Term
| Overview of Major Cardiovascular Diseases |
|
Definition
Congenital heart diseases
Ischemic vascular disease
Hypertension-related disease
Infectious diseases
Autoimmune disorders
Metabolic diseases |
|
|
Term
| Each year, approximately 25,000 babies are born with a heart defect. |
|
Definition
The defect may be:
Minor and asymptomatic or related to only minor clinical symptoms
Major and associated with major clinical problems or may even be lethal |
|
|
Term
| Causes of Congenital Heart Disease |
|
Definition
Cause unknown (most often)
Viruses
Alcohol
Chromosomal abnormalities |
|
|
Term
| Most Common Congenital Heart Diseases |
|
Definition
Ventricular septal defect
Atrial septal defect
Tetralogy of Fallot
_________________________________
Note: Isolated septal defects are initially acyanotic, but later they may become cyanotic when the direction of blood flow through the shunt is reversed. Tetralogy of Fallot presents with early cyanosis. |
|
|
Term
|
Definition
Generalized form
Localized form
Coronary heart disease
Cerebrovascular disease
Atherosclerosis of the aorta
Peripheral vascular disease |
|
|
Term
| Pathogenesis of Atherosclerosis |
|
Definition
Endothelial cell injury
Smooth muscle cell proliferation and lipid accumulation inside of the cells (foam cells)
Macs take up lipid laden SM cells and also become foam cells
Macs release cytokinies that cause more endothelial damage and formation of an atheroma
Atheroma has a cap that ruptures and transforms into an intimal ulceration
Clotting cascade is activated and a clot covers the ulceration |
|
|
Term
| What allows for a high number of UPI upper respiratory infections? |
|
Definition
| Open-ended and in direct contact with the environment |
|
|
Term
| What allows for a high number of immunologic diseases? |
|
Definition
| Exposure to many allergens inhaled in air |
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|
Term
| T/F Can inhaled pollutants, airborne particles, and gases may cause disease? |
|
Definition
|
|
Term
| The heart and the lungs form a functional unit. ______________ in one leads to _____________ in the other |
|
Definition
|
|
Term
| What can inhaled air contain? |
|
Definition
|
|
Term
| What are some major lung diseases? |
|
Definition
| Infectious diseases, Immune diseases, environmentally induced diseases, Circulatory diseases, Tumors |
|
|
Term
| What is the URI etiology recognized as? |
|
Definition
|
|
Term
| What can URI etiology consist of? |
|
Definition
| Acute inflammation of the nose, sinuses, throat or larynx |
|
|
Term
| What are most URI’s caused by? |
|
Definition
|
|
Term
| What are the most common viruses that cause URI’s? |
|
Definition
| Influenza virus, parainfluenza virus, rhinovirus |
|
|
Term
| What are predisposing factors for URI’s? |
|
Definition
| Physical exhaustion, old age, and general poor health |
|
|
Term
| T/F The pathologic findings in URI are nonspecific? |
|
Definition
|
|
Term
| Describe the nose and URT when infected? |
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Definition
| The mucosa of the nose and URT are congested, edematous, and infiltrated with inflammatory cells. In viral infections infiltrates include lymphocytes, macrophages and plasma cells. |
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|
Term
|
Definition
|
|
Term
| What are clinical presentations of URI’s? |
|
Definition
Rhinorrhea
· Throat pain, discomfort swallowing, sneezing and a hacking cough
· Lasts form a few days to 1 to 2 weeks
· Heal spontaneously
· Signs of purulent discharge indicates a bacterial superinfection |
|
|
Term
|
Definition
| Middle respiratory syndrome |
|
|
Term
| What body parts are included in the MRS? |
|
Definition
| Larynx, trachea and the major extrapulmonary bronchi |
|
|
Term
| What is an acute, possibly life-threatening infection of the larynx? |
|
Definition
|
|
Term
| What age is Croup most commonly found in? |
|
Definition
|
|
Term
| What happens to the vocal cords resulting in inpiratory stridor (barking cough)? |
|
Definition
|
|
Term
| What is the cause of Croup? |
|
Definition
| Caused by parainfluenza virus |
|
|
Term
| T/F There is no treatment to end the Croup infection, however, supportive treatment is needed. |
|
Definition
|
|
Term
| What disease causes sudden loss of voice, hoarseness and throat pain on swallowing? |
|
Definition
|
|
Term
| What group of people have peak incidences of Epiglottitis? |
|
Definition
| Peak incidence in school-aged children and adolescents |
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|
Term
| What causes Epiglottitis? |
|
Definition
| Caused by Haemophilus influenzae (a bacteria not a virus) |
|
|
Term
| What are the symptoms of Epiglottitis? |
|
Definition
| Edema and redness of the epiglottis (Key findings: cherry red epiglottis) and surrounding pharyngeal mucosa causing narrowing of the air passage |
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|
Term
| Figure 8.05 depicts two pictures showing Acute inflammation of the larynx. What are the two diseases referenced? |
|
Definition
| Acute Epiglottitis and Croup |
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|
Term
| What is an acute childhood disease involving the bronchi and bronchioles (does not extend into the alveolar spaces)? |
|
Definition
|
|
Term
| Is Bronchiolitis caused by a bacteria or a virus? |
|
Definition
|
|
Term
| What is the virus that causes Bronchiolitis in 80% of the cases? |
|
Definition
| Respiratory suncytial virus |
|
|
Term
| What does the virus cell invade causing cell death and desquamation? |
|
Definition
| Invades the epithelial cells of the bronchi and bronchioli |
|
|
Term
| During bronchiolitis the inflammatory response includes what immune response cells? |
|
Definition
| Lymphocytes, Plasma cells, and Macs |
