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112 Cards in this Set
- Front
- Back
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what is aplastic anemia related to?
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impairment/failure of bone marrow function, leading to:
- loss of stem cells & pancytopenia - decreased # of erythrocytes, leukocytes, platelets |
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what does aplastic anemia occur with?
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cancer treatment
bone marrow damage myelotoxins idiopathic unknown cause viruses, particularly Hep C |
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what virus may cause aplastic anemia?
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Hepatitis C
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RBCs in aplastic anemia
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normal cells
pancytopenia |
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pancytopenia
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A shortage of all types of blood cells, including red and white blood cells as well as platelets
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etiology of aplastic anemia
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bone marrow damage or failure
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additional effects of aplastic anemia
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excessive bleeding
multiple infections |
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symptoms of anemia
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anemia (pallor, weakness, dyspnea)
leukopenia thrombocytopenia, petachia excessive bleeding in the mouth |
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thrombocytopenia
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any disorder in which there are not enough platelets
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effects of abnormal platelet/thrombocyte count
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unable to clot blood due to abnormal platelets
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leukocytosis
define |
increase in WBCs
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leukocytosis often occurs with what?
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inflammation or infection
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leukopenia
define |
decrease in WBCs
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leukopenia often occurs with what?
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some viral infections, radiation, chemo
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effects of abnormal leukocyte count
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multiple infections
severe hemorrhage signs of anemia bone pain weight loss & fatigue leukocytosis and leukopenia |
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leukopenia
values range |
less than 4,500 /mm3
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leukocyte normal range
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4,500 to 10,500 /mm3
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leukocytosis
values range |
more than 10,500
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erythrocytopenia
can cause |
pallor
weakness dyspnea |
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leukocytopenia
can cause |
recurrent or multiple infections
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thrombocytopenia
define |
abnormally low number of thrombocytes or platelets
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thrombocytopenia
causes |
acute viral infections in children
autoimmune reactions HIV heptomegaly splenomegaly certain drugs |
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pancytopenia
define |
decrease in all blood cells, erythrocytes, leukocytes, and thrombocytes
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erythrocyte
normal range |
4.2 mill - 5.9 mill
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thrombocytes/platelets
normal range |
150,000 - 350,000
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how do you treat aplastic anemia?
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blood transfusion
removal of any bone marrow suppressants bone marrow transplantation in younger patients |
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how are bone marrow transplants for aplastic anemia matched?
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using human leukocyte antigen (HLA)
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risk factors for hypertension
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age
more common in men more common in African Americans familial traits, lifestyle high sodium and alcohol intake obesity, prolonged stress |
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medical management of hypertension
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mild diuretics which are antihypertensive
ACE inhibitors antihypertensive agents that block the sympathetic stimulation |
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alphal blockers cause what?
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vasodilation
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calcium channel blockers reduce what?
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heart activity and peripheral resistance
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beta blockers reduce what?
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heart action
renin relase |
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lifestyle changes for hypertension
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reduce salt intake
reduce body weight and stress increase cardiovascular fitness |
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complications of hypertension
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drug side effects
lack of reflex vasoconstriction increased urinary frequency prevent heart rate from increasing with exercise more likely to develop coronary heart disease, congestive heart failure, strokes, kidney failure |
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people with hypertension are more likely to develop what?
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coronary heart disease
congestive heart failure strokes kidney failure |
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3 classifications of hypertension
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primary/essential
secondary malignant/resistant |
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which form of hypertension is idiopathic?
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primary/essential
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which form of hypertension results from renal or endocrine diseaes, or pheochromocytoma?
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secondary
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essential hypertension
values |
consistently above 140/90
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atherosclerosis
define |
plaque forming inside of walls of large arteries
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where are cholesterol and triglycerides synthesized?
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liver
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"bad" cholesterol is
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LDL
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"good" cholesterol is
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HDL
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LDL normal range
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less than 180 mg/dL
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HDL normal range
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greater than 30 mg/dL
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LDL
characteristics |
high in cholesterol content
transports cholesterol from liver TO cells |
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LDL is a major factor in contributing to what?
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artheroma formation
(plaque) |
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HDL
characteristics |
low cholesterol
used to transport cholesterol AWAY from the cells to the liver |
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what causes obesity?
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diets high in cholesterol and animal fat
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how does smoking effect cholesterol levels?
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decreases HDL, increases LDL
promotes platelet adhesion increases fibrinogen and clot formation increases vasoconstriction |
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dietary treatment for atherosclerosis
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reduce intake of saturated & animal fats
high fiber intake weight reduction minimize sodium intake control of primary disorders such as diabetes or hypertension |
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effect of atherosclerosis on blood pressure
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damage to the arterial walls (they become thick)
wall may dilate or tear, forming an aneurysm or encourage atheroma heart has to work harder, causing increasein BP |
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cholesterol
normal range |
150 - 250 mg/dL
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when does mycardial ischemia/infarction occur?
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when a coronary artery is totally obstructed
leading to prolonged ischemia and cell death/infarction of the heart wall |
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what is the most common cause of an MI?
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artherosclerosis
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in what ways can MI develop?
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thrombus build up
vasopasm in the presence of a partial occlusion part of thrombus may break away and flow until it lodges in a smaller branch |
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effect of MI on heart muscle cells
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heart tissue becomes necrotic and inflammation and ischemia develop
functions are lost quickly as oxygen supplies are depleted |
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irreversible damage may be prevented in MI if blood supply can be restored in within what amount of time?
