NR 507 Advance Patho. Midterm

_____________lab values are normal for hemolytic anemia. - answer-MCV __________is a predominant cause of secondary immune deficiencies worldwide - answer-Malnutrition WHY Malnutrition is the predominant cause of secondary immune deficiencies worldwide 1. ________________ ______________are conditions where the immune system become2.____________ because of somithing else - answer-1. Secondary Immundefienciense 2. Compromise 1.____________ __________________ are2. __________ common and occur due to a defect of the development of the3. ____________ ____________ - answer-1. Primary Immunodefeciency 2. Less 3. Immune SYSTEM A deficiency of intrinsic factor will result in_______________ Anemia - answer-Pernicious A renal disease most often associated with autoimmunity is - answer-Glomerulonephritis. A transferrin deficiency will most likely result in: - answer-Iron-deficiency anemia. WHY Transferrin saturation checks how many places on transferrin that can hold iron. Normal values are 20% to 50%. In severe cases of iron-deficiency anemia, this number may fall below 10% A Type II hypersensitivity reaction is____________and usually occurs as a result of happens that cause an___________ antibody or __________ antibody mediated response - e-specific 2.IgG antibody or IgM antibody A Word About Autoimmunity - answer-•Autoimmune diseases can be familial. •Affected family members may not all develop the same disease, but several members may have different disorders characterized by a variety of hypersensitivity reactions •These include autoimmune and allergic reactions. •Associations with particular autoimmune diseases have been identified for a variety of major histocompatibility complex (MHC) alleles or non-MHC genes. Acute Blood Loss Anemia - answer-•Trauma victims who are losing blood Afterload definition - answer-resistance to systolic pressure.(Blood Pressure) Allergic contact dermatitis is an example of_________hypersensitivity reaction. - answer-Type 4 Allergic contact dermatitis is an example of a Type IV hypersensitivity reaction mediated by T-cells. When the individual comes in contact with the antigen (e.g. poison ivy), an antigen complex is formed. On subsequent exposure to the antigen, sensitized T-cells activate the inflammatory process that causes the allergic contact dermatitis to appear Alloimmunity - answer-•General term used to describe when an individual's immune system reacts against antigens on the tissues of other members of the same species Although less common, transferrin deficiencies and mitochondrial defects can lead to iron deficiency anemia TRUE OR FALSE - answer-TRUE An example of a primary immunodeficiency is: - answer-Chronic Granulomatous Disease. WHY Chronic granulomatous disease (CGD) is an example of a primary immunodeficiency An example of a secondary immunodeficiency is - answer-Pneumocystis Carinii. WHY Pneumocystis Carinii is an example of a secondary immunodeficiency. It is caused by something external to the immune system; in this case, a yeast-like fungus. An individual who has received an incorrect blood transfusion will exhibit signs of: - answer-Hemolytic anemia. Anaphylaxis is a _________ hypersensitivity reaction - answer-Type 1 Type 1 hypersensitivity reactions are mediated by IgE and mast cells. An individual who is highly sensitized to the antigen may experience anaphylaxis. Anemia of chronic disease LAB VALUES - answer-TEST Serum Ferritin Levels- NORMAL to INCREASED Red Blood Cell Distribution-NORMAL Serum Iron Levels-NORMAL TO DECREASE Total Iron Binding Capacity- SLIGHTLY DECREASE Transferrin Saturation- NORMAL to SLIGHTLY INCREASE Anemias can also be classified according to the color of the RBCs: - answer-Hypochromic anemia describes RBCs with less hemoglobin than normal. As a result, the RBCs appear pale in color (MCHC is low). Hyperchromic anemia describes RBCs with more hemoglobin than normal. As a result, the RBCs appear a dark hue or red than normal cells (MCHC is high). Normochromic anemia describes RBCs that have a normal amount of hemoglobin. As a result, the RBCs appear neither pale nor dark (MCHC is normal). Aortic Regurgitation - answer-•Shortness of breath that progressively worsens; •High-pitched early diastolic murmur heart loudest at the left lower sternal border •Diastolic rumbling sound at the heart's apex and a •Systolic crescendo-decrescendo murmur heard at the left upper sternal border. •A chest x-ray may show signs of pulmonary edema and cardiomegaly. Aortic Stenosis - answer-•Fainting •Chest pressure upon exercising. •Sustained, laterally displaced apical pulse •Mid-systolic crescendo-decrescendo murmur heard loudest at the base and radiating to the neck. •S4 gallop present Aplastic Anemia - answer-•Diagnosis is made by blood tests and bone marrow biopsy. •AA is suspected if levels of circulating erythrocytes, leukocytes, and platelets are diminished: -a granulocyte count less than 500/µL, -a platelet count less than 20,000/µL, -absolute reticulocyte count less than or equal to 40 × 109/L. Aplastic anemia can be caused by: - answer-1. Antibiotics and other drugs- PCN, Chloramphenicol, Phenytoin, Diuretics, Antidiabetic drugs, Sulfa drugs 2. Chemical or radiation exposure-Side effect of cancer treatment (chemotherapy) 3.Viral induced-Hepatitis, Epstein-Barr virus, Cytomegalovirus 4. Tumors-Multiple Myeloma 5. Congenital defects-Fanconi's anemia ASTHMA - answer-•Airways are constricted •Intrinsic: triggered by something internal such as anxiety •Extrinsic asthma; triggered out something in outside environment-something in the air-dust mites/pet dander •In the mildest form of asthma (intermittent), short-acting beta2-agonist inhalers are prescribed. •Mild-persistent asthma will have night symptoms 3-4 days a month autoimmune diseases may occur when the immune system overreacts again self-antigens to the extent that tissue damage occurs. What causes the damage - answer-autoantibodies and T-cells, and in some cases, B-cells, B12 or Pernicious Anemia Lab values - answer-Lab VALUES MCV-High MCHC-NORMAL Reticulocyte Count=LOW Ferritin=NORMAL Folate=Normal to Low Serum B-12=***LOW** BLOOD FLOW OF THE HEART - answer--Oxygen poor blood enter right atrium and flows into right ventricle via vena cava -Blood is pumped from right ventricle into pulmonary artery (goes into lungs) -Oxygen rich blood returns to heart via pulmonary vein and enters left atrium and flows into left ventricle -Blood is pumped into the aorta and circulated to body Cardiac Output (CO) - answer-Amount of blood pumped in 1 minute (~5 L) Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria T or F - answer-FALSE WHY Cells that contain abnormal types of hemoglobin are more resistant to infection by the parasite that causes malaria. chronic bronchitis - answer-•Productive cough with copious amount of sputum, dyspnea, wheezing, rhonchi and cyanosis of the skin and mucus membranes •Damage occurs in the airway-not the alveoli Clinical Manifestations of Macrocytic Anemia - answer-1. Fatigue 2. Dyspnea 3. Loss of weight or appetite 4. Diarrhea 5. Pallar Contractility of the heart - answer-rate and strength of contraction COPD (chronic obstructive pulmonary disease) - answer-•Diagnosis is based on history of symptoms, physical examination, chest imaging, pulmonary function tests, and blood gas analyses. •Pulmonary function testing reveals airway obstruction (decreased FEV1) that is progressive and unresponsive to bronchodilators. •Emphysema •Chronic bronchitis COPD Staging According to GOLD Guidelines-Is Based on the degree of airway limitation - answer-•GOLD 1: Mild: FEV1 ≥ 80% predicted •GOLD 2: Moderate: 50% ≤ FEV1 <80% predicted •GOLD 3: Severe: 30% ≤ FEV1 < 50% predicted •GOLD 4: Very severe: FEV < 30% predicted Damage occurs with ABO incompatibility because - answer-Complement damages RBC membrane causing cell lysis. WHY The damage from ABO incompatibility occurs because of the effects of complement on the RBC membrane that results in RBC lysis Decreased tissue oxygenation from anemia can manifest as signs and symptoms of the following: - answer-Severe fatigue Pallor Weakness Dyspnea Dizziness REDUCTION OF RBC level will decrease blood volume, activating the renin-angiotensin-aldosterone (RAA) system, which promotes fluid retention and movement of interstitial fluid into the capillaries Define 1. Red Blood Cells 2. Hemoglobin 3. Hematocrit - answer-1. # of erythrocytes in 1 Cubic mm of whole blood 2. Oxygen carrying pigment of red blood cells 3. volume of cells as a percentage of the total volume of cells and plasma in whole blood. Difference Between Type 2 and Type 3 - answer-•Type 2 is organ specific •The antibody binds to the antigen on the cell surface Difference Between Type 2 and Type 3 - answer-•Type 3 is not organ specific the antibody binds to soluble antigen outside the cell surface that was released into the blood or body fluids, and the complex is then deposited in the tissues Differentiate between Right and Left Heart Failure - answer-•Sometimes right-sided heart failure can occur due to left-sided heart failure due to the back-up of fluid from the left side to the right •Sometime right-sided heart failure can occur without there being left-sided heart failure; This usually occurs because the person has long-standing pulmonary issues (COPD). Patients will have classic symptoms of right-sided heart failure without symptoms of left-sided heart failure: -Right JVD distention, peripheral edema, hepatosplenomegaly Differentiating Between the Rash of a Type 1 vs. Type IV Reaction - answer-•Type I: Immediate hypersensitivity reactions, termed atopic dermatitis, are usually characterized by widely distributed lesions, •Type IV: contact dermatitis (delayed hypersensitivity) consists of lesions only at the site of contact with the allergen •The key determinant is the timing of the rash: -Type I: immediate -Type IV: delayed-several days following contact-e.g. poison ivy