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