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20 minutes
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emergency medical treatment for MI
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thromolytic therapy within 20 minutes
fibrinolytic drugs defibrillators immediate bypass surgery rest, oxygen therapy, analgesics |
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what are the most usual MI treatment modalities?
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rest
oxygen therapy analgesics |
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left-sided CHF
causes |
infarction of left ventricle
aortic valve stenosis hypertension hyperthyroidism |
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right-sided CHF
causes |
infarction of right ventricle
pulmonary valve stenosis pulmonary disease |
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left-sided CHF
basic effects |
decreased cardiac output
pulmonary congestion |
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right-sided CHF
basic effects |
decreased cardiac output
systemic congestion edema of legs and abdomen |
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forward effects (decreased output)
left-sided AND right-sided CHF |
fatigue
weakness exercise intolerance cold intolerance |
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compensations for CHF
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tachycardia & pallor
secondary polycythemia daytime oliguria |
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backup effects
left-sided CHF |
orthopnea
cough shortness of breath paroxysmal nocturnal dyspnea hemoptysis rales |
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backup effects
right-sided CHF |
dependent edema in feet
hepatomegaly & splenomegaly ascites distended neck veins headache flushed face |
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pulmonary edema
symptoms |
cough
orthopnea rales hemoptysis hypoxemia cyanosis difficulty breathing |
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surgical treatment to restore circulation
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laser angiopathy
coronary artery bypass grafting |
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coronary artery bypass grafting
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reroutes blood flow around the obstruction
surgeon uses veins for a graft |
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what drugs are used for mild pain?
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ASA
Acetaminophen NSAIDs |
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what drugs are used for moderate pain?
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Codeine
Oxycodone |
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what drugs are used for severe pain?
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Morphine
Meperidine |
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ASA
Acetaminophen NSAIDs action |
decreases pain at peripheral site
antipyretic ASA, NSAIDs are anti-inflammatory |
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ASA
NSAIDs adverse effects |
nausea
gastric ulcers bleeding allergies |
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Codeine
Oxycodone action |
acts on central nervous system
affects perception |
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Codeine
Oxycodone adverse effects |
narcotic/opium often compared with ASA/acetaminophen
high dose may depress respiration |
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Morphine
Meperidine adverse effects |
narcotic-tolerance and addiction
high dose depresses respiration nausea constipation |
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problems associated with aging
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fatty tissue and collagen fibers accumulate in heart muscle
degenerative changes in the arteries accumulation of collagen in the arterial walls (thickening of the walls, thus limited expansion and obstruction) |
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shock/hypotension
results from what? |
a decreased circulating blood volume
leading to decreased tissue perfusion and general hypoxia |
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5 types of shock
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hypovolemic
cardiogenic vasogenic anaphylactic septic |
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hypovolemic shock
mechanism |
loss of blood or plasma
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hypovolemic shock
specific causes |
hemorrhage
burns dehydration peritonitis pancreatitis |
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cardiogenic shock
mechanism |
decreased pumping capability of the heart
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cardiogenic shock
specific cause |
myocardial infarction of LEFT ventricle
cardiac arrhythmia pulmonary embolus cardiac tamponade |
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vasogenic shock
mechanism |
vasodilation due to loss of sympathetic and vasomotor tone
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vasogenic shock
specific causes |
pain and fear
spinal cord injury hypoglycemia |
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anaphylactic shock
mechanism |
systemic vasodilation and increased permeability due to severe allergic reaction
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anaphylactic shock
specific causes |
insect stings
drugs nuts shellfish |
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septic shock
mechanism |
vasodilation due to severe infection
often with gram NEGATIVE bacteria |
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septic shock
specific causes |
virulent microorganisms
multiple infections |
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early signs
manifestations |
anxiety & restlessness
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early signs
rationale |
hypotension stimulates SNS
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compensation
manifestations |
tachycardia
cool, pale, moist skin oliguria thirst rapid respiration |
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progressive
manifestations |
lethargy, weakness, faintness
metabolic acidosis |
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emergency treatment of shock
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supine position
cover & keep warm call for assistance administer oxygen determine underlying cause and treat if possible |
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hypovolemic shock
what is given? |
blood
plasma fluid with electrolytes and bicarbonate |
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anaphylaxis
what is given? |
antihistamines
corticosteroids |
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septic shock
what is given? |
antimicrobials
glucocorticoids |
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sex-linked disorders are usually carried by which sex chromosome?
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X
female |
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hemophilia
an affected male will transmit the defect how to his sons and daughters? |
daughters will all be carriers
sons will not be affected/nor carriers |
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Goodwell's sign
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increased vascularity of cervix and vagina
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Chadwick's sign
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typical deeper purplish color
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Rh incompatibility results when..
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mother Rh is negative
father Rh is positive |
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indirect Coomb's test
tests for what? |
maternal blood for Rh antibodies
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Rh
how can the mother be given passive immunity? |
administer the Rh immunoglobin (RhoGAM) to the mother within 72 hours of delivery
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cystic fibrosis
affects what? |
the exocrine glands, primary lung and pancreas
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an individual with Down syndrome has how many chromosomes?
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47
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what is menarche?
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the absence of menstruation after the age of 17
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usual cause of delayed menarche
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abnormality in the reproductive organs or an abnormality in the pituitary glands or hypothalamus
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blood pressure in anorexia nervosa
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low
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