|
|
Term
| What does the edema of the airways and desquamation of dead cells cause to the bronchi and bronchioli? |
|
Definition
|
|
Term
| What age group is affected by bronchiolitis? |
|
Definition
| Infants and small children |
|
|
Term
| What are some symptoms of bronchiolitis? |
|
Definition
| Wheezing, low grade fever, shortness of breath (Felix also says mucus is present) |
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|
Term
| What is the difference in the areas affected by bronchiolitis and pneumonia? |
|
Definition
| Pneumonia affects the alveolar spaces whereas bronchiolitis does not. |
|
|
Term
| What areas are bronchopneumonia limited to? |
|
Definition
| Limited to the segmental bronchi and surrounding lung parenchyma |
|
|
Term
| What area does lobar pneumonia affect? |
|
Definition
| Widespread/diffuse alveolar pneumonia |
|
|
Term
| T/F Is interstitial Pneumona diffuse and bilateral? |
|
Definition
|
|
Term
| What causes interstitial pneumonia? |
|
Definition
| Infection caused by Mycoplasma pneumiae or viruses |
|
|
Term
| What are common causes of pneumonia? |
|
Definition
| Bacteria (75% of cases); Viruses; Fungi; Bacteria-like organisms |
|
|
Term
| What type of bacteria cause Pneumonia? |
|
Definition
| Streptococcus pneumoniae #1, Haemophilus influenzae, Staphylococcus aureus |
|
|
Term
| What type of virus cause pneumonia? |
|
Definition
|
|
Term
| What type of fungi cause pneumonia? |
|
Definition
| Aspergillus flavus, Candida albicans, Pneumocystis carinii (seen in Aids patients) |
|
|
Term
| What bacteria-like organisms cause pneumonia? |
|
Definition
| Mycoplasma pneumoniae (causes walking pneumonia) |
|
|
Term
| What is the pathogenesis of pulmonary infections? |
|
Definition
| Inhalation of aerosol particles; Aspiration of infected secretion from URT, Aspiration of regurgitated gastric contents; Hematogenous spread |
|
|
Term
| What is inhalation of aerosol particles typical of? |
|
Definition
| Typical of viral infections |
|
|
Term
| What is the aspiration of infected secretions from the upper respiratory tract typical of? |
|
Definition
| Typical of strep and staph |
|
|
Term
| What is the aspiration of regurgitated gastric contents typical of? |
|
Definition
| Common in people who are unconscious especially alcoholics and drug addicts (also epileptic seizures) The infection is caused by anaerobic bacteria |
|
|
Term
| What is a hematogenous spread typical of? |
|
Definition
|
|
Term
| What is know as a bacterial invasion of the bronchial mucosa? |
|
Definition
|
|
Term
| How does a bronchopneumonia occur? |
|
Definition
| PMN move into the lumen of the airways and starts an inflammatory response |
|
|
Term
| In bronchopneumonia the inflammation spreads from the _________ into the adjacent ____________? |
|
Definition
|
|
Term
| What does Lobular indicate? |
|
Definition
|
|
Term
| What does Lobar represent? |
|
Definition
| Large portions of entire lobes |
|
|
Term
| What accumulates and replaces the air causing lung parenchyma to become consolidated? |
|
Definition
| Intra-alveolar exudate accumulates |
|
|
Term
| What inflammation primarily affects the alveolar septa and does not result in the exudation of PMN’s into the alveolar lumen? |
|
Definition
|
|
Term
| What causes interstitial pneumonia by attaching to the surface of respiratory epithelial cells? |
|
Definition
|
|
Term
| T/F Interstitial Pneumonia causes cell necrosis and induce an infiltrate in the alveolar septa. |
|
Definition
|
|
Term
| What are systemic signs of infection for pneumonia? |
|
Definition
| Fever, chills, prostration |
|
|
Term
| What are local signs of irritation in pneumonia? |
|
Definition
|
|
Term
| What can airway obstruction cause? |
|
Definition
| Shortness of breath (dyspnea), Rapid breathing (tachypnea) |
|
|
Term
| Inflammation and tissue destruction during pneumonia can cause expectoration of? |
|
Definition
|
|
Term
| What are complications of Pneumonia? |
|
Definition
| Pleural fibrosis, Empyema, Abscess, Bronchiectasis, Interstitial Fibrosis, Cysts |
|
|
Term
| What are causes of Atypical Pneumonia in which the symptoms are usually milder, with less fever and no chills? |
|
Definition
| Viruses, Mycoplasma Pneumoniae, Pneumocystis carinii (Aids) |
|
|
Term
| What is a key feature in Pulmonary Tuberculosis? |
|
Definition
| Key feature is the formation of granulomas which are composed of lymphocytes, macs and giant cells. |
|
|
Term
| What does the central portion of the granuloma consist of? |
|
Definition
| It is necrotic and consists of caseous necrosis |
|
|
Term
| What is a primary infection that hasn’t been exposed and results in localized lung inflammation? |
|
Definition
| The lession is called the Ghon complex and it consists of granulomas in the lung parenchyma and enlarged regional lymph nodes. 95% of the times the complex heals spontaneously and undergoes calcification. |
|
|
Term
| How does a secondary infection develop in pulmonary tuberculosis? |
|
Definition
| Develops as a result of reactivation of a dormant primary infection or reinfection (Most are due to reactivation) |
|
|
Term
| Bacteria spread to the apex of the lungs and cause? |
|
Definition
| Granulomatous lobular pneumonia |
|
|
Term
| Confluent granulomas can form cavities which become a source of ______________? |
|
Definition
|
|
Term
Pulmonary Tuberculosis – Extrapulmonary Tuberculosis
What is widespread seeding of bacteria in the lungs or other organs causing the formation of many small granulomas? |
|
Definition
|
|
Term
| What is the spread of bacteria through airspaces producing a massive lobar pneumonia? Can involve the same lung or the contralateral one. |
|
Definition
|
|
Term
| What is an infection that extends to the pleura and is accompanied by pleural effusion and formation of granulomas in the pleura? |
