NR283 PATHO EXAM REVIEW STUDY GUIDE

NR283 PATHO EXAM REVIEW STUDY GUIDE Circulatory system ● Cardiovascular system ● Lymphatic system ● Moves O2, nutrients, remove wastes ● arteries/ arterioles ○ Transport blood away from heart/ deoxygenated blood ● veins/ venules ○ Return blood back to heart ● Capillaries ○ Microcirculation within tissue ● Systemic circulation ○ Exchange gases, nutrients, wastes in tissue ● Pulmonary circulation ○ Gas exchange in lung ● CO2/ acid Blood ● plasma/ 55% ○ Proteins ■ Osmotic pressure, antibody, blood clots ■ Yellowish fluid, clear ■ Albumin: osmotic pressure ■ Globulins: antibodies ■ Fibrinogen: clotting ● Hematocrit: % of rbc ○ More rbc, increased viscosity, increased osmolarity ● Rbc: transport O2 + CO2 ● Erythrocytes: rbs ○ Hemoglobin: red color in rbc ■ Globin portion ■ Heme group ○ 120 days alive ○ Erythropoietin produced in kidney stimulates erythrocyte production ● Leukopenia: low wbc ● Thrombopenia: low platelet ● Cytosis increases Clotting ● Steps ○ vasoconstriction/ vasospasm after injury ○ Platelet clot ○ Coagulation mechanism ● Plasmin eventually break down blood clot ● Tpa given for strokes Typing ● Based on antigens in plasma membrane of erythrocytes ● RH system ○ Antigen D in plasma membrane/ Rh+ ○ No antigen D/ Rh- Blood group RBC antigens Antibodies in plasma Donor blood group for transfusion O none Anit-A +Anti-B O A A Anti-B O A B B Anti-A O B AB A + B none O A B AB Blood dyscrasia ● Abnormal pathologic condition of blood ○ Genetics ○ Malnutrition ○ Trauma ○ Cancer ○ Chemotherapy ○ Chronic disease/ cirrhosis ○ Renal failure ○ Surgery ○ Rx ○ Toxins ○ Sepsis Decreased rbc/ sob, fatigue, pale Anemia ● Reduced O transport ○ Due to hemoglobin deficit ■ Leads to ● Less energy production in all cells ● Tachycardia + peripheral vasoconstriction/ compensation mechanisms ● Signs ○ Fatigue ○ pallor/ pale face ○ Dyspnea ○ Tachycardia ○ Decreased regeneration of epithelial cells ■ Digestive tract becomes inflamed + ulcerated/ leads to stomatitis ■ Inflamed + cracked lips ■ Hair + skin/ degenerative changes ○ Severe anemia lead to angina or congestive heart failure, CHF ■ Heart attack ■ Chest pain ■ Angina Iron deficiency anemia • Insufficient Fe impairs hemoglobin synthesis • Etiology o Dietary intake/ Fe below minimum o Chronic blood loss o Impaired duodenal absorption of Fe o Severe liver disease/ helps with Fe absorption, storage • S+s o General ▪ Pallor ▪ Fatigue ▪ Lethargy ▪ CNS stimulation/ hypoxia o Spoon shaped, ridged nails/ brittle hair o Stomatitis/ glossitis/ menstrual irregularities/ delayed healing Pernicious anemia/ Vit B12 deficiency • Lack of intrinsic factor o Secreted by gastric mucosa/ required for intestinal absorption of Vit B12 • Large, immature, nucleated erythrocytes • Vit B12 needed for function and maintenance of neurons • Etiology o Dietary insufficiency o Malabsorption ▪ Chronic gastritis/ common in alcoholics + causes atrophy of gastric mucosa or inflammation condition o Surgery/ gastrectomy • S+s o Tongue typically enlarges, red, sore, shiny o Digestive discomfort/ with nausea and diarrhea o Feeling of pins + needles/ tingling in limbs Aplastic anemia • Impairment/ failure of bone marrow leading to loss of stem cells + pancytopenia o Pancytopenia: decreased # of erythrocytes, leukocytes, platelets in blood • Etiology o Myelotoxins: radiation, industrial