module 4: blood disorders Flashcards
(78 cards)
1
Q
Define anemia and describe two potential causes
A
- a decrease in the oxygen-carrying capacity of the blood
- the number of red blood cells
- the amount of hemoglobin in the red blood cells are low
2
Q
Fill in the blanks with the following terms: hypoxia, anemia, hypoxemia
___________________ produces ___________________ which produces ___________________
A
- anemia
- hypoxemia
- hypoxia
3
Q
what is hypoxemia?
A
a reduction in the oxygen content of the blood
4
Q
what is hypoxia?
A
abnormally low oxygen content in the tissues
5
Q
what may be analyzed when diagnosing anemia?
A
- hemoglobin
- hematocrit
- RBC count
- reticulocytes
6
Q
Describe the general signs and symptoms associated with anemia.
A
- fatigue
- dizziness and headaches
- breathing rate and depth increases
- shortness of breath
- rapid and pounding heartbeat
- vasodilation
- decrease in blood viscosity (thickness
- pale lips, nail beds, mucous membranes
7
Q
why is fatigue a general sign/symptom of anemia?
A
lower aerobic cell respiration = lower ATP
8
Q
why are dizziness and headaches a general sign/symptom of anemia?
A
lower ATP in CNS
- nerve tissue especially sensitive
9
Q
why do breathing rate and depth increase with anemia?
A
body’s attempt to correct hypoxemia: respiratory center response to increase the diffusion rate of oxygen in the lungs
10
Q
why is shortness of breath a general sign/symptom of anemia?
A
- cannot get sufficient oxygen to tissues to supply their demands
- generally happens with more activity because you are trying to gasp in as much air as you can
11
Q
why is rapid and heart beat a general sign/symptom of anemia?
A
body’s attempt to correct hypoxemia:
- cardiac centre response increases heart rate and SV to increase blood flow to lungs and tissues
12
Q
why is vasodilation a general sign/symptom of anemia?
A
- hypoxia releases signaling molecules like nitric oxide = local vasodilation of tissue capillaries
- local vasodilation of tissue capillaries = decrease TPR
- decrease TPR = increase venous return
13
Q
why is a decrease in blood viscosity a general sign/symptom of anemia?
A
- reduction in number of blood cells while the body maintains total volume of blood
- effect is to lower TPR = increase venous return to heart
14
Q
why are pale lips, nail beds, and mucous membranes a general sign/symptom of anemia?
A
blood less oxygenated = less bright red
15
Q
Discuss iron deficiency anemia by addressing the following: etiology (cause)
A
- chronic blood loss
- lack of sufficient iron in diet
- reduced ability to absorb iron
16
Q
Discuss iron deficiency anemia by addressing the following: populations at risk and treatments available
A
- population at risk:
- poverty
- women
- children
- elderly
- treatment:
- replace lost iron
- identify and treat condition causinf loss
17
Q
Discuss iron deficiency anemia by addressing the following: pathogenesis
A
- iron stores deplete
- fewer RBCs (low hematocrit) with reduced cell volume (mean cell volume - MCV) and low hemoglobin content (mean cellular hemoglobin content- MCHC) produced
- theses “anemic” blood cells gradually replace older blood cells
18
Q
Discuss iron deficiency anemia by addressing the following: histological characteristics
A
the anemic blood cells in iron deficiency are distinctive:
- microcytic = very small RBC
- hypochromic = pale RBC due to lack of iron
19
Q
Describe pernicious anemia by addressing the following: pathology (include: why do we need vitamin B12? what is it used for?)
A
- atrophic gastritis = gastric mucosa atrophy
- results in lack of intrinsic factor
- produces B12 deficiency
- essential for DNA synthesis/mitosis in RBC and myelination of nerves/nerve function
20
Q
Describe pernicious anemia by addressing the following: etiology
A
- autoimmune destruction of gastric mucosa
- heavy alcohol ingestion, cigarette smoking
- other causes of B12 deficiency
- gastrectomy, malabsorption, aging
- slow pathogenesis (20-30 years)
- undetected progression of gastritis
- slow depletion of B12 stores in liver
21
Q
Describe pernicious anemia by addressing the following: histological characteristics
A
- megaloblastic RBCs
- macrocytic = large RBC
- normochromic = normal colour
22
Q
Describe pernicious anemia by addressing the following: signs and symptoms
A
- general symptoms of anemia
- low serum B12 levels
- neurologic complications of B12 deficiency:
- paresthesias in hands/feet (tingling/numbness)
- depression
- dementia (sometimes)
23
Q
Describe pernicious anemia by addressing the following: treatment
A
vitamin B12 injections
24
Q
Describe folate deficiency anemia by addressing the following: why do we need folate? what is it used for?