|
Definition
|
|
Term
| What do you get when TB gets to the larynx and if swallowed they can cause GI TB in the SI? |
|
Definition
|
|
Term
| What areas can TB affect through lymphatic spreading? |
|
Definition
| Pleural Surface, Lung Parenchyma, Contralateral Lung |
|
|
Term
| What areas can TB affect through hematogenous spreading? |
|
Definition
| Meningitis, TB of urogenital tract, Bone TB |
|
|
Term
| What areas can TB affect through the airways? |
|
Definition
| Bronchial spread in the same lung, Spread to the larynx, Aspirated TB swallowed into the esophagus leads to intestinal TB |
|
|
Term
| What is chronic obstructive pulmonary disease? |
|
Definition
| A group of diseases characterized by chronic airway obstruction |
|
|
Term
| What diseases are included in COPD? |
|
Definition
| Chronic bronchitis, emphysema, bronchiectasis |
|
|
Term
|
Definition
| A permanent dilatation of the bronchi |
|
|
Term
| Why does bronchectasis occur? |
|
Definition
| Occurs as a result of persistent inflammation inside the airways |
|
|
Term
| What are the differences between the larger and smaller bronchi in bronchiectasis? |
|
Definition
| Larger bronchi show saccular dilatation, smaller bronchi show cylindrical dilatation |
|
|
Term
| What material are dilated bronchi filled with which cannot be cleared by coughing? |
|
Definition
|
|
Term
| Infection spreads to adjacent aveoli can cause what? |
|
Definition
|
|
Term
| What is chronic bronchitis? |
|
Definition
| Excessive production of tracheobronchial mucus causing cough and expectoration for at least three months during 2 consecutive years |
|
|
Term
| What is the cause of chronic bronchitis in over 90% of the cases? |
|
Definition
|
|
Term
| What type of pathology is there for chronic bronchitis? |
|
Definition
|
|
Term
| What occurs to the mucosa during chronic bronchitis? |
|
Definition
| The mucosa becomes infiltrated with lymphocytes, macs and plasma cells. |
|
|
Term
| That occurs to the submucosa during chronic bronchitis? |
|
Definition
| The submucosa shows marked mucous gland hyperplasia, chronic inflammation and fibrosis |
|
|
Term
|
Definition
| Enlargement of the airspaces distal to the terminal bronchioles with destruction of alveolar walls. |
|
|
Term
| What is emphysema linked to? |
|
Definition
| Is linked to chronic cigarette smoking but can be found in non-smokers with Alpha-1-antitrypsin deficiency |
|
|
Term
| What causes an influx of inflammatory cells in the alveoli? |
|
Definition
|
|
Term
| What is the mechanism that destroys alveolar walls? |
|
Definition
| Proteolytic enzymes are released from leukocytes and destroy the alveolar walls |
|
|
Term
| What effect to oxygen radicals have on the alveolar cells? |
|
Definition
| Oxygen radicals produced by cigarettes kill alveolar cells and leukocytes which release even more enzymes. Elastase breaks down elastin fibers and its activity is increased. Oxygen radicals also inactivate antiproteolytic enzymes (Alpha 1 theory) |
|
|
Term
|
Definition
| Widening of the airspaces in the center of a lobule, MC form and is found in smokers, Remaining bronchioles are infiltrated with antracotic macs and chronic inflammatory cells |
|
|
Term
|
Definition
| Involves all the airspaces distal to the terminal bronchioles, occurs with alpha 1 deficiency |
|
|
Term
| What are immune Diseases? |
|
Definition
| Allergic rhinitis, Asthma, Sacroidosis, Hypersensitivity pneumonitis |
|
|
Term
| What are the two types of Asthma? |
|
Definition
|
|
Term
| What are Intrinsic attacks precipitated by? |
|
Definition
| Physical factors, Exercise, Psychological stress, Chemical irritants and air pollution, Bronchial infection, Aspirin |
|
|
Term
| What is the pathgenesis of Asthma? |
|
Definition
| Smooth muscle cells in spasm, mucous plug, mucous excreted into lumen, see figure 8-15 |
|
|
Term
| What is the histopathology of Asthma? |
|
Definition
| Mucus in lumen, Inflammation and basement membrane thickening, Enlarged mucous gland, smooth muscle hyperplasia |
|
|
Term
Hypersensitivity Pneumonitis
Farmers lung is due to? |
|
Definition
|
|
Term
| Furrier’s lung is due to ? |
|
Definition
|
|
Term
|
Definition
| Contaminated fluid/humidity |
|
|
Term
| Pigeon-breeder’s lung is due to? |
|
Definition
|
|
Term
| What are the two pathogenesis of hypersensitivity pneumonitis? |
|
Definition
| Antibody-mediated alveolar injury, and Cell-mediated alveolar injury |
|
|
Term
Causes of dyspnea
What are examples of large airway obstruction? |
|
Definition
| Laryngospasm, foreign body |
|
|
Term
| What are examples of small airway obstruction? |
|
Definition
|
|
Term
| What are examples of intra-alveolar obstruction? |
|
Definition
|
|
Term
| What are examples of Alveolar Septal lesions with destruction? |
|
Definition
|
|
Term
| What are examples of Alveolar Septal lesions with increased thickness? |
|
Definition
|
|
Term
| What are examples of Alveolar Septal lesions with collapse? |
|
Definition
|
|
Term
| What are examples of central nervous causes? |
|
Definition
| Apoplexy of the respirator centers |
|
|
Term
| What are causes of Adult Respiratory Distress Syndrome (ARDS)? Give examples. |
|
Definition
Shock e.g. Trauma, Burns, Acute cardiac failure
Pneumonia e.g. Bacterial, Viral
Toxic lung injury e.g. Toxic fumes, cytotoxic drugs, bacterial endotoxins
Aspiration of fluids e.g. Near-drowning |
|
|
Term
| What is the pathogenesis of ARDS? |
|
Definition
|
|
Term
|
Definition
| Incomplete expansion or collapse |
|
|
Term
| Give examples of Atelectasis? |
|
Definition
Collapse (pneumothorax)
Compression (hydrothorax)
Obstruction (tumor) |
|
|
Term
| What are the most important Neoplasms of the Respiratory system? |
|
Definition
