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108 Cards in this Set
- Front
- Back
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Pathological cause and name of Sickle Cell Anemia
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Sickle Cell disease due to fragile abnormally shaped RBCs. Can be induced by hypoxia, fever, acidosis, dehydration, infection
Valine is substituted for glutamic acid in number 6 of beta chains. Trait carriers are Heterozygous Trait disease homozygous for hgbs. |
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Pathological cause and name of Erythropoeitin Anemia
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Renal failure causes loss of erythropoeitin causing less RBC manufacture and subsequent Anemia.
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Poikilocytosis Anemia
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Abnormal shape of RBC causes Anemia from spherocytosis
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Reticulocytopenia Anemia
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Under-production of RBC`s causing disfunc
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Reticulocytosis
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Blood loss or high elevations. Very high Reticulocytosis
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General Sickle Cell Anemia
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Hemolysis destruction of RBC`s
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Pernicious Anemia
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Vitamin B12 deficiency necessary for maturation of RBC
-Poor B12 absorption -Atrophy of gastric mucosa -Decreased gastric acid secretion -Decreased secretion of intrinsic factor which protects b12 from digestive enzymes |
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Nutritional Deficiency Anemia
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Lack of Iron in diet, chronic blood loss, increased needs
Hypochromic and microcytic anemia |
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Bone Marrow destruction Anemia
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Affects RBC production in bone marrow. Ex: Chemotherapy
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Genetic alterations Anemia
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G6PD deficient
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Hemorrhagic Anemia
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Results from acute/chronic blood loss
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Signs of Hemmorhagic Anemia
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Hypovolemia (Orthostatic Hypotension)
Hypoxemia Diaphoresis Tachycardia Dyspnea |
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RBC characteristics
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Normocytic-Normal rbc shape
Normochromic-Normal color Increased immature RBCs(reticulocyte count) |
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Cause of Hemolytic Anemia
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Mechanical injury to RBC
AG-AB reaction Hereditary membrane defects |
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Characteristics of Hemolytic Anemia
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Normocytic
normochromic Increased reticulocyte count |
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Aplastic Anemia
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Drug toxicity, radiation, chemicals
Infections: Viral, hepatitis, mono, AIDS Often Idiopathic-unknown cause Normocytic and chromic Depletion of Leukocytes and platelets Suppression of bone marrow: heavy metals, viruses, drugs, bacteria Replacement of bone marrow: metatastic tumor, myelofibrosis Congenital: Fanconis syndrome |
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Thalassemias anemia
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defective or absent synthesis of alpha or beta chains in hgb molecule. The unaffected chain continues to be produced leading to RBC desruction and anemia.
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Thalassemia Major
Thalassemia Minor |
Microcytic, hypochromic anemia
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Polycythemia is a anemia
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False
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Sickle cell disease and the pathological causes of a crisis
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Severe hemolysis
widespread vasovocculsion Infarction of many tissues and organs |
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What are the genetics of Sickle cell disease
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virtually all hemoglobin is HBs
Homozygous |
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Causes of polycythemia (excessive RBCs)
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Hypoxia-stimulates erythopoeisis causing
-COPD -Emphysema -Living on the mountain top -Polycythemia Vera Increase RBC. |
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In Erythropoeisis what would cause the body to produce more RBCs
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Testosterone
Pulmonary disorders Shock Low O2 concentration of inspired air Anemia Renal Tumor Polycythemia |
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In Erythropoeisis what would cause the body to creat less RBCs
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Polycythemia
Estrogen High levels of O2 |
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HGB
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hemoglobin- complex protein molecule containing iron. 300 Contained in each RBC a
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HCT
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Percentage of packed red cells within total blood volume
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MCV
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Mean Corpuscular Volume which is the volume and size of the cell.
Terms used are normochromic (color) normocytic |
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MCHC
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Mean Corpuscle Hemoglobin Concentration.
Estimated amount of HGB in Packed RBCs. |
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MCH
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Mean Corpuscular Hemoglobin
Estimated amount of Hgb in a RBC. Not as helpful in determining types of anemia. |
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What is a reticulocyte count?
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Measured to judge erythropoeisis effectiveness, bone marrow response to anemia and its evaluation
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What is intrinsic coagulation?
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Injured endothelial-(vessel) cells are expose to factor 7.
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What is extrinsic coagulation?
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Injured tissue releases thromboplastin which interacts with factor 5
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What is heparin and what lab tests it?
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Anti-coagulant that affects intrinsic pathway.
Tested by aPTT |
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What is Coumadin and what lab tests it
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Anti-coagulant that affects extrinsic pathway.
