Unit 2 - Diseases of blood, lymph, and endocrine systems

Question 1

Anemia of chronic disease

Answer 1

Compromised ability to produce red blood cells, including cancer, Crohn’s disease, HIV/AIDS, kidney failure, rheumatoid arthritis, and some chronic inflammatory diseases

Question 2

True or false: Inhaled corticosteroid drugs are the most common cause of Cushing Syndrome related to drugs.

Answer 2

False. Inhaled steroids usually do not bring on Cushing syndrome unless high doses are taken.

Question 3

What is the cause of Cushing disease?

Answer 3

Abnormally high cortisol levels

Question 4

What are the characteristic features of Cushing syndrome?

Answer 4

A moon face and a fatty hump between the shoulders

Question 5

Drugs that can cause Cushing syndrome

Answer 5

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.

Question 6

How is hemophylia categorized?

Answer 6

Hemophilia is categorized as A, B, and C, with A being the most mild form and C being the most
serious

Question 7

Treatment for von Willebrand disease

Answer 7

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

Question 8

Treatment for hemophilia

Answer 8

Clotting factor is infused into the blood stream to help prevent bleeding. The amount
depends on the severity of the condition

Question 9

Why should patients with bleeding disorders wear medic alert bracelets?

Answer 9

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.

Question 10

Complications of untreated hyperthyroidism

Answer 10

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.

Question 11

Causes of iron deficiency anemia

Answer 11

Heavy
menstrual bleeding, cancer, ulcers, a polyp in the digestive system, or extended use of NSAIDs
can lead to iron deficiency anemia.

Question 12

Causes of vitamin deficiency anemia

Answer 12

Folate or B12 deficiency

Question 13

Aplastic anemia

Answer 13

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.

Question 14

Hemolytic Anemia

Answer 14

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.

Question 15

Anemias Associated with Bone Marrow Disease

Answer 15

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.

Question 16

Sickle cell anemia

Answer 16

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.

Question 17

Diagnosis of anemia

Answer 17

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.

Question 18

Treatment of anemia

Answer 18

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.

Question 19

Polycythemia vera

Answer 19

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.

Question 20

What mutation is responsible for polycythemia vera?

Answer 20

JAK2. This mutation is likely not inherited

Question 21

Most common age of onset and affected demographic for polycythemia vera

Answer 21

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.

Question 22

Symptoms of polycythemia vera

Answer 22

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

Question 23

Complications associated with polycythemia vera

Answer 23

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.

Question 24

Hyperglycemic hyperosmolar nonketotic

syndrome (HHNS

Answer 24

A life-threatening condition that results when a diabetic patient’s blood glucose rises over 600 mg/dL

Question 25

Blood test results that confirm a diagnosis of polycythemia vera

Answer 25

Increased number of red blood cells • Elevated hematocrit measurements • Elevated hemoglobin levels • Low levels of erythropoietin (EPO)

Question 26

Additional tests for polycythemia vera

Answer 26

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.

Question 27

Treatment for polycythemia vera

Answer 27

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.

Question 28

Leukemia

Answer 28

Cancer of the blood- forming tissues, such as the bone marrow and lymphatic system

Question 29

Acute leukemia

Answer 29

Abnormal blood cells are immature and multiply quickly

Question 30

Chronic leukemia

Answer 30

Mature blood cells reproduce incorrectly and gradually build up over time.

Question 31

Lymphocytic leukemia

Answer 31

The lymphoid cells are affected.

Question 32

Myelogenous leukemia

Answer 32

• Myelogenous leukemia:

Question 33

What is the most common form of leukemia in children?

Answer 33

Acute lymphocytic leukemia

Question 34

What are the four major types of leukemia?

Answer 34

Acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myelogenous leukemia, and chronic myelogenous leukemia

Question 35

Acute lymphocytic leukemia (ALL)

Answer 35

Abnormal blood cells are immature and multiply quickly. The lymphoid cells are affected. ALL is the most common form of leukemia in children.

