CARDIOVASCULAR AND HEMATOLOGIC SYSTEMS Flashcards
(276 cards)
1
Q
The heart is made of how many layers?
A
3
2
Q
What are the three layers of the heart?
A
Endocardium
Myocardium
Pericardium
3
Q
Endocardium
A
Smooth, delicate lining of the atria and ventricles
4
Q
Myocardium
A
Muscular wall ( makes up most of the heart)
Myocardium of left ventricle very thick because it forces blood to the rest of the body.
5
Q
Pericardium
A
Thin, sturdy outer membrane.
Consists of two layers: Visceral and parietal pericadium.
6
Q
Visceral Pericadium
A
Adheres to the myocardium
7
Q
Parietal pericardium
A
contains the whole heart like a sac
8
Q
Pericardial cavity
A
Space between visceral and parietal paricardia. Fluid -filled.
9
Q
Heart.. how many chambers?
A
4
10
Q
Atrium
A
Where the blood enters the heart.
(Atrium is an entryway of a building).
11
Q
Ventricle
A
Blood goes through the entry and is pumped down into the “belly” of the heart, from where it goes back into circulation.
(Ventricle middle english meaning stomach or belly).
12
Q
Interatrial septum (septa plural)
A
Partitions the two atria
13
Q
Interventricular Septum (septa plural)
A
Partitions the two ventricles
14
Q
All arteries carry…
A
blood away from the heart
15
Q
All veins carry…
A
blood toward the heart.
16
Q
Where does oxygen-depleted blood go?
A
The heart pumps it to the lungs for oxygenation via the arteries.
17
Q
What happens to oxygenated blood?
A
It gets pumped back to the heart via veins and gets returned to the body by arteries.
18
Q
How are ventricles and atrias connected?
A
Atrioventricular (AV) valves.
19
Q
Right AV valve (Tricuspid valve)
A
Goes from the right atrium to the right ventricle.
The cusp flap allows blood to pass through the heart in one direction and prevents backflow into the chamber.
20
Q
Left AV valve (bicuspid valve/mitral valve)
A
Goes from left atrium to left ventricle.
The cusp flap allows blood to pass through the heart in one direction and prevents backflow into the chamber.
21
Q
Two valves guarding the exits of the ventricles.
A
Pulmonary Semilunar valve
Aortic Semilunar valve
22
Q
Pulmonary semilunar valve
A
Opens from right ventricle into the pulmonary artery.
23
Q
Aortic semilunar valve
A
Opens from the left ventricle into the aorta.
24
Q
Coronary Circulation
A
Process through which the heart receives its own blood supply (capillary networks)
25
Coronary Sinus
Consist of coronary arteris and coronary veines.
Opens into the right atrium.
26
Superior and inferior vena cava
Carry blood from the rest of the body to the right atrium.
27
Single cardiac cycle consist of ...
Simultaneous contraction of both atria followed by simultaneous contraction of both ventricles.
28
Systole
Contaction of the ventricles (relaxation of the atria)
29
Diastole
Relaxation of the ventricles (ventricles dialate to receive blood)
30
Bradycardia
Heart rate slower than 60bpm
31
Tachycardia
Heart rate faster than 100bpm
32
Sinoatrial node (SA)
Main control center of the heart. At the junction between superior vena cava and right atrium.
Know as "pacemaker" of the heart.
33
Does cardiac muscle depend on impulses sent from the nervous system?
NO
34
Pulmonary arteries
Deliver deoxygenated blood from the heart to the lungs.
35
Pulmonary veines
Deliver oxygenated blood from the lungs back to the heart.
36
The muscular wall that makes up the bulk of the heart:
Myocardium
37
Which ventricle is the thicker and larger one?
Left
38
Atria and Ventricles of each side are connected by a/an
atrioventricular valve
39
The heart supplies blood to itself via
coronary arteries
40
The heart pumps blood to the lungs for oxygenation via the
pulmonary artery
41
Explain blood's circulation among the heart and the rest of the body
1. Deoxygenated blood mixed with waste gases and chemicals is collected from body via veins and brought to heart.
2. Hearts pumps deoxygenated blood to lungs via pulmonary arteries.
3. Oxygenated blood goes back to the heart via pulmonary veins.
4. Oxygenated blood is supplied throughout the body via arteries, including the heart itself through coronary arteries.
42
Oxygenation of blood in the lungs via...
lung capillaries
Carbondioxide waste is exhaled and oxygen is inhaled.