A
- folic acid = vitamin B9 is essential for nucleic acid synthesis within RBC and cell growth and mitosis
25
Describe folate deficiency anemia by addressing the following: etiology
* malnutrition
* diets low in green vegetables and meat
26
Describe folate deficiency anemia by addressing the following: histological characteristics
similar features to pernicious anemia
* megaloblastic (large) and normochromic (normal colour)
27
Describe folate deficiency anemia by addressing the following: signs and symptoms
* mouth ulcers (stomatitis)
* watery diarrhea
28
Describe folate deficiency anemia by addressing the following: at risk population and treatment
* at risk:
* elderly
* children
* alcoholism
* pregnancy
* treatment:
* folic acid supplements
29
Define polycythemia and name the two types
* polycythemia = too many erythrocyte presence (too many RBC)
* types:
* relative polycythemia
* absolute polycythemia
30
describe relative polycythemia
* blood cell number is fine, but low fluid
* brought about through dehydration
* minor consequences and easily fixes
* blood becomes very viscous due to low amount of fluids
31
describe absolute polycythemia
* produces too many RBC
* 2 forms:
* primary (polycythemia vera) = rare non-malignant condition where there is an overabundance of bone marrow stem cells
* secondary = due to hypoxia, which results in overproduction of erythropoietin in compensation for low oxygen levels
32
what is primary polycythemia?
“polycythemia vera”
* rare non-malignant condition where there is an overabundance of bone marrow stem cells
33
what is secondary polycythemia?
* due to hypoxia
* results in overproduction of erythropoietin in compenation for low oxygen levels
34
Describe the manifestations of polycythemia
variable and related to an increase in RBCs, haemoglobin level, and hematocrit with creased blood volume and viscosity
* splenomegaly
* depletion of iron
* disrupted cardiac output
* hypertention
* decreased cerebral blood flow
* venous stasis
* thromboembolism
35
what is splenomegaly?
spleen is really big due to processing RBC and working overtime to try to get rid
36
what is venous stasis?
blood so thick, it starts to pool
37
describe leukocytosis vs leukopenia
* leukocytosis = when WBC count is higher than normal
* can be normal response to stressors such as infection, surgery, pregnancy, etc.
* leukopenia = when WBC count is lower than normal
* never normal response, risk of infection increases dramatically
38
Describe neutrophilia vs neutropenia vs agranulocytosis
* neutrophilia = an early response to infection (shift to left)
* neutropenia = decrease due to not being able to keep up with production
* agranulocytosis (granulocytopenia) = extremely low counts of granulocytes
39
Describe lymphocytosis vs lymphocytopenia.
* lymphocytosis = usually produced through viral infection since their job is to attack viruses (adaptive immune response)
* lymphocytopenia = immune deficiencies, neoplasia, drugs, no known cause
40
Discuss infectious mononucleosis to include the following: cause
* acute infection of B lymphocytes by Epstein-Barr virus (EBV)
* too many B cells
* heterophile antibodies are detected = bind to a number of different antigens and can deplete cells
41
Discuss infectious mononucleosis to include the following: Age groups typically become infected? Why?
individuals 15-19 years old because they tend to share more food/drinks, etc. and kiss.. lol
42
Discuss infectious mononucleosis to include the following: signs and symptoms
* fever
* sore throat
* cervical lymph node enlargement
* can progress to more serious symptoms
43
Discuss infectious mononucleosis to include the following: usually self-limiting (which immune cells are responsible?)
* cytotoxic T cells
* natural killer cells
44
Define leukemia
a malignant disorder of the blood and blood-forming organs
45
Define pancytopenia. How does it occur?
* pancytopenia = a reduction in all cellular component of the blood as the end result
* cells start repilicating and get huge expansion of immature cells (malignant leukocytes) = crowds out bone marrow
* crowds out bone marrow = unable to get mature cells
46
What are some common features of leukemic cells?
* are immature and poorly differentiated (divide rapidly and does not become fully functioning)
* proliferate rapidly and have a long life span
* do not function normally
* interfere with the maturation of normal blood cells
* circulate in the bloodstream
* cross the blood-brain barrier
* infiltrate many body organs
47
Describe some risk factors associated with the development of leukemia.
* can reapperar in families and is associated with other hereditary abnormalities (ex: down syndrome)
* increased risk has been linked to cigarette smoke, ionizing radiation, infections with HIV or HCV, some drugs
48
What information is used to classify the different kinds of leukemia?