Tested by PT/INR |
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What is cause and physiologic effects of Lymphoma
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Caused when lymphcyte has malignant changes, multiplies crowds out healthy tissue creating tumors.
PHYS EFFECTS: impaired immunity Impaired cell mediatd response Anemia elevated neutrophils Eosinophilia Hodgkins: Malignant B-Cell (REED-Sternberg Cell) Non-Hodgkins: Could be B or t cells Hyper/hypogammaglobulinemia |
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What is cause and physiologic effects of Myeloma
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Two many Plasma Iga and IGg plasma cells are produced. Cells gather in bone marrow and produce a tumor. Abnormal IG suppress actual ig.
Affects Skeltal system: Osteoporosis, pain, fractures, hypercalcemia Hemat System: Anemia, marrow replacement, thrombocytopenia, bleeding. Renal system: Infiltration by plasma cells, and hyperuricemia and calcemia. Nervous system: Neuropathy, spine compression, IC masses *HYPERVISCOSITY AND SLUDGING |
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What is cause and physiologic effects of Leukemia
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Bone marrow makes to many WBCs and crowd others.
Do not provide immunity, interfere with other cellular growth. Cause anemia, thrombocytopenia, marrow expansion, leukostasis, Hyperuricemia |
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What is Kussmauls breathing pattern
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rapid and deep pattern assoc. with diabetic ketoacidosis
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What do Type 1 Alveolar Cells do
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Exchange of gas
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What do type 2 Alveolar Cells do
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Produce, store and secrete surfactant
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What are the functional units of the respiratory system and how many are there
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Alveoli
300 million |
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What do the conducting airways do?
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Warm and humidify the air
Prevent foreign bodies from entering Lead to the alveoli Lined with mucociliary blanket |
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Which are the conducting airways
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Upper Airways
Trahea Bronchial Tree |
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How many alveolar ducts branch from each resp bronchiole
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two
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What is the diaphragm innervated by?
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It is innervated by the 4th cervical disc-Phrenic Nerve
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What is the larynx and pharynx innervated by
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The xi cranial nerve
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Which CNS element is responsible for bronchodilation
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Sypathetic
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Which CNS element is responsible for bronchoconstriction
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Parasympthetic
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When is Cheynes-Stokes breathing heard
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CVA
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In the upright position which spaces aerate better?
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The Bases aerate better than the apices
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What can cause a V/Q mismatch
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PE perfusion deficit from blockage of blood flow
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Low V/Q Ratio
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(impaired ventilation) Inadequate ventilation of well perfused areas of the lung
Asthma Pulmonary Edema Pneumonia |
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Very low V/Q
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(Blocked Ventilation)
Adult resp distress syndrome Resp distress syndrome of newborn |
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High V/Q ratio
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Poor perfusion of well-ventilated portions of lung
Pulmonary embolus |
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What is Atelectasis
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Collapse of the alveoli braught on by deficiency in surfactant with alveolar instability.
Seen in preemies causes impairment of gas exchange |
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Where does gas exchange occur
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Gas exchange occurs in the Type 1 alveolar cells at the pores of kohn
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What is restrictive lung disease and what are examples
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Inability for the lungs to fully expand.
Examples: Pulmonary Fibrosis Pleural effusion chest wall expansion neuromuscular diseases |
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What is obstructive lung disease and what are examples.
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Air flow into and out of the lungs is obstructed primarily through expiration.
Emphysema Asthma Foreign body Allergies infection Chronic bronchitis |
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Hypoxia is the poor oxygenation of the bodys cells. What are its causes and what kind of mismatch is occuring
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Caused by ARDS and pulmonary edema.
Caused by a v/q (perfusion)mismatch |
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What are different types of pneumonia
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Community Acquired
(Atipical-Mycoplasma/Typical-Streptococcal) Aspiration Hospital Acquired Distribution (lobar/bronchiole) Pneumocystitis Carinii (aids) |
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What is aspiration Pneumonia
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Pneumonia caused from inhalation of solids or liquids. Most common is emesis(vomitting)
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What is treatment of Aspiration Pneumonia
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Positioning (Trendelenburg position)
O2 Suction Bronchoscopy Turn Lateral Recumbant h2 inhibitors Metaclopramide |
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Risk factors of aspiration pneumonia
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Decreased LOC
Feeding tubes improper positioning Anesthesia Artificial airways |
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What are the hallmark signs of Asthma
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Wheezing
Tachyapnea Cough Tight feeling in chest |
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Tuberculosis information infects the ____
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Upper lobes
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What happens to the tissue in the upper lobes from TB?
