patho exam 3 Flashcards
(102 cards)
1
Q
sodium lab value
A
136-145
2
Q
potassium lab value
A
3.5-5
3
Q
magnesium lab value
A
1.7-2.2
4
Q
calcium lab value
A
9-11
5
Q
phosphate
A
3.2-4.3
6
Q
leukocytes
A
subcat: gran & agran
-neutrophils (gran)
-lymphocytes (agran)
-monocytes (agran)
-eosinophils (gran)
-basophils (gran)
immunity & inflammation
7
Q
granulocytes
A
have cells w/ a nucleus in several lobes & granules -> they release mediators w/ immunity & inflammatory properties
8
Q
agranulocytes
A
have a nucleus but have few to no granules -> still aid in immunity & inflammation
9
Q
neutrophils
A
-1st to arrive
-bands (immature/left) & segs (mature/right)
-shift to left = acute phase
increase w/ acute bacteria infections & trauma
10
Q
lymphocytes
A
-primary cells of immune response (T&B cells) that live in the lymphoid tissues
increase w/ chronic bacterial infection & actute viral infection
11
Q
monocytes
A
phagocytosis
increase w/ bacterial infections & cancers (or could be lower for cancer)
12
Q
eosinophils
A
increase w/ allergic rx or parasitic infections
worms, wheezes & weird disease
13
Q
basophils
A
increase w/ allergic rx
14
Q
low hgb indicates
A
bleeding, folate/b12 defic, cancers, kidney & liver disease
15
Q
high hgb indicates
A
polycythemia, COPD, high alt, heavy smoking
16
Q
low hct indicates
A
anemia, bleeding, bleeding disorders, fluid imbalances
17
Q
high hct indicates
A
polycythemia, COPD, dehydration, shock, congenital heart disease
18
Q
neutropenia precautions
A
-good hygiene
-avoid contact w/ sick people
-avoid raw fruits, veg, & grains
-keep doors closed
19
Q
neutropenia
A
absolute count < 1000
20
Q
infectious mononucleosis
A
infection of B lymphs caused by epstein barr virus
21
Q
myelodysplastic syndrome
A
a group of related hematologic disorders characterized by a change in the quantity and quality of bone marrow elements (bone marrow failure)
22
Q
myelodysplastic syndrome CM
A
(cytopenias) anemia, infection & spontaneous bleeding or bruising
23
Q
leukemias
A
malignant neoplasms of cells originally derived from a single hematopoietic cell line (WBC that are unregulated and/or undifferentiated)
24
Q
leukemic cells
A
-immature & unregualated
-proliferation in bone marrow
-circulate in blood
-infiltrate spleen, lymph nodes
25
leukemia classifications
according to their predominant cell (lymphocytic or myelocytic) & whether the condition is acute or chronic
26
what is the most common childhood leukemia
acute lymphocytic (lymphoblastic) leukemia
27
what is the most common leukemia in older adults
chronic lymphocytic leukemia
28
malignant lymphomas
neoplasms of cells derived from lymphoid tissues (hodgkin disease & nonhodgkin disease)
29
what cell is specific to hodgkin disease
reed-stenberg cell: a distinctive tumor cell found w/ lymph biopsy
30
hodgkin disease
characterized by painless, progressive, rubbery enlargement of single node or group of nodes, usually around the neck (good prognosis)
31
nonhodgkin disease
neoplastic disorder of lymphoid tissue that spreads early (to liver, spleen & bone marrow), characterized by painless, superficial lymphadenopathy
32
multiple myeloma
plasma cell cancer (B cells), atypical proliferation of one of immunoglobulins "M protein" which increases osteoclast activity **unable to maintain humoral immunity**
33
multiple myeloma characteristics
bone pain/fractures, impaired production of RBC & WBC
**hypercalcemia**
34
hyponatremia causes
-GI loses
-renal losses (diuretics)
-skin loses (burns, wounds)
-fasting diets, polydipsia (water intox)
-excess hypotonic fluid
35
hyponatremia S/s
-confusion/altered LOC
-anorexia, muscle weakness
-can lead to seeizures/coma
36
with Na, think
brain
37
