may choose to monitor the condition for changes instead of ordering
immediate treatment. If the cancer is found to be progressing, further treatment will be
pursued.
Hodgkin and progressive noon-Hodgkin lymphoma treatment
Non- Hodgkin lymphoma that is progressing and Hodgkin lymphoma require treatment.
Chemotherapy and radiation are the traditional treatments. Stem cell transplants may also be
used. In a stem cell transplant, strong doses of chemotherapy and radiation kill the cancerous
cells within the body. The diseased bone marrow is then replaced with healthy stem cells to help
the body grow new bone marrow. Medications to help boost the body’s immune system are
frequently a treatment option as well.
Cause of bleeding disorders
Bleeding disorders result when blood platelets lack the appropriate level of clotting factor
necessary to form clots
What causes hemophilia?
THe lack of clotting factor
What effect does the bleeding associated with hemophilia have?
While hemophilia causes extended bleeding, small cuts and injuries
are not necessarily life- threatening. Larger injuries, however, can lead to deep internal bleeding
and bleeding that pools in the joints, causing irritation, destruction of the joint, and arthritis.
When is hemophilia usually first noticed?
The
first indication of hemophilia is usually prolonged bleeding after circumcision.
Von Willebrand Disease
Von Willebrand is a genetic condition caused when the blood has an insufficient amount of von
Willebrand factor, a protein that carries clotting factor and helps the blood clot.
How does von Willebrand disease affect clotting?
Lack of the von
Willebrand factor makes it difficult for platelets to attach to vessel walls or stick together to
form clots after an injury occurs.
How does von Willebrand disease compare to hemophilia?
Von Willebrand is much milder than Hemophilia as patients
with von Willebrand disease do have the ability to form clots, but the process takes longer than
normal.
What is the pattern of inheritance of von Willebrand disease?
Von Willebrand is a dominant disorder, meaning that only one abnormal gene is needed to
cause the condition. People who have von Willebrand disease have a 50% chance of passing the
gene on to offspring.
General symptoms of a bleeding disorder
The symptoms of these bleeding disorders include: • Heavy bleeding from small cuts • Easy bruising • Anemia • Bleeding gums • Unexplained nosebleeds • Heavy menstrual bleeding • Blood in urine or stool
Hemophilia-specific symptoms
Joint tightness
• Bleeding after immunizations
• Unexplained irritability in infants
When are mild bleeding disorders often detected?
Mild bleeding disorders may not be diagnosed until excessive bleeding during or after surgery
indicates a possible problem.
Diagnosis of bleeding disorders
Mild bleeding disorders may not be diagnosed until excessive bleeding during or after surgery
indicates a possible problem. Blood tests are used to test for bleeding disorders. Blood samples
are analyzed for the amount of platelets in the blood, levels of von Willebrand factor (vWF), and
clotting activity.
Thyroid hormones
thyroxine (T4) and triiodothyronine (T3). Calcitonin
Calcitonin
A hormone produced by the thyroid that places a fundamental role in calcium homeostasis
What organ regulates the production of TSH by the pituitary?
The hypothalamus
What secretes TSH?
The pituitary gland
Causes of hyperthyroidism
Graves’ disease: Graves’ disease is the most common form of hyperthyroidism, caused
when antibodies target the thyroid. When this occurs, the immune system stimulates the thyroid to produce excess levels of T4. Graves’ disease can also affect the tissue
behind the eyes and skin over the shins of the lower legs.
• Hyperfunctioning thyroid nodules: Adenomas of the thyroid can lead to too much
production of T4, although not all adenomas lead to excess hormone production. This
condition is referred to as toxic multinodular goiter, toxic adenoma, or Plummer
disease.
• Thyroiditis: Inflammation of the thyroid gland can cause leakage of thyroid hormones
into the bloodstream.
What is the most common form of hyperthyroidism?
Grave’s disease
Graves’ disease
The most common form of hyperthyroidism, caused
when antibodies target the thyroid. When this occurs, the immune system stimulates the thyroid to produce excess levels of T4. Graves’ disease can also affect the tissue
behind the eyes and skin over the shins of the lower legs
Hyperfunctioning thyroid nodules
Adenomas of the thyroid can lead to too much
production of T4, although not all adenomas lead to excess hormone production. This
condition is referred to as toxic multinodular goiter, toxic adenoma, or Plummer
disease.
Thyroiditis:
Inflammation of the thyroid gland can cause leakage of thyroid hormones
into the bloodstream.
Characteristics and symptoms of babies born with hypothyroidism
- Jaundice
- Large tongue that protrudes
- Frequent choking
- Puffy face
- Problems feeding
- Growth delays
- Abnormal development
- Constipation
- Excessive sleepiness
- Poor muscle tone