43
Veins carry blood ... heart
Toward the heart
44
Arteries carry blood... heart
Away from the heart
45
What makes the "lub dub" heartbeat sound you hear under a stethscope ?
Closing of valves after cardiac contractions.
46
Blood pressure =
Pressure placed on arterial walls during systole and diastole.
47
Bundle of His
Lies in the septum between the two ventricles
48
Purkinje fibers
Stimulate both ventricles to constract simultaneously.
49
Hypertension
Elevated blood pressure over a significant period of time and under varied conditions.
50
Atherosclerosis
Buildup of plaque in the arteries.
51
Atherosclerosis of the renal arteries
Plaque buildup in the arteries leading to the kidneys
52
Atherosclerosis of the renal arteries can lead to ...
Hypertension (Kidneys play vital role in bp regulation)
53
Uncontrolled hypertension can lead to ...
Strokes
Heart Attack (myocardial infarctions)
Peripheral vascular disease
Chronic kidney disease
Retinal disease
54
Idiopathic hypertension
Cause unknown
55
Risk factors for high blood pressure
- Increased Age
- High salt and saturated fat intake
- Hyperlipedemia
- Being overweight or obese
- Not having an active lifestyle
- Smoking
- Family history of high bp
56
Lifestyle changes for treatment of high bp:
- Losing weight
- Drinking less alcohol
- Decreasing salt intake
- Exercising
- Quitting smoking
- Eating a healthy diet
57
Classes of medications to treat hypertension :
1. Diuretics
2. Beta blockers
3. ACE inhibitors
4. ARBs
5. CCBs
6. Vasodilators
58
Diuretics
Stop kidneys from reabsorbing water and electrolytes. Leads to increased loss of water and electrolytes in the form of urine. Increased water loss lowers the blood volume, which lowers the blood pressure.
59
Diuretic medication names
- Spironolactone (Aldactone)
- Furosemide (Lasix)
- Bumetanide (Bumex)
- Hydrochlorothiazide (Esidrix)
60
Side effect of taking diuretics
- Hypotension
- Dehydration
- Electrolyte deficiencies
- Arrythmias
61
Precautions when taking diuretics
- Avoid taking at bedtime
- May need electrolyte supplements
- Spironolatone, a potassium- sparing diuretic , may not require a potassium supplement
62
Beta Blockers define functions
Beta receptor antagonists that act on the beta receptors in the heart.
This causes decreased heart rate and cardiac output and lowers the bp.
Beta blocker names end in -lol
63
Beta blocker names
- Metoprolol (Lopressor)
- Atenolol (Tenormin)
- Metoprolol XL (Toprol XL)
- Carvedilol (Coreg)
- Labetalol (Normodyne)
- Propranolol (Inderal)
64
Side effects of Beta Blockers
- Hypotension
- Dizziness
- Syncope
- Bradycardia
- Fatigue
- Hepatic toxicity
65
Precautions taking beta blockers
Don't abruptly discontinue
Major drug-drug interactions with certain asthma medications
66
Beta blockers end in the suffix....
-lol
67
Angiotensin Converting Enzyme (ACE) inhibitors
Restrain the conversion of Angiotensin I to Angiotensin II. They decrease the fluid volume and also cause peripheral vasodilation resulting in lower bp.
68
Suffix of most ACE inhibitors
-pril
69
ACE inhibitor medications
- Captopril (Capoten)
- Lisinopril (Prinvil)
- Enalapril (Vasotec)
- Benazepril (Lotensin)
70
ACE inhibitor side effects
- Hyperkalemia (increased potassium in blood)
- Hypotension
- Dry, persistent cough
- Angioedema (swelling of tongue, lips and mouth; immediate treatment required!)
- Increased serrum creatinine (kidney failure indicator)
71
Precautions ACE inhibitors
- Monitor kidney function
- If cough not tolerable switching to different class of hypertensive
72
Angiotensin II receptor blockers (ARBs)
Inhibit binding of Angiotensin II to the Angiotensin II receptors. Produce similar end results as ACE inhibitors to lower bp.
73
Medication suffix for Angiotensin II receptor blockers (ARBs)
- sartan
74
Common ARB mediccations
- Losartan (Cozaar)
- Valsartan (Diovan)
- Irbesartan (Avapro)
75
Side effects ARBs
- Hyperkalemia (increased potassium in blood)
- Hypotension
- Dry, persistent cough
- Angioedema (swelling of tongue, lips and mouth; immediate treatment required!)
