Advanced Pathophysiology Advanced Pathophysiology, Exams of Pathophysiology

Download Advanced Pathophysiology Advanced Pathophysiology and more Exams Pathophysiology in PDF only on Docsity! Advanced Pathophysiology a new painless palpable lymph node in the neck accompanied by recent weight loss would be a sign of - Hodgkins lymphoma A mediastinal mass and mediastinal nodes present on xray could be which type of cancer - Hodgkin's Lymphoma What is the function of TPA - to break up a blood clot and restore blood flow to the brain following a stroke. Promotes fibrinolysis. Iron Deficiency Anemia - the presence of small, often hypochromic, red blood cells in a peripheral blood smear and is usually characterized by a low MCV Vitamin deficiency anemia - occurs when your body doesn't have enough of the vitamins needed to produce adequate numbers of healthy red blood cells. low B12 (pernicious anemia) Aplastic Anemia - stops producing red blood cells - causes viral infections, exposure to toxic chemicals, autoimmune diseases. Hemolytic Anemia - Abnormal breakdown of red blood cells - causes sickle cell, artificial heart valve, infection or autoimmune disease Anemia of chronic disease - Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin. Causes - cancer, kidney dx, liver dx, thyroid dx and RA Type of hematologic cancer in pediatric patient with hepatomegaly, splenomegaly and small bruises - Acute lymphoblastic leukemia Hemophilia - a group of hereditary bleeding disorders in which a blood-clotting factor is missing multiple myeloma - In MM abnormal plasma cells make monoclonal (one type of) antibodies. Tests are conducted to detect monoclonal antibodies in bone marrow, urine, or blood as well as one or more of the CRAB features (hyperCalcemia,Renal failure, Anemia and Bone problems) - diffused well defined "punched out" lytic lesions Electrolyte imbalance: Hypercalcemia - Bone breakdown causes release of Calcium Abnormal immunoglobulins known as M proteins and free light chains produced by plasma cells are characteristic of - Multiple Myeloma Abnormalities associated with Leukemia - Acute - rapid increase in number of immature blood cells. crowding makes the bone marrow unable to produce healthy blood cells - low HGB, low platelets- Most common in children Chronic - excessive buildup of relatively mature but still abnormal white blood cells. Months or years to progress - typically seen in older people. How to diagnose childhood lymphoma - Painless swelling of lymph nodes in your neck, armpits or groin. Persistent fatigue, fever, night sweats. SOB, sudden weight loss Dietary Recommendations for different kinds of anemia - B12 deficiency - increase red meat consumption iron deficiency - green, leafy veggies, liver Hematologic cancer associated with myelodysplastic syndrome - Acute myelogenous leukemia Important factors for coagulation cascade - fibrinogen, prothrombin, Christmas factor, Stuart-Prower factor, plasma thromboplastin, Hageman factor and stable factor (fibrigin and calcium) What makes B cells become defective with Hodgkins Lympohoma - healthy B-cells change into fast-growing cancer cells that don't die. The cancer cells duplicate, eventually overwhelming healthy cells. The cancer cells can also spread to other areas of your body including the bone marrow, spleen or other organs. Errors in immunoglobulin gene arrangement result in defective lymphocytes Where does lymphoma begin - B cells What to expect when an infant/child is diagnosed with sickle cell anemia - paleness, weakness or extreme tiredness, an enlarged spleen, and belly pain - Painful swelling of fingers and toes which is the definition of a condition called "dactylitis. How and for how long is folic acid stored in your body - Folate dissolves in water, which means your body is unable to store it for long periods of time. Your body's store of folate is usually enough to last 4 months What is von Willebrand factor directly involved with? - platelet adhesion and aggregation - helps the platelets stick together, like glue, to form a clot at the site of injury and stop the bleeding. Chronic myelogenous leukemia is associated with which type of chromosomal abnormality - Philadelphia chromosome: created during translocation on chromosome 9 and chromosome 22 resulting in BCR-ABL fusion gene Stable Angina - Usually happens during activity( exertion) and goes away with rest or angina medication (NG) chest pain that lasts short time - 5 mins or less Unstable Angina - Medical emergency - unpredictable and occurs at rest. Typically severe and last longer than stable angina (20 mins or longer) Pain does not subside with rest or meds Variant Angina - (Prinzmental Angina) not due to coronary dx. Caused by spasm in heart's arteries that temporarily reduces blood flow. Sever chest pain - occurs in cycles, typically at rest and overnight. Pain may be relieved by NG Refractory Angina - frequent episodes after combination of medications and lifestyle changes Cardiac cells and their function - Cardiac cells are able to generate an impulse to contract even with no external nerve stimulus, a process called automaticity. When impulses travel through the cardiac cells, the result is a shortening of muscle fibers, which then causes contraction and pumping out of blood (i.e., systole). Between impulses, the fibers rest and go back to their usual length, which is when filling (i.e., diastole) occurs. All cardiac muscle cells can initiate impulses, but normally the conduction pathway originates in the sinoatrial (SA) node. What factor(s) can affect stroke volume - The stroke volume is influenced by the preload, afterload, and contractility. Cardiac output is determined by stroke volume and heart rate. Stroke volume is the amount of blood ejected from the heart with each contraction. Stimulation of alpha receptors results in - Vasoconstriction (Alpha 1) and Vasodilation ( Alpha 2) acute coronary syndrome - A group of symptoms caused by myocardial ischemia; includes angina and myocardial infarction. The acute coronary syndromes are usually the result of the sequelae of atherosclerosis— coronary artery disease whether silent or