exam 3 diseases

Anemia

↓ RBCs or ↓ hemoglobin → ↓ O₂ delivery to tissues

c: blood loss, hemolysis, ↓ RBC production

s/s: fatigue, pallor, SOB, dizziness

Iron deficiency Anemia

↓ iron → ↓ Hgb synthesis → ↓ RBC production

c: low intake, blood loss, malabsorption (celiac, H.pylori)

s/s: PICA

Thalassemia

genetic defect → ↓ or abnormal α- or β-globin chain synthesis

s/s: fatigue, pallor, splenomegaly

Folate B9 deficiency

↓ intake (poor diet), alcoholism, ↑ demand (pregnancy)

s/s: ↑ neural tube defects risk

Vitamin B12 deficiency

↓ intake (vegan), ↓ absorption

neuro s/s: numbness, parathesia, imbalance, memory loss

Pernicious anemia

Autoimmune loss of intrinsic factor → ↓ B12 absorption

AOCD: Anemia of Chronic Disease

chronic inflammation → ↓ RBC production ↓ Fe use, ↓ EPO

C: HIV, TB, RA, SLE, Hodgkin’s, Lung, Breast CA, CKD

Aplastic anemia

bone marrow failure → ↓ RBC, WBC, PLT

c: autoimmune destruction, radiation, toxins (benzene), drugs (chloramphenicol)

Hemolytic anemia

Premature destruction of RBCs → anemia

c: SLE, sickle cell, G6PD deficiency, malaria

s/s: Fatigue, jaundice, splenomegaly, dark urine, pain crises

sickle cell anemia

→ abnormal Hgb (Hbs) → sickling & occlusion

s/s: pain crisis, jaundice, fatigue, stroke, delayed growth, organ damage

Leukopenia/ Neutropenia

WBC < 4,000/ ANC < 1,500 → infection risk

cause: chemo, radiation, autoimmune, marrow failure

s/s: fever, infections w/o inflammation, ulcers

Thrombocytopenia

Platelets <150,000

c: ↓ Production (marrow failure), ↑ Destruction (ITP), ↑ Consumption (DIC, TTP)

s/s: petechiae, purpura, bleeding gums, hematuria, melena

Myelodysplastic syndromes

marrow disorders→ stem cells fail to mature → abnormal ineffective blood cells → pancytopenia → acute myeloid leukemia

Polycythemia

↑ RBC Production, bone marrow overproduction

C: primary: JAK2 mutation (polycythemia Vera) | second: hypoxia, tumor

s/s: ruddy skin, headache, dizziness, pruritus, ↑ thrombosis

leukemia

malignant ↑ abnormal WBCs in bone marrow & blood

c: Philadelphia chr, Radiation, chemical exposure

s/s: Fatigue, fever, wt loss, ↑ infections, bruising/bleeding, bone pain, lymphadenopathy

leukocytosis

reactive WBC >11,000 → infection, inflammation, stress, or malignancy

cause: infection, inflammation, corticosteroids, epi

thrombocytosis

↑ Platelets in bone marrow

cause: primary: JAK2 (myeloproliferative) | second: inflammation response, infection, Fe deficiency

s/s: visual changes, ↑ thrombosis risk, bruising/bleeding

Factor V leiden

→ Inherited F5 gene mutation → Factor V resistance → Protein C inactivation

Heparin-Induced Thrombocytopenia (HIT)

Immune-mediated reaction to heparin → platelet activation → thrombosis

s/s: thrombosis, skin necrosis

Von Willebrand Disease

→ deficiency or dysfunction of vWF (platelet adhesion defect)

s/s: Easy bruising, nosebleeds, heavy menses, post-op bleeding

Hemophilia A

→ X-linked genetic disorder → deficient Factor VIII → impaired intrinsic pathway

s/s: bleeding, joint hemarthrosis, bruising, post-surgical bleeding

Hemophilia B (christmas disease)

→ X-linked Factor IX deficiency

s/s:  bleeding, joint pain and swelling, delayed clot formation

Disseminated Intravascular Coagulation (DIC)

→ Secondary process → widespread activation of clotting → microthrombi + factor consumption

s/s: bleeding (bruising, oozing), thrombosis, organ ischemia, shock

Immune Thrombocytopenic Purpura (ITP)

→ Autoimmune platelet destruction → isolated thrombocytopenia

s/s: petechiae, purpura, mucosal bleeding, nosebleeds, gum bleeding

liver disease

Coagulopathy due to impaired synthesis of clotting factors

hypothermia & met. acidosis

↓ Coagulation capacity

c : platelet dysfunction, ↓ factor synthesis, ↓ inhibitor activity

Shock

↓ tissue perfusion → cellular hypoxia → organ dysfunction

Hypovolemic shock

↓ volume → ↓ preload → ↓ CO → ↓ perfusion

c: hemorrhage, burns, dehydration

s/s: early: tachy, narrow pulse pressure, oliguria | late: hypotension, ↓ CO, confusion

cardiogenic shock

pump failure → ↓ CO → pulmonary congestion

c: MI, arrhythmia, valve disease

s/s: chest pain, crackles,  ↓ UOP, JVD + hepatic congestion

Obstructive shock

Mechanical obstruction → ↓ CO → ↓ tissue perfusion ↑ right-sided pressure → systemic venous congestion

c: PE, tamponade, tension pneumo, dissection

s/s: sudden hypotension, JVD, cyanosis, weak pulse, muffled hrt sounds

Distributive Shock

Widespread vasodilation → ↓ SVR → blood pooling → ↓ venous return → ↓ CO

Septic Shock

cytokine storm → endothelial damage → nitric oxide release → massive vasodilation, capillary leak, ↓ CO

s/s: early: warm, bounding, → ↑ CO, ↓ SVR, ↓ preload | late: cool, mottled → ↓ CO, ↑ SVR, ↓ preload

anaphylactic shock

IgE- response → histamine → vasodilation + bronchoconstriction

cause: allergens

s/s: early: flushing, urticaria, wheezing, edema | progressive: resp. distress, cyanosis, LOC | hemo: ↓ SVR, ↓ BP, hypoxia

neurogenic shock

SCI above T6 → SNS tone loss → bradycardia + vasodilation

c: SCI, head trauma, spinal anesthesia, CNS insult

s/s:

 • early: ↓ BP, bradycardia, warm, dry skin, paralysis, ↓ JVD, hypothermia

• late: ↓ LOC, ↓ UOP, respiratory, ↓ Sweating below lesion

DVT

Clot formation in a deep vein (legs)

c: