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140 Cards in this Set

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kinetic anemia
decreased production of RBC or increased destruction
nutritional anemia
vitB12, folate, or iron deficiency
RBC destruction anemia
hemolytic anemia
iron deficiency anemia test
ferritin, iron, transferrin, receptors in blood serum
iron deficiency anemia caused by
thalassemias
define thalassemia
genetic disorder. decreases hemoglobin, erythropoeisis, and folate deficiency
megaloblastic anemia
B12, folate deficiencies - pre-leukemia
hemostasis
arrest of blood flow from or within a vessel
primary hemostasis
platelet plug, sm. musc. stimulation
2ndary hemostasis
fibrin clot formation
hemostatic resolution
remodelling - fibrin clot lysis
immune vascular response to bleeding caused by
local release of vasoactive factors - cause vasoconstriction
3A’s platelet plug formation
Adhesion, Activation, aggregation.
what causes platelet adhesion
von Willebrands factor, platelet factor
what activates platelets
ADP, thrombin, collagen
Why do platelets aggregate?
attracted to fibrinogen, and VonWillebrands factor
platelet aggregation causes
platelet plug
purpose secondary hemostasis
holds platelet plug in place
trigger for clotting
Tissue Factor VIIa
extrinsic clotting pathway
dissue damage leads to tissue factor release and expression of factor X.
test for intrinsic clotting path
APTT - test time: activated partial thrombo plastin time
factor which hemophiliacs lack (usually)
VIII
factor which covalently links fibrin mesh clots
XIII
common anticoagulant
warfarin, heparin
term: “bruise”
ecchymosis
greatest hemostatic challenge
surgery
drug causing qualitative platelet disorder
aspirin - makes platelets not stick
quantitative platelet disorders show
low counts - usually production related
low platelet count-term
thrombocytopenia
platelet clumping
pseudothrombocytopenia
test for bleeding time
platelet and vascular function by puncturing skin
sequestration
too many platelets hiding in spleen
treatment for sequestration thrombocytopenia
splenectomy
platelet production too low?
transfuse platelets
platelet destruction by immunosupression
IV Immunoglobulin as treatment
deficiencies of hemophilia A and B
factor VIII, factor IX
determine thrombocytopathy how
counts normal, but bleeding time prolonged
common cause of platelet defect
hyperuremia
hemophilia is
Xlinked genetic disorder, 1 in 10,000
treatment hemophilia
purified blood factor VIII
Von Willebrands disease
most common blood disease - deficiency of VWF
4 acquired coagulopathies
liverdisease, Vitamin K deficiency, anticoagulants
Jewish hemophilia
factor XI deficiency in 1/8 ashkenazi jews
factor XI deficiency causes
unpredictable bleeding rates
PTT
partial thromboplastin time - clotting test
von willebrands disease symptoms
unstable clots, increased clotting time
vWf missing - significance
PRIMARY hemostasis defect - platelets don’t stick
liver disease impact on clotting
liver prim.prod.site of clotting factors. II, VII,IX,X, uses less Vit.K if diseased, produces less clotting factors.
cure for liver defects causing platelet probs
FFP: give fresh frozen plasma
DIC definition
disseminated intravascular coagulation
DIC is
uncontroled thrombin and plasmin, clotting and bleeding
consequence of DIC
consumes blood factors
DIC caused by
underlying malignancies
UFH
low molecular weight heparin used for patients with overcoagulation.
problem with people on UFH
risk for bleeding during operations and dentistry
warfarin works how
stops vitamin K metabolism by liver, so clotting factors not produced
five drugs which interfere with clotting
aspirin (NSAIDS), anticoagulants, antibiotics, alcohol, anti-CA drugs
bacteria associated with TB
mycobacterium tuberculi
molecular method for detecting TB
PCR - amplifies TB
mycobacterium classifactions
only TB or not TB
Ghon complex definition
granuloma with central caseous necrosis, clusters of fused and epithelial macrophages
Ghon complex in TB-macro
subpleural granuloma and hilar lymph node granuloma
Giant multinucleated cells associated with TB
Langhans cells
TB and HIV gross effects
granulomas don’t form (no lymphocytes)
TB transmission requires
prolonged close contact with actively infected person
if untreated, percent of TB patients that die
50
where most cases of TB occur
95percent developing world, esp. Africa
TB test
mantoux skin test
if sick with TB
contagious
most cases of TB are
latent (not contagious)
TB risk factors
immunosupression, diseased, underweight, age
problem with BCG
can cause a false positive skin test
Treatment of TB using
TB prophylaxis - MUST comply w medication
TB transmission via
droplet nuclei - talking, coughing
most cases of TB are in what organ
lungs (pulmonary)
term for a normal mole
nevi
nevi melanoma definition
tumours of melanocytes
melanocyte origin
neural crest cells to skin, eye, etc
melanin purpose
absorbs UV radiation, protects keratinocytes
characteristics of Nevis
symmetrical, proliferation of normal melanocytes
nevi mature in what fashion
from base up
nevi grow where
dermo-epidermal junction
dysplastic nevi appearance
fuzzy borders, varied elevation, colours, “fried egg” look
risk with dysplastic nevi
skin cancer
melanoma signs
asymmetry, border irregular, colour chg, dimension chg, bleeding, ulceration
melanoma etiologies
sunlight, genetics, P16 gene
migration to upper part of lesion
pagetoid spread
vertical growth melanoma
most aggressive - into dermis
type of melanoma always in vertical growth
nodular
clarks levels
grading system for melanoma invasion
measurement of tumour using ocular micrometer
breslow thickness
poor prognosis melanomas
ulceration, mitosis, vascular invasion, vertical growth
worst prognosis melanoma metastasis
brain
most important prognostic indicator
sentinal node biopsy
melanoma treatment
surgical incision, including border
features of seborrheic keratosis
benign elevated brown or yellow, irreg. surf, chronic, progressive
key diagnostic features seborrheic keratosis
well outlined, elevated, yellow black, patients 50+
pigmented nevus
smaller than seb. ker, no plugged follicles on surf
basal cell CA
irregular, rolled border, ulcerated ctr, dilated vessels below surf
feature basal cell CA
rarely metastasis
term-dilated vess below surf
telangiectasis
skin tag term
acrochordon
skintags increase with
aging, obesity, pregnancy, diabetes
solar keratosis - transformation
squamous cell carcinoma
solar keratosis cause
carcinoma - result of excess sun exposure
solar keratosis susceptibility determinant
genetic - amt. of melanin in skin
prone to solar keratosis
fair skinned, sunburn easily, work outdoors
etiology solar keratosis
cumulative radiation effect in predisposed people
type of carcinoma from solar keratosis
well differentiated, seldom metastasis
solar damage to collagen
solar elastosis
critical in skin CA patients
life long followup
skin cancer probably related to what genetic defect
tumour supressor gene or defective oncogene
basal cell CA chars
local, invasive, slow growing, rarely metastasis,
what skin CA most common
basal cell carcinoma
char basal cell CA
insidious onset, single lesion, well demarcated, waxy, central depression, rolled border, bleeds occassionally
2nd most common skin cancer
squamous cell carcinoma
SCC arises from
abnormal skin, mucous membrane, fails to heal
SCC has a tendency to
bleed, crust over
growth rate SCC
faster than basal, 1cm per year
poor prognosis re SCC
not differentiated, invasive, vascular or perineural invasion, metastasis
vasogenic edema
fluid accum. due to incr. vasc. permeability
cytotoxic edema
cellular metabolism problem impairs fluid balance
interstitial edema
elevated CSF pressure
SAH
subarachnoid hemorrhage
Cancer remission rates in kids vs. adults
95 percent in kids, 60 - 85 in adults
CML
chronic myeloid leukemia
main sign of chronic myeloid leukemia
onset incidious, asymptomatic, elevated WBC’s
CML is
RARE in children, but common overall CA
Mean survival rate CML
5 - 7 years
Hodgkin lymphoma stage 1 and 2 survival rate
more than 80 percent 10 year survival
Myeloma
median survival rate 3 years, 10 percent 10 year surv.
Leukemia - def
liquid tumour - malignancy of blood cells
percent of blasts needed to confirm leukemia diagnosis
20 percent
pediatric age group leukemia is?
acute lymphoblastic leukemia
diagnostic for CML
philadelphia chromosome
Lymphoma def
malignancy of lymphocytes in lymph nodes
Cell type diagnostic for hodgkin lymphoma
reed-sternberg
leukemia/lymphoma treatment
chemotherapy and or radiation
term: malignancy of plasma cells
myeloma
diagnosis of lymphoma how?
biopsy evaluation of lymph node.