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Human Diseases: A Systemic Approach > Diseases Of The Blood > Flashcards

Flashcards in Diseases Of The Blood Deck (73):
1

What are the cellular components of the blood?

Erythrocytes, leukocytes, and platelets.

2

Fluid portion of the blood?

Plasma

3

What's the average amount of red blood cells in the body?

5 million per cubic millimeter in males
4.5 million per cubic millimeter in females

4

Hemoglobin is the most important component of red blood cells. What is it composed of?

Globulin, a protein, and heme, a molecule which binds to iron. Heme binds to oxygen in exchange for carbon dioxide in the lungs.

5

Erythropoiesis is regulated by which hormone?

Erythropoietin

6

Measures total blood counts, hemoglobin, hematocrit, serum chemistry, an enzyme and hormone levels within the body.

Blood analysis

7

Used to diagnose malignant blood disorders and increases or decreases in blood counts without any apparent cause.

Bone marrow smear

8

A condition of reduced numbers of red blood cells. Potential causes, including hemorrhage, excessive destruction of red blood cells, nutritional deficiency, and chronic disease, decrease the number of red blood cells and oxygen delivery to the cells and tissues.

Anemia

9

What are the symptoms and signs of anemia?

Symptoms are due to hypoxia. Acute hemorrhages result in rapid appearance of symptoms. Most patients have few symptoms, usually usually fatigue, less exercise, dyspnea, and palpitations. Patient appears pallor with jaundice and splenomegaly caused by hemolysis. Tachycardia

10

The condition in which there is anemia with evidence of iron deficiency.

Iron deficiency anemia

11

What causes iron deficiency anemia?

Most frequent cause is gastrointestinal bleeding. In premenopausal women, occurs frequently secondary to loss of iron with menstruation and during pregnancy. Dietary deficiency is most common seen in young children.

12

What are the symptoms and signs of iron deficiency anemia?

Associated with weakness and fatigue. Can affect cognitive performance, behavior, and the growth in school age children. Iron deficiency during pregnancy increases overall infant mortality.

13

How do you treat iron deficiency anemia?

Treatment of choice is oral iron supplementation. Injectable iron supplements are available for individuals with malabsorption.

14

Occurs in patients with chronic inflammatory, infectious, and autoimmune disease is. That etiology most often is a defect in the synthesis of red blood cells.

Anemia of chronic disease

15

Blood is a medium for transporting what?

Oxygen, carbon dioxide, water, nutrients, proteins, and hormones where needed throughout the body and waste products to excretory organs of the body.

15

The severity of the anemia of chronic disease depends on the primary condition. So what are the symptoms and signs of moderate anemia?

Angina pectoris, and exercise intolerance.

16

How can you treat anemia of chronic disease?

This disease may resolve if the underlying disease is treated.

17

Chronic kidney or renal failure is associated with moderate to severe anemia. This type of anemia is due to a failure to produce adequate amounts of erythropoietin and a reduction of red blood cell survival.

Anemia of renal disease

18

What's the difference between anemia of renal disease and iron deficiency anemia?

Patients with anemia for renal disease usually have normal serum iron.

19

Disorders caused by impaired DNA synthesis. Megaloblastic red blood cells tend to be large and contain an increase ratio of RNA to DNA. The number of red blood cells produced is decreased by ineffective erythropoiesis.

Megaloblastic anemia

20

What causes megaloblastic anemia?

Most are due to a deficiency of vitamin B12 and/or folic acid.

21

Caused by inadequate absorption or intake of vitamin B12 or a deficiency in a protein called intrinsic factor, which is produced in the stomach and is essential for the absorption of vitamin B12 from the small intestine.

Vitamin B12 deficiency anemia (pernicious anemia)

22

What happens without enough vitamin B12 in the body?

Membranes of immature red blood cells rupture easily within the chemical environment of the bloodstream. Results in fewer normal red blood cells and less oxygen carrying capacity.

23

What causes pernicious anemia?

In adequate diet, inadequate absorption, inadequate utilize nation, increase requirements, and increased excretion of vitamin B12. Principal dietary sources of vitamin B12 come from animal products.

24

What are the symptoms and signs of pernicious anemia?

Abdominal distress, nausea, vomiting, burning of the tongue. Neurologically; numbness, weakness, and yellow and blue color blindness.

25

How do you treat pernicious anemia?

Vitamin B 12 supplementation effectively reverses the effects of pernicious anemia. Must be replaced by injection.