- Increased serrum creatinine (kidney failure indicator)
76
Precautions when taking ARBs
- Monitor kidney function
- If cough not tolerable switching to different class of hypertensive
77
Calcium Channel Blockers (CCBs)
Hinder the calcium ion influx (calcium required during contraction) in the vascular smooth muscle of the heart, resulting in heart muscle relaxation- decreasing bp.
78
suffix CCBs
-pril
79
CCB Medications
- Diltiazem (Cardizem)
- Verapamil (Calan)
- Amlodipine (Norvasc)
- Felodipine (Plendil)
80
Side effects CCBs
- Hypotension
- Dizziness
- Flushing
- Headache
- Tachycardia
- Exacerbation of CHF (congestive heart failure)
81
Precautions CCBs
Monitor for signs of peripheral or pulmonary edema
82
Vasodilators
- Work by directly dilating the blood vessels to produce rapid and significant reduction in bp.
- Used to treat dangerously high bp in emergency situations due to rapid effect
83
Vasodilator prefix
Nitro-
84
Vasodilator Medications
- Hydralazine (Apresoline)
- Nitroprusside (Nitropress)
- Nitroglycerin (Nitrostat)
- Isosorbide mononitrate (Imbdur)
85
Vasodilator Side efffects
- Tachycardia
- Edema or fluid retention
- Lupus
- Postural hypotension
86
Precautions Vasodilators
- Don't suddenly stand up
- Monitor for signs of swelling
87
CHF
Congestive Heart Failure
88
Congestive Heart Disease (CHF)
Happens when the heart can’t pump blood efficiently to deliver an adequate supply of blood to the metabolizing tissues, usually because of water and sodium retention.
It may precede or follow a heart attack.
It also may be associated with other cardiovascular problems, such as high blood pressure, aortic stenosis, and coronary artery disease.
89
Congestive
implies edemous state commonly associated with fluid retention.
90
Symptoms CHF
- Fatigue
- Increased urination at night
- Swelling
- Shortness of breath
- Tachycardia
- Nausea/Vomiting
91
Treatment CHF
Medications to relieve symptoms, prevent further damage and prolong survival.
Damaged heart muscle can't be repaired.
92
Risk factors CHF
- Increased age
- Infections
- Valve disease
- Arrythmia
- Traum to heart muscle
- Chemotherapy and certain illicit medications
- Congenital heart disease
93
Nonpharmacologic Therapy for CHF
- Bed rest to decrease cardiac load
- Progressive ambulation
- Dietary control with small, frequent meals
- Salt restriction
94
Medications used to treat CHF
- Digoxin (Lanoxin)
- Diuretics
- Beta Blockers
- ACE inhibitors and ARBs
95
Narrow Therapeutic Index (NTI)
Narrow therapeutic index (NTI) drugs are drugs
where small differences in dose or blood
concentration may lead to serious therapeutic
failures and/or adverse drug reactions that are
life-threatening or result in persistent or
significant disability or incapacity.
96
Digoxin
Medication that's proven to be very effective treating CHF symptoms and reducing hospitalization.
Digoxin levels in the blood have to be closely monitored to avoid digoxin toxicity due to its narrow therapeutic Index (NTI)
97
Diuretics as treatment for CHF
Diuretics are slowly titrated to minimize or eliminate fluid retention. Diuretics increase urination and sodium excretion.
98
Beta Blockers as treatment for CHF
Reduce heart rate and prevent arrhythmias to help reduce CHF symptoms. Beta Blockers are known to reduce the risk of mortality and hospitalization and improve the overall clinical status of CHF patients. Sometimes beta blockers are used in conjuction with diuretics.
99
ACE inhibitors and ARBs in CHF treatment
Generally used for long-term management of chronic CHF.
100
Hyperlipidemia (High Cholesterol)
Increase in circulating concentration of cholesterol, cholesterol esters, triglycerides, or phospolipids.
101
Cholesterol classified as...
Steroid-based and primary component of cell membrane.
102
Two main types of cholesterol
- HDL (High-Density Lipoprotein. Good cholesterol associated with a decreased risk of heart disease.
- LDL (Low-Density Lipoprotein). Bad cholesterol associated with an increased risk of heart disease and stroke.