| Carcinoma of the larynx, Lung cancer |
|
|
Term
| What is the most common malignant tumor of internal organs in the US? |
|
Definition
|
|
Term
| What is Lung carcinoma most related to? |
|
Definition
|
|
Term
| What is the prognosis of Lung carcinoma? |
|
Definition
|
|
Term
| At what age is lung carcinoma rare? |
|
Definition
| Rare before the age of 40, but its incidence rises with age |
|
|
Term
| Review Figure 8-25 on Histogenesis of Lung carcinoma |
|
Definition
|
|
Term
| What is the histopathology of Lung tumors? |
|
Definition
| Squamous cell carcinoma, Adenocarcinoma, Large0cell undifferentiated carcinoma, Small-cell carcinoma, Tumors of mixed pattern, Carcinoid, Mesothelioma |
|
|
Term
| T/F Tumors can be central (hilar) or peripheral (subpleural) |
|
Definition
|
|
Term
| What are clinical features of Lung Cancer? |
|
Definition
| What are clinical features of Lung Cancer? |
|
|
Term
| Where can Lung carcinoma metastasize to? |
|
Definition
| Adrenals, Kidneys, Bones, Heart (pericardium), Brain, Liver, Hilar and Mediastinal lymph nodes, Pleura |
|
|
Term
| What is the most common malignant tumor of the lungs? |
|
Definition
| Metastatic cancer in the lungs |
|
|
Term
| What may metastatic cancer in the lungs present as? |
|
Definition
| Solitary lesion, Multiple lesion (cannonballs on x-ray films), Diffuse involvement of the lungs. |
|
|
Term
| Name 3 types of white blood cells? |
|
Definition
| Granulocytes, monocytes, lymphocytes |
|
|
Term
| Name 3 types of granulocytes? |
|
Definition
| Neutrophils, eosinophils, basophils |
|
|
Term
| Pluripotent hematopoietic stem cells form what 2 types of stem cells? |
|
Definition
| Trilineage or Lymphoid stem cells |
|
|
Term
| What types of cells can be created by the trilineage stemcell? |
|
Definition
| RBC’s and megakaryocytes which will become platelets. The Trilineage stem cell also creates monocytes and granulocytes (neutrophils, eosinophils, basophils) |
|
|
Term
| What is the composition of blood? |
|
Definition
|
|
Term
| When peripheral blood is collected via tube, it is collected with an anticoagulant so it doesn’t clot. Once it is spun in a centrifuge, where is it location in the tube? |
|
Definition
| Plasma rises to top, buffy coat is in the center (WBC’s and platelets) and the cells settle to the bottom. |
|
|
Term
| What is the primary function of the erythrocytes? |
|
Definition
| To transport oxygen from the lungs into the peripheral tissues |
|
|
Term
| What is a complex molecule that consists of 4 heme and 4 globin molecules and is located within a RBC? |
|
Definition
|
|
Term
| What is the size of a normal blood cell? |
|
Definition
|
|
Term
| What requires iron, vitamins B-12, B-6, and folic acid? |
|
Definition
|
|
Term
| How long does an RBC live in the circulation for? |
|
Definition
|
|
Term
| How are old and damaged blood cells removed from circulation? |
|
Definition
|
|
Term
| What does the SP do with these old and damaged RBC’s? |
|
Definition
| Breaks them down (cell lysis), recycles heme and globin to make hemoglobin |
|
|
Term
| If the Heme is not usable, what happens to it? |
|
Definition
| It becomes bilirubin, which is then converted to bile and stored in the GB |
|
|
Term
| Erythropoetin is responsible for RBC production. Where is it located? |
|
Definition
|
|
Term
| Why would the KID stimulate erythropoietin? |
|
Definition
| If it detects low blood oxygen |
|
|
Term
| Why would the KID stimulate erythropoietin? |
|
Definition
| If it detects low blood oxygen |
|
|
Term
| Identify 3 types of objective measurements done to estimate the size of an RBC and their hemoglobin content? |
|
Definition
| Mean corpuscular volume (MVC) The higher the MVC the larger the RBC and vis versa. Mean corpuscular Hemoglobin (MVH), and Mean Corpuscular Concentration (MCHC) |
|
|
Term
| Are WBC’s formed from Lymphoid or Myloid Stem Cells? |
|
Definition
|
|
Term
Answer the following as they relate to the hematpoietic system?
a) Participate in the body’s defense against infections? |
|
Definition
|
|
Term
| Short lived cells that survive no more than 4 days in peripheral circulation? |
|
Definition
|
|
Term
|
Definition
| Monocytes and lymphocytes |
|
|
Term
| Essential for clotting factors? |
|
Definition
| Platelets or thrombocytes |
|
|
Term
| Malignant transformation of hematopoietic cells may result in? |
|
Definition
|
|
Term
| What is a reduction of hemoglobin in the blood to below normal levels? |
|
Definition
|
|
Term
| List 3 consequences of anemia? |
|
Definition
| Decreased hematopoiesis, Abnormal hematopoiesis (non functional hemoglobin), Increased loss of destruction of red blood cells |
|
|
Term
| Name 2 reasons for decreased hematpoiesis? |
|
Definition
| Bone marrow failure and nutrient deficiencies |
|
|
Term
| What are 2 results of decreased hematopoiesis by bone marrow failure? |
|
Definition
| Aplastic anemia, myelophthisic anemia |
|
|
Term
| List 2 reasons for decreased hematopoiesis by deficiencies of nutrients? |
|
Definition
| Vitamin B-12 def and folic acid (megaloplastic anemia) and protein def |
|
|
Term
| What is usually a consequence of genetic abnormalities such as Sickle Cell Anemia? |
|
Definition
|
|
Term
| List 4 reasons for increased loss and destruction of RBC’s? |
|
Definition
| Bleeding, Intrasplenic sequestration, immune hemolysis, infections (malaria) |
|
|
Term
Identify the cause by morphology of anemia?
a) Normocytic, normocromic anemia? |
|
Definition
| Dilutional anemia (decrease is due to increased plasma volume) |
|
|
Term
|
Definition
|
|
Term
| Macrocytic, normochromic? |
|
Definition
| Def of vitamin B-12 and/or folic acid |
|
|
Term
| Anemias characterized by abnormal RBC shape? |
|
Definition
| Elliptocytosis, spherocytosis, Sickle Cell Anemia |
|
|
Term
Identify the anemia?