Question 36

Most common form of acute leukemia in adults

Answer 36

Acute myelogenous leukemia (AML)

Question 37

Acute myelogenous leukemia (AML)

Answer 37

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.

Question 38

Chronic lymphocytic leukemia (CLL):

Answer 38

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.

Question 39

Chronic myelogenous leukemia (CML):

Answer 39

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.

Question 40

What form of leukemia is associated with the Philadelphia chromosome?

Answer 40

CML.

Question 41

Risk factors for leukemia

Answer 41

``` 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 ```

Question 42

What do early symptoms of leukemia resemble?

Answer 42

Influenza

Question 43

Symptoms of leukemia

Answer 43

``` 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 ```

Question 44

Diagnosis of leukemia

Answer 44

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.

Question 45

Treatment of leukemia

Answer 45

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.

Question 46

Two most common types of lymphoma

Answer 46

Hodgkin lymphoma and non- Hodgkin lymphoma.

Question 47

Lymphoma

Answer 47

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.

Question 48

Most common type of lymphoma

Answer 48

Non-Hodgekin

Question 49

Non-Hodgkin lymphoma

Answer 49

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.

Question 50

Hodgkin lymphoma

Answer 50

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.

Question 51

Symptoms of lymphoma

Answer 51

``` Swollen lymph nodes • Chest pain • Coughing • Trouble breathing • Abdominal pain or swelling Loss of appetite • Fatigue • Fever • Night sweats • Weight loss ```

Question 52

Diagnosis of lymphoma

Answer 52

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.

Question 53

Treatment of non-Hodgkin lymphoma

Answer 53

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.

Question 54

Hodgkin and progressive noon-Hodgkin lymphoma treatment

Answer 54

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.

Question 55

Cause of bleeding disorders

Answer 55

Bleeding disorders result when blood platelets lack the appropriate level of clotting factor necessary to form clots

Question 56

What causes hemophilia?

Answer 56

THe lack of clotting factor

Question 57

What effect does the bleeding associated with hemophilia have?

Answer 57

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.

Question 58

When is hemophilia usually first noticed?

Answer 58

The | first indication of hemophilia is usually prolonged bleeding after circumcision.

Question 59

Von Willebrand Disease

Answer 59

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.

Question 60

How does von Willebrand disease affect clotting?

Answer 60

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.

Question 61

How does von Willebrand disease compare to hemophilia?

Answer 61

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.

Question 62

What is the pattern of inheritance of von Willebrand disease?

Answer 62

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.

Question 63

General symptoms of a bleeding disorder

Answer 63

``` 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 ```

Question 64

Hemophilia-specific symptoms

Answer 64

Joint tightness • Bleeding after immunizations • Unexplained irritability in infants

Question 65

When are mild bleeding disorders often detected?

Answer 65

Mild bleeding disorders may not be diagnosed until excessive bleeding during or after surgery indicates a possible problem.

Question 66

Diagnosis of bleeding disorders

Answer 66

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.

Question 67

Thyroid hormones

Answer 67

thyroxine (T4) and triiodothyronine (T3). Calcitonin

Question 68

Calcitonin

Answer 68

A hormone produced by the thyroid that places a fundamental role in calcium homeostasis

Question 69

What organ regulates the production of TSH by the pituitary?

Answer 69

The hypothalamus

Question 70

What secretes TSH?

Answer 70

The pituitary gland

Question 71

Causes of hyperthyroidism

Answer 71

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.

Question 72

What is the most common form of hyperthyroidism?

Answer 72

Grave's disease

Question 73

Graves' disease

Answer 73

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

Question 74

Hyperfunctioning thyroid nodules

Answer 74

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.

Question 75

Thyroiditis:

Answer 75

Inflammation of the thyroid gland can cause leakage of thyroid hormones into the bloodstream.

Question 76

Characteristics and symptoms of babies born with hypothyroidism

Answer 76

* Jaundice * Large tongue that protrudes * Frequent choking * Puffy face * Problems feeding * Growth delays * Abnormal development * Constipation * Excessive sleepiness * Poor muscle tone