hyponatremia treatment
-Na replacement (slowly)
-PO/IV
-IV fluids
-treat underlying problem
**for dilutional, fluid restriction**
38
hypernatremia causes
-IV fluid
-near drowning
-not enough fluid intake or too much water loss
-profound diuresis
**will not get from eating too much salty food**
39
hypernatremia S/s
-altered LOC/confusion, seizure, coma
-extreme thirst (hypereosmolality)
-dry, sticky mucous membranes
-muscle cramps
40
hypernatremia
-if H20 loss, add water
-if Na excess, remove sodium
41
what is the main source of K+
diet
42
hypokalemia causes
-renal or GI losses
-acid base disorders
43
hypokalemia S/s
-cardiac rhythm disturbances (can be lethal)
-muscle weakness, leg cramps
-decreased bowel motility
44
magnesium
helps stabilize cardiac muscle cells by blocking K+
45
hypomagnesium causes
-GI or renal losses
-limited intake
-alc abuse
-pancreatitis
-hypergly
46
hypomagnesium S/s
-hyperactive reflexes
-confusion
-cramps
-tremors
-seizures
**nystagmus**
47
hypermagnesium causes
-increased intake accompanied by renal failure (chronic renal failure pt who take milk of mag, OB pt)
48
hypermagnesium S/s
-lethargy
-floppiness
-muscle weakness
-decreased reflexes
-flushed warm skin
-decreased pulse/BP
49
calcium think
bone & thyroid
50
K+ think
heart
51
hypocalcemia: positive chovstek's
-ipsilateral twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior to the ear **eye will close if present**
52
hypocalcemia: positive trousseau's
-carpal spasm upon inflation of a BP cuff to 20 mmHg above the pt's systolic blood pressure for 3 mins **will see twitch**
53
hypercalcemia causes
-hyperparathyroidism
-cancers (breast, lung, hematologic)
-tums overdose
54
hypercalcemia S/s
**calcium acts like a sedative**
-fatigue
-lethargy
-confusion
-weakness
-leading to seizures
-coma
55
what form of phosphorous is measured
inorganic (circulating and measured)
56
phosphate
-essential for ATP formation
-needed for glucose, protein, & fat metabolism
-part of DNA & RNA
57
hypophosphatemia causes
-decreased absorption
-antacid
-severe diarrhea
-increased kidney elimination
-malnutrition
58
hyperphosphatemia causes
-kidney failure
-laxatives
59
hyperphos S/s
-usually asymptomatic
-muscle spasms
-paresthesia
-tetany
(sim to hypoCa)
60
fungal transmission: implementation
tineas -> skin to skin touching
61
fungal transmission: inhalation
cryptococcal -> through air
62
fungal transmission: taking antibiotics
candidiasis
63
superficial fungal skin lesions
-tinea pedis/captitis/versicolor
-candidiasis
64
tinea corporois
ringworm of the body
65
tinea pedis
athlete's foot - dry, scaling pruritic lesions
treatment: topical anti fungals
66
tinea versicolor
skin on the upper chest, back or arms - rash - risks are hot climates, sweating, oily skin, weakened immune system **not contagious**
treatment: topical anti fungal including shampoos
67
tinea capitis
hair (cradle cap) - scaly erythematous lesions and hair loss
treatment: PO systemic anti fungals
68
tinea cruris
ringworm of the groin
69
herpes zoster is
shingles , activated by immunosuppression, stress or illness
treatment: anti virals
70
prodrome
burning/tingling along dermatome & then rash develops w/ vesicles that dry and crust over
71
bacteria skin infections
-impetigo
-abscess
-furuncle
-cellulitis
-MRSA
72
impetigo
-causative agents: staph & strep
-acute & contagious
-appearance: vesicles, pustules, crust
-treatment: tropical antibacterial (bactroban)
73
abscess
-inflamed skin w/ pus
-tender
-treatment: incision & drainage -> antibiotics
74
furuncle
bacterial infection of hair follicle
treat w/ I&D -> PO antibiotics
75
carbuncle
painful, deep swelling of the skin caused by bacteria
treat w/ I&D -> antibiotics
76
cellulitis