26

Common in the Western world, where consumption of raw fruits and vegetables is low.

Folic acid deficiency anemia

27

What causes folic acid deficiency anemia?

Inflammation of the bowel, as in Crohn's disease, and adverse affects of certain medications imperatives option of full look acid. Pregnant and lactating females, alcohol abusers, and individuals with kidney disease are especially susceptible to folic acid deficiency anemia.

28

How do you treat folic acid deficiency anemia?

Oral folic acid supplementation is effective in replacing folic acid and meeting increased requirements for those with increased metabolic demands.

29

What is the average lifespan of a red blood cell?

90 to 120 days

30

A reduction in circulating red blood cells that is caused by pathological conditions that accelerate destruction of red blood cells.

Hemolytic anemia

31

What may cause hemolytic anemia?

Inherited abnormalities such as hemoglobin defects, enzyme defects, and memory defects impair intrinsic physical properties that are needed for optimal red blood cell survival. Infectious agents, medications, and immune disorders may reduce rbc survival.

32

What are the symptoms and signs of hemolytic anemia?

Produce symptoms similar to those other anemias. Unlike other anemias, this produces increased serum levels of bilirubin that result from degradation of heme in the destroyed red blood cells. Causes a jaundice appearance to tissue, urine, feces.

33

How do you treat hemolytic anemia?

Splenectomy is recommended in cases of inherited causes. Removal of spleen decreases risk of gallstones, hemolytic crises, and pathological changes to bone marrow. Blood transfusions are recommended in cases of severe blood loss. Infectious causes are treated with appropriate antibiotics.

34

Mutations that results from the synthesis of abnormal hemoglobin. Most common of these diseases are sickle cell anemia and thalassemia.

Hemoglobinopathies

35

A genetically transmitted disorder marked by severe hemolytic anemia, episodes of painful crisis, and increased susceptibility to infections.

Sickle cell anemia

36

What happens in sickle cell anemia?

Red blood cells contain an abnormal form of hemoglobin. As red blood cell deoxygenated, long crystals develop. This causes RBC to obtain sickle shape.

37

What are the symptoms and signs of sickle cell anemia?

Sickle cells block capillaries, leading to pain and ischemia. Fragile cells lead to hemolysis. Patients also suffer tissue death secondary to ischemia causes painful crises that progress to organ failure.

38

How do you treat sickle cell anemia?

Cannot be cured. Patients require continuous care. Treatment aimed at preventing sickle cell crisis, controlling anemia, and relieving painful symptoms.

39

A group of inherited disorders in which there is deficient synthesis of one or more Alfa or Beta chains required for proper formation and optimal performance of the hemoglobin molecule.

Thalassemia

40

What are the symptoms and signs of thalassemia?

Severe signs include life-threatening anemia, bone marrow hyperactivity, splenomegaly, growth retardation, and bone deformities.

41

How do you treat thalassemia?

Blood transfusions are required to sustain life, and life expectancy is reduced.

42

Is a rise in red blood cell mass accompanied by an increase in white blood cells and platelets in the absence of a recognizable physiological stimulus.

Polycythemia vera

43

What causes polycythemia vera?

Etiology is unknown, although chromosomal abnormality is have been documented in some cases.

44

What are the symptoms and signs of polycythemia vera?

Due to increased viscosity of blood, can lead to neurologic symptoms such as dizziness, headaches, visual disturbances. Hypertension is included. Patients may experience itching and pain in fingers and toes. Thromboembolism with death may occur if undiagnosed.

45

What elements are required for hemostasis, or arrest of bleeding?

Platelets, prothrombin, thrombin, vitamin K, and calcium

46

And abnormally small number of circulating platelets, result from conditions that either in pair production, increased distraction, or cause sequestration of platelets. Results in prolonged bleeding from minor or major trauma.

Thrombocytopenia

47

What causes thrombocytopenia?

Production of platelets can be suppressed by malignant diseases or destruction of bone marrow, mostly by cancer chemotherapy and radiation. Autoimmune disorders may increase platelet destruction, as well as massive blood transfusions.

48

What are the symptoms and signs of thrombocytopenia?

Prolonged bleeding, spontaneous hemorrhages visible on the skin as small, flat, red spots called petechiae, or as larger purplish patches called ecchymosis.

49

How do you treat thrombocytopenia?

Usually be corrected by treating the underlying cause. Bedrest to avoid accidental trauma is highly recommended until platelet count increases to acceptable levels. Platelet transfusions are reserved for severe cases.