103
Triglycerides
Provided by deitary fats and hepatic conversion of carbohydrates.
Also increase the risk of heart disease.
104
Risk Facotors Hyperlipidemia
- A genetic defect in the recptor and/or enzyme abnormality or deficiency
- Obesity
- High fat and cholesterol dietary intake
-Certain medications that cause increased cholesterol
105
Treatment for hyperlipidemia
- Dietary restrictions to avoid fatty foods
- Exercise
- Weight reduction
- Smoking cessation
106
Medications (Statins) that are used to treat hyperlipidemia include
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Pravastatin ( Pravachol)
Rosuvastatin (Crestor)
107
Statin Side effects
-Nausea
-Headache
-Abdominal Pain
-Muscle Pain (May be an indicator of a serious side effect of statins, called rhabdomyolysis, which is a breakdown of skeletal muscle. Routine monitoring of CK (creatine kinase) is recommended for high-risk patients.
-Liver damage (Liver function tests are recommended periodically while patients are on statins).
108
Other medications used to treat hyperlipidemia
Niacin (Niaspan)
Fenofibrate (Tricor)
Gemfibrozil (Lopid)
Ezetimibe (Zetia)
109
Rhabdomyolysis
Breakdown of skeletal muscle.
110
CAD
Coronary Artery Disease
111
Myocardial Infarction (MI)
heart attack
112
Acute Coronary syndrome (ACS)
A rupture of coronary arteries due to plaque buildup.
113
CAD Coronary Artery Disease
Condition in which plaque builds up inside the coronary arteries (atherosclerosis).
This narrows the arteries and limits the amount of blood and oxygen that the heart can receive.
Most feared outcome of CAD is a myocardial infartion (MI)
114
MI occurs...
When a thrombus (blood clot) develops in a coronary artery that's already narrowed by atherosclerosis.
The complete blockage of blood flow through the coronary artery prevents the surrounding heart muscle from receiving any blood and oxygen.
115
One proven measure to decrease the incidence of CAD and MI?
Controlling cholestrol levels.
116
Risk factors for coronary artery disease include:
Hyperlipidemia
Hypertension
Smoking
Obesity
Age
Family history
Sedentary lifestyle
117
thrombos
blood clot
118
Medications commonly used to prevent MI and ACS are:
- Aspirin
- Nitroglycerin
- Blood thinners
119
Examples of blood thinners:
- Clopidogrel (Plavix)- an anticoagulant or blood thinner that prevents platelets from sticking together
- Heparin- an intravenous blood thinner, commonly used in the hospital in acute thrombosis
- Low Molecular Weight Heparins (LMWH), such as Enoxaparin (Lovenox) and Fondaparinux (Axistra)- LMWHs are available as alternatives to heparin as anticoagulants.
- Warfarin (Coumadin)- an oral blood thinner, used as maintenance therapy to prevent clot formation
- Alteplase (TPA)- a thrombolytic that causes lysis (disintegration) of the clot. Risks and benefits need to be compared and evaluated before using this potent agent.
120
Dysrhythmia
Disorganized or abnormal heart rhythm
121
Common causes of Dysrhythmia include:
- Hypertension
- ACS
- Heart Failure
122
Dysrhythmia may be.... if not treated
Fatal
123
Medications used to treat cardiac dysrhythmia :
- Amiodarone (Cordarone)
- Disopyramide (Norpace)
- Dofetilide (Tikosyn)
- Propafenone (Rhytmol)
124
.... is an anticoagulant or blood thinner that prevents platelets from sticking together
Clopidogrel (Plavix)
125
... is a lack of oxygen and results from obstruction significant enough to deprive heart muscles of oxygen
Ischemia
126
.... is the resulting chest pain.
Angina
127
White Blood Cells (WBCs)
Main function is to defend against infection and foreign invaders. An increase in WBC count is indicator of infection.
128
Leuko-
White
129
White Blood Cells also called...
Leukocytes
130
-cyte
cell
131
WBCs divided into which categories ?
Granulocytes
Agranulocytes
132
Granulocytes
Granulocyte cells have a granular appearance under the microscope.
133
Agranulocytes
Agranulocyte cells don't have a granular appearance under the microscope.
134
There are three main types of granulocytes.....
- Neutrophils
- Eosinophils
- Basophils
135
Agranulocytes can be further classified as ...