* which type of cell line is affected (lymphocytic or myelogenous)
* the progression of the disease (acute or chronic)
49
Describe acute leukemias to include: general description
* rapid growth of immature blood cells
* abrupt onset of disease: short survival time if untreated
50
Describe acute leukemias to include: difference between ALL and AML
* acute lymphocytic (ALL) = concerns lymphycytes
* vast majority (85%) of all are problems with B cell line
* least common type overall, but **most common type in children**
* accounts for 3 out of 4 cases of childhood cancer
* acute myelogenous (AML) = concerns any cells except lymphocytes
* tends to **occur more in older adults**, but is also seen in children and younger adults
51
Describe acute leukemias to include: manifestations
* fatigue caused by anemia- not fully mature RBC
* bleeding caused by thrombocytopenia - no functioning platelets
* infections and fever - no functioning WBC
* anorexia liver, spleen, lymph node enlargement, neurological/CNS manifestations
* bone pain - overproduction of cells on bones
* SOB & tachycardia - anemia compensation
* swollen lymph nodes - overworking
* weight loss
52
Describe acute leukemias to include: evaluation and treatment
* difficult to detect early since symptoms are so general
* blood test and bone marrow biopsy reveal how to diagnose it
* chemotherapy is typical treatment, along with blood transfusions, and antimicrobial agent
53
Describe chronic leukemias to include: general description
* slow growth of more mature (differentiated) cells which do not function normally
* onset is gradual: longer survival times. symptoms appear very slowly
54
Describe chronic leukemias to include: CLL
* chronic lymphocytic leukemia (CLL) = accounts for ½ of all leukemias, generally in older people (72)
* transformation of primarily B cells- refuse apoptosis and accumulate while also becoming inactive = no antibody production
* supression of normal antibody production = increase in infections
* causes anemia, thrombocytopenia, and neutropenia
* can be slow or very aggressive
55
Describe chronic leukemias to include: CML
* chronic myelogenous leukemia
* clinical manifestations:
* disease of older people (average age = 67)
* affect stem cells (exessive amounts of marrow granulocytes, RBC precursos, and megakaryocytes)
* 3 phases
* chronic
* accelerated
* terminal blast
56
Describe chronic leukemias to include: the 3 phases of CML
* chronic
* lasting 2-5 years
* may be asymptomatic
* accelerated
* lasting 6-18 months
* primary symptoms develop, more immature cells in bone marrow and blood
* enlargement of spleen and liver, infections, weight loss, and fever
* terminal blast phase
* lasting 3-6 months
* more blast cells in blood
* increase in severity of symptims
* resembles AML
* prognosis poor at this point
* philiadelphia chromosome is observed in 95% of those with CML
57
What is a Philadelphia chromosome?
* chromosomes 9 and 22 exchange parts of long ends
* the new protein that has been made allows the cell to bypass controls of normal cell growth and differentiation
58
Describe chronic leukemias to include: evalutation and treatment
* blood tests and bone marrow biopsy
* combined treatments
* bone marrow transplant - deplete bone marrow and replace it
* biologic response modifiers - increase body's immune response
* combination chemotherapy
59
Describe thrombocytopenia to include the following: general description
* can be alteration in number or quality of platelets
* too few platelets
60
Describe thrombocytopenia to include the following: risks associated with bleeding
risk of hemmorrhage with minor trauma if numbers fall too low
61
Define petechiae and purpuric spots
numbers can fall sufficiently low that spontaneous bleeding can occur without ant trauma
* petechaie = smaller than 2 mm
* pupuria = larger
62
Describe thrombocytopenia to include the following: etiology
* results from decreased platelet production, increased consumption (over using platelets), or both
* usually due to increased platelet consumption
63
what are 2 examples of thrombocytopenia?
1. heparin induced
2. immune thrombocytopenic purpura
64
what is a heparin induced thrombocytopenia?
* IgG bind to platelets and antibodies stick to form clots/clumping of cells
* most common drug induced condition
65
what is immune thrombocytopenic purpura thrombocutopenia?
* antibodies bind to platelet membrane and clumps together, then phagocytosis happens since they are more susceptible
66
Describe thrombocythemia to include the following: general description
too many platelets
67
describe primary thrombocythemia
* receptors does not recognize thrombopoietin, so body always has this hormone in the blood stream because it does not bind to platelets = more platelet production
* negative feedback effect
68
describe secondary thrombocythemia
* something happens to cause more platelet production (ex: disease)
* would occur with any disease state that stimulates thrombopoietin production
69
TRUE or FALSE: Individuals have a high risk of large-vessel thrombosis and ischemia in the extremities.
true
70
Impaired platelet function is characterized by:
* increased bleeding time in the presence of a normal platelet count
71
Describe inherited vs acquired causes of impaired platelet function.
* inherited = rare
* aquired
* drugs decreases platelet aggregation (ex: aspirin, NSAIDs)
* secondary to leukemia (cowding out effect) = low quality platelets produced
72
Describe the general cause of coagulation disorders.
defects of deficiences in one or more of the clotting factors
73
Distinguish between inherited vs acquired coagulation disorders.
* inherited = mutation in genes and don't make functional clotting factors
* ex: hemophilia
* aquired = a result of deficient synthesis of clotting factors by the liver, or due to dietary deficiency or vitamin K
74
Describe the effects of coagulation disorders.
* turbulent or reduced blood flow
* tissue factor induced
75
describe turbulent or reduced blood flow in the effect of inappropriate coagulation
triggers clotting cascade
* get innapropriate activation of clotting factors
76
describe the tissue factor induced effect of inappropriate coagulation
Tf (thromboplastin) released from damaged or inflamed, or dead tissues
* start cascade of blood clotting
77
what is important to remember with the effect of inappropriate coagulation?
not only do you start making emboli/thrombosis, you also lead to uncontrolled bleeding
* as you start making inappropriate blood clots, you deplete the number of available clotting factors = uncontrolled bleeding
78
Describe disseminated intravascular coagulation to include: general description
aquired clinical syndrome characterized by widespread activation of coagulation
* blood clots all around your body/tissues = block smaller blood vessels/embolus
