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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: “bruiseâ€
- 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.