-causes: bacteria infection of skin & surrounding tissues (initial wound becomes infected)
-not contagious (possible bite)
-appearance: red, swollen, warm
-treatment: PO systemic antibiotics, IV based on severity
77
MRSA high risk
high school wrestlers, child care workers, & people who live in crowded conditions
78
MRSA treatment
-hospital: IV vancomycin or zyvox
-community acquire: bactrim or dicloxacillin
79
prophylaxis
bactroban nasal ointment prior to surgery
80
actinic keratosis
-benign lesions
-d/t damage by sun's UV rays
-common in fair skin persons
-rough, scaly, red plaques
81
solar lentigos
-benign lesions
-also known as liver/age spots
**can indicate cancer risk**
82
skin cancer: basal cell
most common, least often malignant (usually won't be problematic)
-sun
-translucent, shiny, pearly nodule -> ulcer
83
skin cancer: squamous cell
2nd most common, can metastasize to remote areas
-sun
-curable if early treatment
-red & scaling, slightly elevated lesion, irregular border, shallow
84
skin cancer: melanoma
rarer, but high rates of metastasis
-can spread to epidermis & dermis
-risks: blonde/red hair, freckles upper back, blistering sunburn before 20, outdoor job as a teenager
85
pulmonary embolism
**most serious DVT complication**
the thrombus becomes lodged in our permanent pulmonary circulation preventing gas exchange
86
chronic thromboembolic pulmonary HTN
**rare, most common symptom is SOB**
caused by repeated clots in the lung which causes increased pressure in the lung circulation
87
post thrombotic syndrome
8-70% of pt who have DVT/VTEs can develop
**related to chronic inflammation & chronic venous htn**
causes damage to the vein walls leading to pain, achy, fatigue, sensation of swelling, cramps, itching, parenthesis, bursting pain w/ exercise, color change
88
phlegmesia cerula dolens (pain blue inflammation)
when clots are in your major leg veins and they become totally occluded **sudden massive swelling w/ deep pain**
-can lead to amputation or gangrene
89
what is the first sign of a GI tract disorder
diarrhea
90
episodic diarrhea
**intermittent** food allergies or irritant (like caffeine)
91
osmotic diarrhea
increased amounts of osmotically active solutes (**epsom salt & mag sulfate), water rushes into the colon area resulting in diarrhea
**tube feeding**
92
secretory diarrhea
causes by some kind of bacteria or toxin which increases secretion & inhibits reabsorption of water in the gut **bacteria: vibrio cholerae & staph aureus**
93
exudative diarrhea
active sites of inflammation in the bowel lumen that results in excitation of mucus, blood & protein from those sites **open internal wounds**, water gets pulled into the intestines leading to diarrhea **Crohns & UC**
94
diarrhea related to motility disturbances
result of decreased absorption in the small intestine so large amounts of fluid will be delivered to the colon **gastrectomy, dumping syndrome & IBS**
95
hypersen: type 1
-allergens
-IgE on Mast Cells
-Mediator release
**allergic rhinitis, asthma, urticaria**
96
hypersen: type 2
-IgG and IgM antibodies
-attach cells (on surface, leads to cell death)
-cell lysis
**wrong blood given, newborn/mother Rh incompatibilliaty, autoimmune disorders**
97
hypersen: type 3
-IgG or IgM antibodies
-accumulate in tissues (deposits)
-inflammation
**arthritis, glomerulonephritis, lupus**
98
hypersen: type 4
-delayed Tcell activation
-cytokines
-48 to 72 hr peak
**contact dermatitis, tuberculin**
99
opioid onset, peak & duration
onset: 12-24 hr
peak: 72 hr
duration: less @1wk
100
benzo onset & peak
onset: 6-12hr
peak: 2 wks
101
alc onset & peak
onset: 8 hr
peak: 1-3 day
102
treatment for benzo & alc withdrawal
-thiamine
-lorazepam
-diazepam