- Lymphocytes
- Monocytes
136
Neutrophils
Most prevelant of the WBCs. They respond to bacterial infections, such as pneumonia or urinary tract infections by engulfing the bacteria through process of phagocytosis.
If infection is modrate to severe bone marrow will produce extra amounts of neutrophils.
137
phagocytosis
the ingestion of bacteria or other material by phagocytes
138
Esonophils
Granulocyte involved in allergic reactions.
Concentration may be elevated after allergic reactions to food or drugs.
Help fight infections by certain parasites and microorganisms.
139
Basophils
Involved in the process of inflammation.
140
Lymphocytes
Produce antibodies against foreign particles (Microorganisms, drugs, canceerous cells, cells from transplanted organs). Further classified as T-lymphocytes (T-cells) and B-lymphocytes (B-cells).
141
B-cells
Produce antibodies
142
T-cells
Participate in cell-mediated immune response against bacterial and viral infections.
143
Monocytes
Phagocytic cells; main function is to engulf and digest other cells and pathogens.
144
Process of Blood Coagulation
Thromboplastin is triggered when a cut or injury occurs, converting prothrombin to thrombin. Thrombin then converts fibrinogen to fibrin. Fibrin makes a mesh over the bleeding site to trap various blood cells. Platelets are the main blood cells that stick or clump together at bleeding site to make a scab or clot. RBCs and plasma also needed to form the clot.
145
.... is a complex protein that's designed to bind and release oxygen.
Hemoglobin
146
.... is a protein that acts as an enzyme to convert the fibrinogen in the plasma to fibrin.
Thrombin
147
Individuals with which blood type are known to be universal recipients?
AB+
148
Individuals with which blood type are known to be universal donors?
O-
149
What is the average life span of RBCs?
120 days
150
What is the average blood volume of the body?
5-7% of the body's total weight
151
What are the three main types of blood cells?
- White blood cells
- Red blood cells
- Platelets
152
Where are blood cells produced?
In the bone marrow
153
What is the process of formation of blood cells called?
hematopoiesis
154
What is the basic foundation of blood?
Plasma
155
Red Blood Cells (RBCs) also referred to as
Erythrocytes
156
What is the main function of RBCs?
To deliver oxygen to the body and remove waste products.
157
What is hemoglobin?
A complex protein designed to bind and release oxygen.
158
When hemoglobin binds with oxygen it's called?
Oxyhemoglobin
159
Bone marrow generation of red blood cells
Erythropoiesis
160
Which organs destroy RBCs after about 120 days?
Spleen and liver
161
Platelets are also known as
thrombocytes
162
Process of thrombosis
Blood clotting
163
Normal RBC count
4-6 million cells per microliter
164
Main funtion of RBCs
Transporting hemoglobin that carries oxygen from the lungs to the entire body
165
Life span RBCs
120 days
166
Common RBC disorder
Anemia
167
Normal Platelet (Thrombocyte) Count
150,000- 450,000 cells per microliter of blood
168
Main funtion of platelets
Promote blood clotting to sop bleeding
169
Common platelet disorder
Thrombocytopenia
170
Normal WBC count
4,500- 10,000 cells
171
Main function of WBCs
Produce an immune response and protect the body against foreign pathogens
172
What is an increased WBC count an idication of ?
Infection
173
Common WBC disorder?
Leukemia
Lymphoma
174
How much of our blood volume is plasma?
More than 50% is plasma (92% of plasma is water)
175
What does plasma consist of?
Water
Proteins
Nutrients
Electrolytes
Hormones
Vitamins
Enzymes
Waste products of metabolism
176
3 Importan proteins in plasma
- Fibrinogen
- Albumin
- Globulin
177
Fibrinogen (Protein in Plasma)
Blood-clotting protein made in the liver.
178
Albumin (Protein in Plasma)
- Made in the liver and is the most plentiful protein in the plasma.
- It maintains the pressure needed to pull water from tissues back into the blood vessels.
179
Globulin (Protein in Plasma)
- Formed both in the liver and lymphatic system.
- Can be found as two different forms in plasma.
- Gamma globulin helps form antibodies, and prothrombin helps blood coagulation.
180
thromboplastin
An enzyme that works with calcium and other factors to convert prothrombin in the plasma to thrombin.
181
Gamma globulin (a protein in the plasma)
helps form antibodies, and prothrombin helps blood coagulation.
182
prothrombin (a protein in the plasma)
helps blood coagulation.