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Caseous necrosis
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What is the bacterium name in TB
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Mycobacterium tuberculare
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How is TB transmitted
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Transmitted in aerosal droplets
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What does TB form in the lungs
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Granulomatous formation
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What kind of capsule bacteria is TB
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Waxy capsule
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How many stages in TB
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Two
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What happens in the first stage of TB
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Baccili in the lungs are phagocytized and transported to lyph system. Macrophages cant kill, forms a granuloma and becomes calcified
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What happens in the second stage of TB
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Infection is reactivated
Numbers of granulomas increase Extensive necrosis Bacilli can spread systematically. |
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TB signs and symptoms
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Fever
fatigue night sweats weight loss cough malaise |
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Tuberculosis treatment
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Isonizid
Rifampin Pyrazinamide ethambutol |
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What are the two COPDS
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Emphysema
Chronic Bronchitis |
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Pathophysiology of COPD Emphysema
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Chronic irritation of lungs with inflammation response
Breakdown of elastin Poor recoil/expiration Hyperinflation of lung spaces |
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Pathophysiology of COPD Chronic Bronchitis
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Airway obstruction causing inflammation of major/minor airways
Edema Hyperplasia of goblet cells Excess mucus production |
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Differences between emphysema and chronic bronchitis
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Emphysema(pink puffer)
proportionate loss of v/q pursed lips barrell chest Chronic Bronchitis(blue bloater) Mismatched V/Q No extra ventila to compensate cyanosis mucos and edema excess bronchial secretions |
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Manifestations of emphysema
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Inflammation
Edema Fibrosis of bronchial wall Hypertrophy of submucosal glands Hypersecretion of mucos Loss of elastic fibers for alveoli recoil(decreased expiration) Loss of alveolar tissue |
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Cystic Fibrosis pathophysiology
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Autosomal recessive disorder
of mucos glands in body(lungs/digestive) Dysfunction of epithelial chloride channels Lungs get NA reabsorption and decreased excretion dehydration of mucosal layer increased mucos viscosity defective ciliary action plugging great spot for bacteria to colonize |
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Pulmonary manifestations of cystic fibrosis
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Cough, congestion, copius sputum, SOB, infection resistance.
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Non-pulmonary manifestations of cystic fibrosis
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Salty skin, FTT, Mucos plugging of pancreas, sterility, large foul stools
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Ventilation disorders
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Restrictive
Obstructive Restrictive or obstructive |
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Restrictive or obstructive disorders
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Atelectasis
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Obstructive disorders
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COPD
ASTHMA |
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Restrictive disorders
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Pleural effusion
pneumothorax |
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Perfussion disorders
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Pulmonary embolism
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Types of pleural effusion
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Empyema
Hydrothorax Chylothorax Hemothorax |
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Pleural effusion pathophysiology
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Fluid moves into pleura
Lung tissue compressed Decreased ventilation Decreased tissue perfusion |
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Treatment of pleural effusion
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Thoracentesis
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Pathophysiology of ARDS
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large scale epithelial injury to capillary and alveoli beds
Leaking of fluid into alveoli poor ventilation and diffusion Hypoxemia-Tissue death and organ failure. |
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Manifestations of ARDS
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Sudden marked respiratory distress 1 or 2 days prior to onset of condition
Increased pulse, dyspnea, low pao2, hypotension, restlessness, decreased mental status. |
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Pulmonary causes of ARDS
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Pulmonary infection aspiration, smoke inhalation, chest trauma
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Extrapulmonary causes of ards
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Severe burns, septic shock
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What is a chest tube used for
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Treatment of a spontaneous pneumothorax or tension pneumorthorax
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What is a needle throacentesis used for
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To release air in a tension pneumothorax and or to drain pleural effusions.
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What is a bronchoscopy
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Used in the treatment of aspiration. Literal term is to view into the bronchiols or lungs with or without a scope.
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Type O
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No Antigens on the RBC.
Have A and B antibodies Universal donor |
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Type B
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B Antigen
Have a Antibody |
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Type AB
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A and B antigens
Have no antibodies universal recipient |
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Rhesus factor
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type of blood antigen
Positive most common Negative |
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What a normal X-RAY looks like
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White or lighter gray show tissue bone.
Air dark black area. |
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Lobar Pneumonia x-ray
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Large white area base of lung, Fluid is filled up in the area. Will show up as white in the X-RAY
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X-ray patient with TB
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White dots of capsulatin of BASIILI AND NECROSIS. FOUND IN THE UPPER PARTS OF THE LUNGS
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X-RAY OF Pleural effusion
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Area of lung very dense and shows up as a white out of specific area. Kind of looks like Pneumonia but def effusion.
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X-RAY of Tension Pneumothorax
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Cloud out area of `lung tissue compressed.
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Pulmonary Edema X-RAY
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Large white out of mediastinum cloudy throuougt lungs.
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