a) Ideopathic and secondary, bone marrow is depleted of hematopoiesis cells and consists only of fibroblasts, fat cells, and scattered lymphocyted. Seen in anemia and leucopenia and thrombocytopenia. Uncontrollable infections, bleeding tendency, chronic fatigue, sleepiness and weakness? |
|
Definition
|
|
Term
| Most common of anemia, hypochromic microcytic anemia. Increased loss of iron (chronic bleeding), inadequate iron intake or absorption, increased iron requirements. It is also the cause of a chronic disease? |
|
Definition
|
|
Term
| Caused by deficiency of vitamin B-12 or folic acid. Bone marrow is hypercellular and has numerous megaloplasts. Peripheral blood is macrocytic anemia. There is a hypersegmentation of neutrophils. Symptoms include shortness of breath, weakness, destruction of posterior and lateral columns in the spinal cord, resulting in proprioception, as well as loss of tendon reflexes? |
|
Definition
|
|
Term
| There is inadequate intake in the diet or due to malabsorption caused by intestinal disease? |
|
Definition
|
|
Term
| Is a pernicious anemia, lacks gastric intrinsic factor, and there is atrophic gastritis? |
|
Definition
|
|
Term
| Caused by increased RBC destruction (hemolysis), intracorpuscular defects, and extracorpuscular defects? |
|
Definition
|
|
Term
| Name examples of intracorpuscular defects? |
|
Definition
| Structural abnormalities such as Sickle cell anemia, Thalassemia, or hereditary spherocytosis |
|
|
Term
| Name some extracorpuscular defects? |
|
Definition
| Antibodies, infectous agents, or mechanical factors such as transfusion reactions, malaria, artificial heart valve |
|
|
Term
| Identify 3 manifestations of hemolytic anemia? |
|
Definition
| Anemia, Compensatory erythroid hyperplasia of the bone marrow, hyper bilirubiemia and jaundice |
|
|
Term
| Caused by a substitution of glutamic acid by valine. It synthesizes an abnormal beta chain of globin. They manifest with multiple infarcts such as neurological defects, sharp pain in the bones, autosplenectomy, and is most common in blacks. Will also present with jaundice and hyperbilirubinemia? |
|
Definition
|
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Term
Sickle Cell Anemia
1. What are they predisposed to? |
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Definition
| Osteomylitis caused by salmonella |
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Term
| List 3 manifestations of Sickle Cell Anemia? |
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Definition
| Retarded intellectual development and neurological defects, cardiopulmonary insufficiency, recurrent infections |
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Term
| Genetic defect in the synthesis of HbA that reduces the rate of global chain synthesis. No abnormal hemoglobin is produced. It is a hypochromic anemia that results in splenomegaly, hapatomegaly, hemosiderosis. The bone marrow has compensatory hyperplasia, They have Calvarium (crew cut hair on radiographic study. There is hyperbilirubinemia and jaundice, chronic anemia that retards the growth of children, impairment of intellectual development, and cardiovascular insufficiency? |
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Definition
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Term
| Name the 4 types of Thalassemia? |
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Definition
| B Thalassemia (from reduced synthesis of the Beta chains), A-Thalassemia (from reduced synthesis of the Alpha chain, Thalassemiia minor (Heterozygus and mild non specific symptoms), Thalassemia Major (Homozygote and results in severe disease) |
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Term
| Autosomal dominant disease where there is a primary defect in the genes encoding either ankyrin or alpha or beta chains of spectrin. It is the most common hereditary disease in RBC’s in whites. Peripheral blood consists of spherocytes and anisocytosis. Hemolytic or aplastic crises result in spenomegaly and jaundice. May result in a splenectomy? |
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Definition
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Term
| Mediated by antigens that destroy red blood cells such as ABO incompatability, type 2 reaction where there is a reaction to a normal antigen, or reacts to a modified antigen such as lupus? |
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Definition
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Term
| Marked by erythrocytosis (increased RBC’s). Symptoms include hypertension, dark red or flushed face, headaches, visual problems, neurologic symptoms, splenomegaly, hypercellular bone marrow? |
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Definition
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Term
| List 2 types of Polycythemia? |
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Definition
| Primary Polycythemia (Plycythemia vera) and Secondary Polycythemia |
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Term
| List 3 important things about Primary Polycythemia (Plycythemia vera)? |
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Definition
| Clonal proliferation of hematopoietic cells, uncontrolled production of RBC’s and an increased total RBC mass… It is a myeloproliferative disorder |
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Term
| List 3 important things about Secondary Polycythemia? |
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Definition
| Increased RBC volume owing to erythroid bone marrow hyperplasia caused by erythropoietin, caused by prolonged hypoxia, and living at high altitudes, anoxia secondary to chronic lung disease, congenital heart disease, and renal carcinoma. |
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Term
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Definition
| Transferrin transfers iron to the circulatory system as is stored in the LIV as ferotin |
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Term
| List 4 types of leukocytic disorders? |
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Definition
| Leukopenia, leukocytosis, leukemia, lymphoma |
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Term
| Characterized by a decrease in WBC count to below normal levels, neutropenia (agranulocytosis) from bacterial infections, and lymphopenia from bacterial, viral and fungal parasitic infections? |
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Definition
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Term
| Characterized by and increased number of WBC’s in the peripheral blood. Neutophilia (granulocytosis) from bacterial infections, eosinophilic leukocytosis (eosinophilia) from allergies and some skin diseases or parasitic infections, and lymphocytosis caused by viral infections, chronic infections, and some autoimmune disorders. Results in splenomegaly and lymphadenopathy? |
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Definition
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Term
| Name 3 malignant diseases of WBC’s? |
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Definition
| Leukemias, lymphomas, multiple myeloma |
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Term
| Lymphoid cell malignant diseases predominantly involving the lymph nodes? |
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Definition
| Lymphomas such as hodgkins and non hodgkins lymphoma |
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Term
| Malignant diseases of the plasma cells? |
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Definition
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Term
| Malignant disease involving WBC precursors in the bone marrow and peripheral blood (can be acute or chronic) |
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Definition
| Leukemias (myloid or lymphoid) |
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Term
| Lymphomas and Leukemias cause is unknown but there are 2 viruses that relate to the etiology and pathogenesis. Name them? |
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Definition
| Epstein Barr Virus (EBV) and HTLV-1 |
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Term
| Identify the oncogenes involved in the etiology and pathogenesis of lymphomas and leukemias? |
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Definition
| Burkitts Lymphoma-t(8,14) and Chronic mylogeneous leukemia also called the Philidelphia chromosome-t(9,22) |