183
Pro-Coagulant
Promotes coagulation
184
Anti-Coagulant
Inhibits coagulation
185
What defines a blood type ?
Genetic Markers
(Depends on blood protein agglutinogen or antigen on the surface of red blood cell).
186
Name the four blood types:
A
B
AB
O
Two types of antigen: A & B.
187
Name the eight bood types with RH factor:
Type A+
Type B+
Type AB+
Type O+
Type A-
Type B-
Type AB-
Type O-
188
One of the most common causes of microcytic anemia is an........ deficiency
Iron
189
Macrocytic anemia is commonly caused by ..... and..... deficiency...
Vitamin B12 and folic acid deficiencies
190
A major risk factor associated with anticoagulants is....
Bleeding
191
List four risk factors of developing DVT (Deep Vein Thrombosis)
1. Atrial fibrillation (A-fib)
2. Prosthetic heart valves
3. Pregnancy
4. Prolonged Immobility
192
Anemia is defined as
Low red blood cell (RBC) or hemoglobin concentration.
193
Sickle Cell Anemia (SCA)
Is a genetic disorder that’s caused by abnormal hemoglobin production. Abnormal hemoglobin molecules are unable to carry appropriate amounts of oxygen and also make a rigid polymer that can occlude small blood vessels.
The occlusion of blood vessels causes extreme pain, requiring hospitalization and treatment with pain relievers, such as acetaminophen (Tylenol), Ibuprofen (Advil), morphine, or fentanyl.
There’s no definitive treatment option for SCA. Patients require frequent blood transfusions and also need treatment for severe pain during an SCA
194
Microcytic anemia
- Characterized by the formation of tiny RBCs. - The main cause of microcytic anemia is iron deficiency and lead poisoning
195
Iron deficiency
- Refers to the improper intake of iron or chronic diseases leading to iron deficiency.
- Mild forms of iron deficiency anemia can be treated by increasing the iron-rich food in your diet.
196
Macrocytic anemia
- Body forms very large RBCs.
- The main cause of macrocytic anemia is a vitamin B12 and folic acid deficiency.
- This deficiency could be due to an inappropriate amount of vitamin B12 and folic acid in the diet or the result of another health condition or genetic disorder.
197
ferrous
Iron
198
fumarate
A salt or ester of fumaric acid
199
Common medications for treatment of microcytic or iron deficiency anemia also include:
Ferrous sulfate (Feosol)
Ferrous fumarate (Ferro-Sequels)
Ferrous gluconate (Fergon)
Polysaccharide iron complex (Niferex)
Vitamin C (absorbic acid) is generally recommended, along with iron to increase its absorption from the GI tract.
200
Where does Vitamin B12 occur in our diet?
Animal Products
201
What foods do we get folic acid from?
- Green vegetables
- Meat
-Eggs
202
What disease cause folic acid deficiency?
- Macrocytic Anemia
- Alcoholism
- Liver disease
- Renal failure
203
What chronic diseases can cause anemia?
- Renal or kidney disease
- Cancer
- HIV
204
Erythropoietin is a..
Hormone produced in the kidneys that stimulates RBC production.
205
Hemolytic Anemia
Result o decreased RBC survival time due to excessive hemolysis or destruction of RBCs. Exessive destruction of RBCs releases too much bile pigment bilirubin for the liver to handle.
206
Janudice
Yellowing of the skin, is a sign of hemolytic anemia.
207
Treatment for Hemolytic anemia
- Handling underlying disorders
- Steroids
- Immune supressants
208
Aplastic Anemia
Caused by Aplasia
(Aplaria is a bone marrow condition in which the bone marrow cells fail to develop. Body doesn't produce enough platelets to help the blood clot or not enough leukocytes to help with infections.
209
How is Aplastic Anemia treated?
Serious condition, treated with blood transfusion.
210
Neutropenia
Condition in which the neutrophil count is decreased. Neutropenia is usually a side effect of medications such as chemotherapy medications, heparin, and antibiotics, but can also be the result of some genetic disorders.
211
Dangerously low levels of neutrophil pose an extremely high risk of contracting various............
Bacterial and fungal infections
212
Treatment of neutropenia ....
Discontinuation of offending medications causing neutropenia.
medications called granulocyte colony stimulating factors (gCSF) available that stimulate the production of neutrophils.
Two common gCSF medications are
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)
Patients with severe neutropenia are generally treated with a course of prophylactic antibiotics.