50

Autoimmune disorder resulting in excess destruction of platelets. Most commonly occurs as an acute problem in children less than five years of age following a viral infection.

Idiopathic Thrombocytopenic Purpura (ITP)

51

What are the symptoms and signs of idiopathic Thrombocytopenic purpura?

Characterized by the sudden appearance of petechiae

52

How do you treat idiopathic thrombocytopenic Purpura?

Depends on age of patient. Hemorrhage in patients can usually be controlled by administration of corticosteroid medication. Splenectomy reserved for patients who do not respond well to medications.

53

Can result from deficiencies or impairment of one or more of the clotting factors. Arise because of defective synthesis, inherited disease, or increased breakdown of clotting factors.

Coagulation defects

54

And X-linked recessive disorder that primarily affects males and their clotting factor VIII. May not be detected during childhood if not severe.

Hemophilia A

55

What are the symptoms and signs of hemophilia A?

Bleeding causes inflammation with acute pain and swelling. Chronic bleeding and inflammation cause joint fibrosis that can progress to major disability. Intracranial hemorrhage is an important cause of death with severe hemophilia.

56

How do you treat hemophilia A?

Involves replacement of factor VIII chronically, with additional doses administered during phases of acute bleeding.

57

Is an inherited bleeding disorder that is often diagnosed in adulthood. Many forms of this disease cause a defect in the adhesion of platelets (different from Hemophilia). Also may be accompanied by reduce level of factor VIII, contributes to impaired clotting.

Von Willebrand disease

58

What are the symptoms and signs of von Willebrand disease?

Frequent bruises from Miner bombs, frequent nosebleeds, extended bleeding following dental procedures, heavy menstrual bleeds, and heavy bleeding following surgery. In severe cases, life-threatening G.I. or joint hemorrhage may resemble hemophilia.

59

How do you treat von Willebrand disease?

Includes medications and lifestyle changes to minimize trauma. Medications used to increase release of von Willebrand factor into blood to prevent breakdown of clots, and control heavy menstrual bleeding.

60

Potentially life-threatening condition that involves destruction of the platelets and consumption of clotting factors. Occurs in a variety of disorders, such as sepsis, endothelial damage as in state of shock, obstetrical complications with delivery of child, and various neoplasms.

Disseminated intravascular coagulation

61

What happens in disseminated intravascular coagulation?

Release of thrombin into the systemic circulation, causing systemic coagulation and suppression of normal physiological anticoagulation mechanisms. Extensive clotting produces tissue ischemia, organ damage, and depletion of platelets and clotting factors, results in extensive bleeding.

62

How do you treat disseminated intravascular coagulation?

Treatment of underlying disorder is cornerstone of therapy. Supportive treatment includes platelet transfusions, administration of concentrates of coagulation inhibitors, and administration of intravenous anticoagulant.

63

What are the five leukocytes?

Neutrophils, eosinophils, basophils, monocytes, and lymphocytes.

64

A reduction of circulating neutrophils increases the risk for bacterial and fungal infections.

Neutropenia

65

What causes neutropenia?

A frequent complication of medication use for cancer chemotherapy or medications for immune suppression. Immune destruction of neutrophils occurs with rheumatoid arthritis or as primary condition with unknown causes.

66

What are the symptoms and signs of neutropenia?

Chronic neutropenia may lead to chronic infections. Acute and severe neutropenia may be associated with fever, skin inflammation, liver abscesses, and septicemia.

67

How do you treat neutropenia?

Sometimes may resolve without treatment. Severe patients require hospitalization with isolation and intravenous antibiotic therapy.

68

Persistent increases in blood eosinophils and associated involvement of the heart and nervous system are responsible for the most important clinical symptoms.

Idiopathic hypereosinophilic syndrome

69

What are the symptoms and signs of idiopathic hypereosinophilic syndrome?

With the heart; congestive heart failure or, valvular dysfunction, conduction defects, and myocarditis. Neurologically; altered behavior and cognitive function, spasticity, and ataxia. Prognosis is very poor.

70

A chronic, multisystem disease with a spectrum of clinical symptoms ranging from self-limiting myalgias and fatigue to progressive and potentially fatal illness

Eosinophilia-myalgia syndrome

71

What characterizes eosinophilia-myalgia syndrome?

Skin changes, nervous system abnormalities, and pulmonary hypertension. Elevated circulating levels of the eosinophils is a universal feature of this disorder, and is related to ingestion of dietary supplement L-tryptophan.

72

Review questions on page 166

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