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Term
| Characterized by malignant cells that infilitrate the bone marrow, increased number of immature blood cells in the peripheral blood, and complications of anemia, recurrent infections, and uncontrollable bleeding. The anemia is caused by and overproduction of WBC’s in the bone marrow and decreased productions of the RBC’s and platelets? |
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Definition
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Term
| This is the most common form of leukemia in children. It is characterized by a massive infiltration of the bone marrow and peripheral blood with immature lymphoid cells (blasts). Symptoms include recurrent infections, generalized weakness, and bleeding into the skin and major organs. Chemotherapy results in remission? |
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Definition
| Acute Lymphoblatic Leukemia |
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Term
| Most common form of leukemia in adults. There is clonal proliferation of myeloblasts in the bone marrow (20% myeloblasts). Most people die within 6 mo’s after onset of symptoms without treatment? |
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Definition
| Acute Myelogenous Leukemia |
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Term
| It is a malignant disease of pluripotent hematopoietic stemcells. The bone marrow and peripheral blood are overgrown with malignant stem cells and their descendants? |
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Definition
| Chronic Myelogenous Leukemia |
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Term
Chronic Myelogenous Leukemia
1. List 3 phases of the disease? |
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Definition
| Chronic phase, Accelerated phase, and Blast Crises |
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Term
| What is the oncogene involved? |
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Definition
| Philidelphia Chromosome (Ph1) with BCR/ABL gene rearrangement |
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Term
Chronic Myelogenous Leukemia
1. List 3 phases of the disease?
Chronic phase, Accelerated phase, and Blast Crises
2. What is the oncogene involved?
Philidelphia Chromosome (Ph1) with BCR/ABL gene rearrangement
3. What is used to aid in the treatment of the disease? |
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Definition
| Tyrosine Kinase inhibitors such as imatinb “Glevee” |
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Term
| Malignant disease involving the lymphoid cells that affects most patients over the age of 50. Patients can survive 7-9 years after diagnosis? |
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Definition
| Chronic lymphocytic Leukemia |
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Term
| CLL should be suspected if the number of lymphocytes exceed? |
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Definition
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Term
| Can affect any age group. Malignant cells often infiltrate the lymph nodes, spleen, thymus, or bone marrow, can be extranodal and they also may involve any other organ in the body? |
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Definition
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Term
| Is there such thing as a benign lymphoma? |
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Definition
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Term
| Where are the most common sites of extranodal lymphomas? |
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Definition
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Term
| Lymphomas can spiull over to the blood and present as? |
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Definition
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Term
| This is the most common form of lymphoma in the U.S., representing 45% of the total population. It is seen mostly in older people. The tumor is slow growing. Most patients present with long standing enlargement of lymphnodes and only mild constitutional symptoms. Mosgt patients survive 7-9 years after the diagnosis of the disease? |
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Definition
| Follicular Lymphoma (Non-Hodgkins Lymphoma) |
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Term
| This is the most common aggressive aggressive form of non-hodgkins lymphoma. The tissue is infiltrated with large lymphoid cells that have irregular nuclear outlines and prominent nucleoli. Chemotherapy is responsible for complete remission in 75% of all patients? |
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Definition
| Diffuse Large Cell Lymphomas |
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Term
| This form of non-hodgkins lymphoma is a highly malignant tumor composed of small B cells. Extranodal masses are often more prominent than enlarged lymphnodes. Most children and young adults can be cured? |
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Definition
| Burkitt’s Lymphoma (keep in mind it’s oncogene… t(8,14) |
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Term
| Identify 3 endemic variants? |
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Definition
| Sub-Saharan Africa, Children infected with Epstein Barr Virus (EBV), Mandible and facial soft tissue involvement. |
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Term
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Definition
| Abdominal mass (Ovarian or intestinal), Children and yound adults most often affected. |
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Term
| This lymphoma has a bimodal peek (2 peeks). Lymphnodes are enlarged in the neck and mediastinum, extra nodal involvement an leukemia spread is rare, stage I and II tumors have greater that 90% cure rate with chemo and advanced stage has less favorable prognosis. Identify the lymphoma and list the peek ages of the affected? |
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Definition
| Hodgkins Lymphoma (25 and 55) |
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Term
| What are the cells present in Hodgkins Lymphoma? |
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Definition
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Term
| What doe Reed Sternberg Cells look like? |
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Definition
| Bilobed or multilobed nucleus and prominent nucleoli surrounded by a clear halo |
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Term
| Affects patients older than 45 yrs of age. Malignant plasma cells typically proliferate in the bone marrow and destroy the surrounding bone resulting in bone fractures. There are punched out holes (lytic lesions) in the calvaria and vertebrae. There is hypercalcemia, renal failure, anemia and leucopenia? |
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Definition
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Term
| Multiple myeloma has a specific protein called? |
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Definition
| Bence Joes Protein (Proteinuria) |
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Term
| How long do people live for with Mulitple Myeloma and what is their cause of death? |
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Definition
| Die within 3 to 4 years from Kidney failure infection |
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Term
| List 3 diagnostic studies for multiple myeloma? |
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Definition
| X-ray studies of lytic lesions, serum electrophoresis for monoclonal spike, bone marrow bopsy for the detection of neoplastic plasma cells in increased numbers |
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Term
| List 3 factors of normal hemostasis? |
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Definition
| Vascular, Platelet, coagulation |
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Term
| What is the end result of the coagulation pathway? |
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Definition
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Term
| Escape of blood from the heart or the blood vessels. Can be internal or external? |
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Definition
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Term