213
Leukemia
Disorder in which the bone marrow produces an extreme abundance of WBCs. Leukemia is a type of cancer.
It’s caused by the production of WBCs going unchecked, which can destroy other blood cells.
214
Two types of leukemia:
Acute (sudden onset) leukemia is characterized by large numbers of undeveloped WBCs. Chronic (gradual development) leukemia has fully matured WBCs present.
215
The subtypes of leukemia include:
- Acute myelogenous (or myelocytic) leukemia (AML)
- Acute lymphocytic leukemia (ALL)
- Chronic myelogenous (myelocytic) leukemia (CML)
- Chronic lymphocytic leukemia (CLL)
216
Treatment options Leukemia
Leukemia is treated with a combination of chemotherapy medications. The combination depends on the type of leukemia. When the patient goes into remission, a period in which signs of disease are absent, a bone marrow transplant may be performed.
217
Lymphoma
Caused by cancerous tumor cells developing in the lymphatic system. There are two types of lymphoma:
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
218
Non-Hodgkin’s lymphoma (more common)
If a doctor doesn't see the Reed-Sternberg cell under a microscope, the lymphoma is classified as Non-Hodgkin’s.
Treatment: chemotherapy
219
Hodgkin’s lymphoma
If a doctor sees the Reed-Sternberg cell under a microscope, the lymphoma is classified as Hodgkin’s.
Lymphoma is treated with a combination of chemotherapy medications.
220
Hemophilia
Genetically inherited disease. It’s generally characterized by a deficiency of certain clotting factors (factor VII and factor IX), which prevents blood from clotting.
221
Treatment hemophilia
Hemophilia is treated by infusing factors that are available as injectable medications. Hemophilic patients may lose a lot of blood, which means many patients require frequent blood transfusion.
222
Thrombocytopenia
Defined as an abnormally low level of platelets in the blood. It’s a general condition that stems from an underlying disease.
223
Low level of platelets can be due to:
- Chronic liver disease, causing the spleen to enlarge and destroy platelets
- Antibodies to platelets in some individuals
- Diseases of the bone marrow, resulting in inadequate production of platelets
- Certain medications (such as Heparin)
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Idiopathic Thrombocytopenic Purpura (ITP)
A body’s own antibodies destroy the blood platelets.
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Treatment Thrombocytopenia
Treating the underlying disease or discontinuing offending medications.
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Arterial Clots
Blood clots that occur in the arteries.
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Atherosclerosis
Results from the adherence of cholesterol, RBCs, plateltes, fibrin and other substances to injured arterial walls that can result in MI or stroke.
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Venous clots
Blood clots that occure in veins, usually deep veins within the legs.
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Venous clots = DVT
Deep Vein Thrombosis
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Describe DVT process
Venous clot (Embolus) breaks off and travels through the blood stream. Leg DVTs often travel to the lungs, causing pulmonary embolism (PE). PE is usually painful and fatal.
A clot that develops in the heart can travel to the brain causing a stroke.
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Common causes of DVT:
- Trauma to the blood vessels
- Clotting factor deficiencies
- Prosthetic heart valves
- Pregnancy
- Artial fibration (afib), irregular heartbeat
- Prolonged immobility
- Orthopedic surgery
- Certain cancers
- Estrogen use
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Antiplatelet medications disrupt...
Platelet aggreation to help prevent clots from forming.
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Antiplatelet medications
Oral:
- Aspirin (Ecotrin)
- Dipyridamole (Persantine)
- Clopidogrel (Plavix)
- Ticlopidine (Ticlid)
- Prasugel (Effient)
Intravenous :
Abciximab (Reopro)
Eptifibatide (Integrilin)
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Anticoagulant medications disrupt the....
Clotting pathway to slow or stop the clotting process. These medications don’t:
- Require routine lab tests to adjust dosage and measure effectiveness
- Have many drug-drug interactions
- Have many drug-herbal interactions
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Disadvantage of anticoagulants:
Reversal agent to control bleeding may not be easily accessible.
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Heparin is used...
Subcutaneously to prevent DVT in high risk patients and intravenously to treat DVT and PE.
Heparin works by inactivating factor X and preventing the conversion of prothrombin to thrombin.
Heparin doesn’t dissolve clots. It prevents the clot from becoming bigger, and it also stops more clots from forming. Prothrombin (PT) is a lab test used to measure the outcome of heparin and adjust heparin dose.