symptomatic, and persistent ischemia or obstruction. Risk factors: those for atherosclerosis, including dyslipidemia, diabetes mellitus, hypertension, stress, and tobacco. In most cases of MI, an unstable plaque tears or ruptures, triggering platelet aggregation, the coagulation cascade, and thrombus formation. As a result, the vessel becomes occluded, and the myocardial oxygen supply cannot meet the body's demand for oxygen. Door to balloon time - 90 minutes or less Different waves in EKG - P wave - atrial depolarization QRS wave - ventricular depolarization T wave - ventricular repolarization Why are patient with atrial fibrillation prescribed anticoagulants - Anticoagulants are given to patient's with atrial fibrillation for the prevention thromboembolism (blood clots). The ineffective atrial quivering/filling causes blood to pool and promote clot formation How is preclampsia developed - A result of placental vascular alterations that cause placental decreased perfusion, hypoxia, and ischemia. The maternal inflammatory reaction is activated in response to the placental alterations with resulting endothelial dysfunction, systemic inflammation, and a thrombotic state. Diagnogstic criteria: thrombocytopenia, impaired liver function test, renal insufficiency (elevated creatinine), pulmonary edema, cerebral/visual disorders, BP 160+/90+ What is the cause of septic shock - Gram Negative Bacteria - An organism's endotoxin or exotoxin activates an immune reaction. Starts with systemic inflammatory immune response syndrome (SIRS), which is a response to and clinical insult that is infectious or noninfectious (i.e. pancreatitis). Next step, septicemia (blood infection), next sepsis (systemic response to infection), then septic shock (inappropriate distribution of volume from inflammatory mediators causing increased capillary permeability, capillary pooling, and fluid shift vascular to the tissue (MODS-multiple system failure). Thrombosis formation - Blood clot consisting of platelets, fibrin, erythrocytes, and leukocytes. Occurs mostly in the legs Study the pathway of renin-angiotensin-aldosterone - Activated when renal blood flow decreased (RENIN) Increases blood volume Renin released from kidneys→ Increase in Na retention Angiotensin production vasoconstriction Aldosterone secretion Na and water retention Increase in volume = hypertension cardiac tamponade - acute compression of the heart caused by fluid accumulation in the pericardial cavity which impairs filling in diastole Fluid accumulates in the pericardial cavity to the point that it compresses the heart. This compression prevents the heart from stretching and filling during diastole, initially affecting the right side of the heart due to its lower pressure. The decreased right-side stretching and filling causes blood to back up into the venous circulation, causing right-sided heart failure and a reduction in left ventricle filling. Causes decreased CO. Symptoms: low arterial pressure, high venous pressure, narrow pulse pressure. Muffled heart sounds because the excess fluid drowns out the sound. SOB, chest pain, pain with deep inspiration or lying flat, feels better when leaning forward. Beck's triade: low BP, JVD, muffled heart sounds Treat: pericardiocentesis to drain fluid from pericardium. Pericardiectomy (a surgical procedure in which a window is created in the pericardium) may be performed to release constriction and allow excess fluid to drain into the pleural cavity Compensatory mechanism to the initial stage of shock - Increased heart rate silent myocardial infarction - a myocardial infarction that occurs without exhibiting obvious signs and symptoms. Ex: An obese male diagnosed with DM Ventricular remodeling in heart failure - ·The ventricle tends to become enlarged (HYPERTROPHY), its general shape becomes more globular, and the muscular wall of the ventricle often becomes thinner. · Ventricular remodeling may include ventricular hypertrophy, ventricular dilation, cardiomegaly, and other changes. What is Bacterial (ineffective) endocarditis - It is an infection of the endocardial surfaces of the heart muscle, heart valves, or lining of the heart. ·In endocarditis, irregular growths made of germs and cell pieces form a mass in the heart. These clumps are called vegetation. They can break loose and travel to the brain, lungs, kidneys and other organs (Emboli). · Damaged endocardium fosters platelet aggregation and activation of the coagulation cascade, which fosters the formation of a sterile, non-bacterial thrombotic vegetation. Sepsis - is defined as the systemic inflammatory response to infection. · A life-threatening organ dysfunction caused by a dysregulated host response to infection. · Sepsis can rapidly lead to tissue damage, organ failure, and death. ·Usually requires broad spectrum antibiotics to be given. Acute myocardial infarction and cardiac enzymes - When the heart experiences damage or stress due to lack of oxygen, it releases substances called cardiac enzymes into the bloodstream. High (elevated) levels of cardiac enzymes can be a sign of a heart attack (myocardial infarction) or another heart problem. Mitral Valve Prolapse and leaflets - The leaflets of the mitral valve bulge (prolapse) into the left atrium during the heart's contraction. Mitral valve prolapse causes blood to leak back into the atrium from the ventricle Abnormal thickened mitral valve leaflet prolapsing into the left atrium during systole. Hematopoiesis - production of blood cells - process by which red blood cells, white blood cells, and platelets are produced •The production of all of the cellular components of blood and blood plasma. •It occurs within the hematopoietic system, which includes organs and tissues such as the bone marrow, liver, and spleen Erythropoietin production in the fetus vs in the adults - Fetus: Liverproduces growth factor erythropoietin in response to reduced oxygen supply Adults: Kidneys produce growth factor erythropoietin (EPO) in response to reduced oxygen supply Mature erythrocytes removed from the bloodstream by? - Macrophages (from the spleen) remove mature erythrocytes in about 4 months