| What 3 defects can cause a bleeding disorder? |
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Definition
| Vessel wall related, platelet related, clotting factor related |
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Term
| List 3 reasons for vascular disorders? |
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Definition
| Mechanical trauma (injuries), Vessel wall weakness (Cushings syndrome congenital disorders of connective tissue, hyposvitaminosis C scurvy), Immune injury such as vasculitits |
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Term
| Name 2 diseases that might be seen with vascular disorders? |
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Definition
| Marfans Syndrome & Osteogenesis |
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Term
| List 4 disorders that could lead to a decreased production of platelets? |
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Definition
| Aplastic anemia, leukemia, drugs, infectious disease |
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Term
| List 4 disorders caused by increased intravascular destruction of platelets or their increased consumption? |
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Definition
| Systemic Lupus Erythomatous, various forms of hemalitic anemias, drug induced hematologic disorders, Idiopathic Thrombocytopenia purpura |
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Term
| Platelet disorders cause what 3 things? |
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Definition
| Increased removal of platelets (Hypersplenism), Consumption of platelets (Disseminated intravascular coagulopathy), Disorders of platelet function (Congenital disorders duch as thrombasthenia and acquired disorders such as chronic renal failure) |
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Term
| Disseminated intravascular coagulation (DIC) by tumors, shock and infection leads to bleeding but how? |
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Definition
| Infection, tumors, and shock cause injury to endothelial cells and tissues which can either lead to consumption of clotting factors or plasmin fibrinolysis which will lead to bleeding. |
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Term
| In what way will endothelial cell or tissue injury not lead to bleeding? |
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Definition
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Term
| What strain of E. Coli can cause (DIC)? |
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Definition
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Term
| List 3 types of clotting factor deficiencies? |
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Definition
| Congenital, Acquired, Hemophilia |
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Term
| List 6 things about hemophilia? |
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Definition
| Sex-linked clotting factor deficiency, Hemophilia A (def of factor VIII), Hemophilia B (def of Factor IX), uncontrollable bleeding from trauma, subcutaneous hematoma or hemarthrosis, prolonged a PPT (bleeding time and prothrombin time are normal) |
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Term
| What are the major Cardiovascular Diseases? |
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Definition
Congenital heart diseases
· Ischemic vascular disease
· Hypertension-related disease
· Infectious disease
· Autoimmune disorders
· Metabolic diseases |
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Term
| . What is the greatest cause of cardiac diseases? |
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Definition
· Atherosclerosis 80%
· Hypertensive 9%
· Congenital 2%
· Other 6 % |
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Term
| Each year approx. 25,000 babies are born w/ heart defect. The defect may be: |
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Definition
· Minor and asymptomatic or related to only minor clinical symptoms
· Major and associated w/major clinical problems or may even be lethal |
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Term
| Causes of Congenital Heart Disease? |
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Definition
· Cause unknown (most often)
· Viruses
· Alcohol
· Chromosomal abnormalities |
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Term
| Most Common congenital heart diseases? |
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Definition
· Ventricular septal defect
· Atrial septal defect
· Tetralogy of fallot |
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Term
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Definition
· Generalized form
· Localized form
-coronary heart disease
-cerebrovascular disease
-atherosclerosis of the aorta
-peripheral vascular disease |
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Term
| What is the most common occlusion of myocardial infarction? |
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Definition
| Left anterior descending artery |
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Term
| What is the artery of sudden death? |
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Definition
| Left anterior descending artery |
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Term
| 9. What are the structural complications of myocardial infarctions? |
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Definition
a. develop thrombus right over defect in wall of heart called mural thrombus
b. develop aneurysm of ventricular wall
c. ventricular wall rupture= guaranteed death! |
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Term
| What is hematopericardium? |
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Definition
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Term
| 11. Physiological complications of myocardial infarction? |
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Definition
a. immediate: most common problem: sudden death due to
arrhtyhmia (most common and cause of death)
b. 1rst week: early complications:
arrhythmia 90%,
CHF 60 %,
Shock 12%
Heart rupture 1%
c. Late complications (first year):
CHF 70%
Arrhythmia 20%
Aneurysm 10%
Thromboemboli 10%
d. Late complications (10 years):
CHF 70 %
Recurrent Infarcts
Arrhythmia |
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Term
| 12. What is the most common biochemical lab diagnosis of myocardial infarction? |
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Definition
| Troponin is the most specific and most common marker used in hospitals to diagnose myocardial infarction |
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Term
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Definition
| Substance inside of myocytes (inside cardiac muscle) when myocytes die they release troponin and that can be measured, elevated means myocardial infarction has occurred. |
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Term
| 14. What is the most common longterm complication of myocardial infarction? |
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Definition
| Congestive heart disease or congestive heart failure |
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Term
| 15. What are the warning signs for aortic aneurisms? |
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Definition
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Term
| 16. Where will blood back up with left sided heart failure? |
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Definition
Into lungs, then pressure increases-where?
Hydrostatic then edema will occur in lungs |
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Term
| 17. What do patients with left sided heart failure get? |
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Definition
| Pulmonary Edema/ Pleural Effusion |
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Term
| 18. Where will blood back up with right sided heart failure? |
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Definition
| Blood backs up in Right side of heart=blood backs up into veins= increased hydrostatic pressure in veins |
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Term
| 19. Compare the blood flow in the early stages of ventricular septal defect with that in the cyanotic stage? |
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Definition
The symptoms of v.s.d. result from the mixing of blood in the left and right heart chambers as a consequence of the septal defect.