The main side effect of heparin is bleeding and thrombocytopenia- commonly called heparin associated thrombocytopenia (HAT) or heparin-induced thrombocytopenia (HIT).
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LMWs are
LMWs are newer and better forms of heparin. The side effect profile is similar to heparin. LMWs are administered subcutaneously once or twice daily for the prevention and/or treatment of DVT and PE.
No routine lab monitoring is required for patients taking LMWs. These medications work by inactivating factor Xa. Examples of LMWs are enoxaparin (Lovenox) and dalteparin (Fragmin).
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Warfarin is an
Oral anticoagulant
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How does Warfarin work?
It interrupts the coagulation pathway by preventing the activation of the vitamin K-dependent clotting factors. Clotting factors II, VII, IX, and X activation depends on vitamin K. It takes approximately 5 to 7 days for Warfarin to be fully effective due the long half-lives of the factors. Warfarin effectiveness as an anticoagulant is monitored by a lab test called international normalized ratio (INR). Warfarin is used as maintenance therapy to prevent DVT, PE, and stroke. One of the disadvantages of warfarin is that it interacts with many OTC and prescription medications and herbal supplements. Patients are also instructed to consistently consume a vitamin K-rich diet to avoid fluctuations in the warfarin effectiveness.
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Newer oral anticiagulants (not warfarin)
Dabigatran (Pradaxa), Rivaroxaban (Xarelto) Apixaban (Eliquis).
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Acute Myocardial Infarction (AMI)
A condition in which complete obstruction of the coronary artery results in death of the heart muscle.
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Hematologic System
The composition, formation, and transportation of blood; also blood's function within the body.
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Erythrocytes
A type of blood cell; also called red blood cells or RBCs.
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Leukocytes
A type of blood cell; also called white blood cell or WBCs.
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Thrombocytes
A type of blood cell; also called platelets.
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Plasma
The liquid portion of the blood
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Coagulation
The process of blood clotting
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Hematopoiesis
Formation of blood cells in the bone marrow
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Anemia
Low levels o red blood cells in the body.
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Leukemia
A type of cancer that results in abnormal production of white blood cells.
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Vasoconstrictor
Medications or agents that cause blood vessels to constrict.
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Vasodilators
Medications or agents that cause blood vessels to dilate.
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Systolic Blood Pressure (SBP)
Blood pressure during systole or ventricle contraction; the highest exerted pressure on the arterial wall.
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Diastolic Blood Pressure (DBP)
Blood pressure during distole or relaxation period; the lowest exerted pressure on the arterial wall.
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Coronary Arteries
Arteries that supply oxygen-rich blood to the heart itself.
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Ischemia
A lack of oxygen due to an obstruction significant enough to deprive the heart muscles of oxygen.
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Angina
Chest pain that's caused by ischemia or lack of oxygen.
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Acute Coronary Syndrome (ACS)
Occurs when a rupturing of plaque results in a blood clot in the coronary arteries.
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Bradycardia
A heart rate slower than 60bpm
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Tachycardia
A heart rate faster than 100bmp
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Atria
The top two chambers of the heart that receive blood from other parts of the body.
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Ventricles
Bottom two chambers of the heart that supply purified blood to the other parts of the body; larger and thicker than the atria
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Valves
There are four main valves in the heart that open and close to move blood in one direction between the heart chambers.
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Cardiac Cycle
Cyclic flow of blood through the heart, valves, and vessels to and from the body.
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Diastole
Period of heart relaxation; the flow of blood is passive and only due to gravity.
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Systole
Period of heart contraction; the flow of blood is faster due to force of contraction.
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Arteries
Blood vessels that carry blood away from the heart.
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Veins
Blood vessels that carry blood to the heart.
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Stroke volume
Amount of blood pumped by the left ventricle of the heart per single heartbeat. Normal value is 60-80ml per beat.
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Heart rate
Number of heart contractions per minute; measured in beats per minute
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Cardiac output
Volume of blood pumped by heart per minute. Can be calculated by multiplying the stroke volume and the heart rate; normal value is 4-8 liters.
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Vessel
Arteries and Veins that carry to or away from the heart.
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Disrhythmias
Disorganized or abnormal heartbeats or irregular heartrate.
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Hypertension
Increased blood pressure over a certain period of time, normal BP 120/80mmHg.
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Hyperlipidemia
Increase in cholesterol; typically LDL (low-density lipo proteins
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