chemicals, Rx o Genetic abnormalities, hep C, SLE • S+s o Blood count indicate pancytopenia/ low levels, rbc, wbc, platelelts ▪ Anemia/ pallor, weakness, dyspnea ▪ Leukopenia/ recurrent infection ▪ Thrombocytopenia/ petechiae Sickle cell anemia • Cause o Genetics ▪ Autosomal recessive disorder ▪ More common in african ancestry ▪ Both parents have to carry trait • Abnormal hemoglobin • Occurs when O2 levels lowered o Lung infection/ dehydration • Sickle-shaped cells/ shorter lifespan/ anemia • S+s o Pallor/ weakness/ tachycardia/ dyspnea o Sever pain due to ischemia of tissues + infarction/ rbc clot easily o Jaundice/ hyperbillirubinema o Rbc clump/ cause hypoxia Anemia Rbc Eiology Additional effects S+s Fe deficient Microcytic Hypochromi c Decreased hemoglobin production Decreased dietary intake Malabsorptio n Blood loss Only effects of anemia General: Pallor/ Fatigue/ Lethargy/ CNS stimulation, hypoxia Spoon shaped, ridged nail, brittle hair Stomatitis, glossitis, menstrual irregularities, delayed healing Pernicious Megaloblast s Short lifespans Deficit of intrinsic factor due to immune reaction Neurologic damage Achlorhydria Tongue typically enlarges, red, sore, shiny Digestive discomfort/ with nausea and diarrhea Feeling of pins + needles/ tingling in limbs Aplastic Normal cells Pancytopeni a Bone marrow damage/ failure Excessive bleeding Multiple infections Blood count indicate pancytopenia/ low levels, rbc, wbc, platelelts Anemia/ pallor, weakness, dyspnea Leukopenia/ recurrent infection Thrombocytope nia/ petechiae Sickle cell Sickle shape when O2 levels low Short lifespan Recessive inheritance Painful crises with multiple infarction hyperbilirubine mia Pallor/ weakness/ tachycardia/ dyspnea Sever pain due to ischemia of tissues + infarction/ rbc clot easily Jaundice/ hyperbillirubine ma Rbc clump/ cause hypoxia Polycythemia • Primary/ polycythemia vera o Increased production of erythrocytes + other cells in bone marrow o Neoplastic disorder o Serum erythropoietin levels low • 2nd / erythrocytosis o Increase in rbc in response to prolonged hypoxia/ copd, high elevation o Increased erythropoietin secretion o Compensation mechanism to provide increased O2 transport ▪ Increased elevation • S+s o Plethoric + cyanotic ▪ Deep bluish-red tone of skin and mucosa resulting from engorged blood vessels and sluggish blood flow o Hepatomegaly o Increased blood pressure o Thromboses + infarctions o Chf can develop Blood clotting disorder • Spontaneous bleeding/ excessive bleeding following minor tissue trauma • Warning signs o Persistent bleeding from gums, petechiae, bruises, ecchymosis • Complication o Risk for hemorrhage/ invasive procedure Hemophilia A • Classic hemophilia/ deficit, abnormality of factor VIII o X-linked recessive trait o Manifested in men/ carried by women • S+s o Prolonged bleeding after minor tissue trauma o Spontaneous bleeding into joints o Hematuria (blood in urine) or blood in feces Leukemias • Neoplastic disorders involving wbc • Undifferentiated, immature, nonfunction cells that multiply uncontrollable/ infection, uncontrolled • Acute o High proportion of immature nonfunctional cells o Onset usually abrupt/ marked signs of complications o Occurs primarily in kids+young adults • Chronic o Higher proportion of mature cells with reduced function o Insidious onset o Common in older adults