Cyanosis occurs when the reversal of blood flow sends unoxygenated venous blood from right side enters the systemic circulation |
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Term
| 20. What is the Tetralogy of Fallot? |
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Definition
A complex congenital defect of the heart and major vessels, is the most common cause of cardiac cyanosis in newborn children, accounting for 10% of all congenital heart defects. The pathologic changes associated w/this condition include 4 typical legions?
a. Valvular stenosis-narrowing of the pulmonary artery
b. Ventricular septal defect involving the uppermost membranous part of the septum
c. Dextroposition of the aorta
d. Hypertrophy of the right ventricle |
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Term
| 21. What is the pathogenesis of rheumatic fever? |
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Definition
| Following infection (strep throat), an immune response elicited by the streptococci acts on the heart and several other organs, most notably, the joints, skin, and central nervous system. In the heart, it causes endocarditis, myocarditis, and pericarditis. |
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Term
| 22. Tetralogy of Fallot presents with early or late cyanosis? |
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Definition
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Term
| 23. What are the atherosclerosis of the extremities? |
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Definition
a. intermittent claudication
b. dry gangrene (black and mummified)
c. wet gangrene (infected) |
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Term
| 24. where does endocardits affect? What virus? |
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Definition
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Term
| 25. where does myocarditis affect? What infection? |
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Definition
| Viruses, coxsackie B, parasites and protozoa (Triypanosoma C) |
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Term
| 26. where does pericarditis affect? What infection? |
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Definition
| Pericardium, bacteria, viruses, SLE , fungi(rare), rheumatic ht dis., uremia, open ht. surg. |
|
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Term
| 27. What is cardiomyopathy? |
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Definition
In response to injury the ht. may undergo dilation or hypertrophy, cardiomyopathy is divided into 3 forms:
a. dilated cardiomyopathy-viral infect.
b. hypertrophic cardiomyopathy-genetic
c. restrictive cardiomyopathy-amyloidosis |
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Term
| 28. What is only treatment for Cardiomyopathy? |
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Definition
|
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Term
| 29. What is the most common primary cardiac tumor? |
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Definition
| Atrial myxoma (benign and can be removed surgically) |
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Term
| 30. Where do cardiac metastases usually come from? |
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Definition
| Lung cancer-involves pericardium |
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Term
| 31. What are Iatrogenic Heart Lesions? |
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Definition
| Drug-induced , radiation-induced and surgery related cardiac changes. |
|
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Term
| What is the most important disease affecting the blood vessels? |
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Definition
|
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Term
| 33. What are the various forms of auto immune arteritis? |
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Definition
a. polyarteritis nodosa
b. giant cell arteritis
c. Raynaud’s disease
d. Buerger’s disease |
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Term
| 34. What is Raynaud’s Disease? |
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Definition
| Functional disturbance affecting muscular arteries and arterioles (contract in disorderly manner, esp. in winter) |
|
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Term
| 35. Varicose veins are multifactorial disease with _________ and _________ component. |
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Definition
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Term
| 36. What is thrombophlebitis and where does it occur? |
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Definition
| Inflammation of vessel walls, occurs in varicose veins. |
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Term
| Where is the Gohn Complex typically seen? |
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Definition
|
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Term
| What is the term for pus in the pleural space? |
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Definition
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Term
| Those with pink puffer tend to have a? |
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Definition
| Larger anteroposterior diameter |
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Term
| Incomplete expansion or collapse of the lung is referred to as? |
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Definition
|
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Term
| What is the most common congenital defect? |
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Definition
| Ventricular Septal Defect |
|
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Term
| Name the features of tetrology of fallot? |
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Definition
| Pulmonary stenosis, defect in ventricular septa, hypertrophy of RT ventrical, Dextraposition of aorta(normal position overides septum) |
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Term
| What are the risks of atherosclerosis? |
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Definition
| High cholesterol, diet, smoking, diabetes, hypertension, age, gender, heredity |
|
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Term
| List 2 protective factors against atherosclerosis? |
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Definition
| exercise and estrogen supplement (woman) |
|
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Term
| What is a symptom of atherosclerosis of the lower legs? |
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Definition
| Intermittent claudication |
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Term
| What is the most common Myocardial Infarction? |
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Definition
| Left anterior descending artery (effects lower medial ventricular wall) |
|
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Term
| List 3 structural complications of a myocardial infarction? |
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Definition
| Thrombus, rupture of ventricular wall, aneurism |
|
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Term
| List 3 non structural complications of MI? |
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Definition
| Edema, Arrythmia, HT failure |
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Term
| What is a finding of confirmation on an EKG/ECG for MI? |
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Definition
| Troponin-1 elevation (seen 3-6 hours after infarction) |
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Term
| Not sure about the question but I have Ht damages what 3 organs? |
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Definition
| LU, Brain (stroke), Renals |
|
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Term
| Name 3 viruses seen in myocarditis? |
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Definition
| Coxsakie B, trypanosoma, toxoplasma |
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Term
| What is the most common type of anemia and what are it's characteristics? |
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Definition
| Iron Deficiency anemia (Hypochromic/microcytic) |
|
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Term
| Vitamin B-12 and folic acid deficiency is characterized by? |
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Definition
| Macrocytic/normochromic (megaloblastic anemia) |
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Term
| If the megaloblastic anemia is based on Vitamin B-12 def, what are the? |
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Definition
| Pernicious anemia, atrophic gastritis, lack of gastric intrinsic factor |
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Term
| If the megaloblastic anemia is based on folic acid def, what is the cause? |
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Definition
| Lack of intake due to malabsorption or intestinal disease |
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Term
| Since the bone marrow is not producing RBC's or WBC's in aplastic anemia, what would be found in the bone marrow? |
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Definition
| Fat cells, scattered lymphocytes, and fibroblasts |
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Term
| Name 3 types of structural types of anemia? |
|
Definition
| Elyptical, spherical, Sickle Cell |
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Term
| Which leukemia is the most common in children? |
|
Definition
| Acute Lymphoblastic Leukemia |
|
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Term
| What is the most common symptom of lymphoma? |
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Definition
|
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Term
| What is the change in multiple myloma seen on an x-ray? |
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Definition
|
|
Term
| Consumption of platelets and bleeding is called? |
|
Definition
| Dissemination intravascular coagulation (DIC) |
|
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Term
| What is an infection related to DIC? |
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Definition
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