SBP starred slides

Hematologic system

Study of the structure of blood and blood forming tissues

Formed elements of blood

Erythrocytes, leukocytes (lymphocytes), thrombocytes

Anemia

Lack of a normal number of red blood cells

Anemia presentations

Spoon shaped nails, chest pain, leg cramps, orthostatic hypotension

Decrease in both HgB and Hct

Bleeding and various causes of anemia

Normal Hgb, decrease Hct

Pregnacy, over hydration

Normal Hgb, increase Hct

Dehydration

Decrease in both HgB and Hct

Low oxygen states (Smoking, COPD, altitude)

Disorder of Leukocytes causes

Body reaction to infection, inflammation, tissue damage, degeneration

Granulocytes

neutrophils, eosinophils, basophils

Monocytes

Immature cell until enters interstitial space

Lymphocytes

B and T cells

Neutrophils

First line of defense against pathogens, digest foreign material

Basophils and eosinophils

Involved in allergic reactions, respond to parasitic and fungal infections

Leukocytosis

Abnormally high WBC count (neutrophilia)

Causes of leukocytosis

Tissue necrosis, malignancies, inflammation

Clinical manifestations of leukocytosis

Fever, symptoms of localized or systemic infection or inflammation

Leukopenia

Reduction in the number of white blood cells, never beneficial

Leukopenia causes

HIV, alcohol, leukemia, connective tissue disorders, nutritional deficiency

Leukopenia dangers

Pt is at high risk for infection

Acute myeloid leukemia frequency

Uncommon, mostly in adults > 45 y/o (men)

Acute myeloid leukemia risk factors

Cancer treatments, occupational exposure, down sysndrome

Acute myeloid leukemia clinical manifestations

Splenomegaly, bone discomfort, thrombocytopenia

Acute lymphoblastic leukemia frequency

More common in children

Acute lymphoblastic leukemia

Abnormal growth of T and B cells

Acute lymphoblastic leukemia clinical manifestations

SVC syndrome, lymphadenopathy, hepatosplenomegaly, bleeding/bruising

Chronic myeloid leukemia

Genetic abnormalities created in Philadelphia chromosome of stem cell

Chronic myeloid leukemia clinical manifestations

Anorexia, night sweats, malaise, splenomegaly

Chronic lymphocytic leukemia frequency

Common type of adult leukemia

Chronic lymphocytic leukemia risk factors

Environmental factors, genetic predisposition

Chronic lymphocytic leukemia clinical manifestation

Early stages largely asymptomatic, late stages bone marrow infiltration, hepatomegaly

Hodgkin's lymphoma

Distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as Reed-Sternberg cells

Hodgkin's lymphoma frequency

25-30 y/o, >55 y/o

Platelet inhibiters effect and indication

Inhibit platelet aggregation, prevent arterial thrombus formation/occlusion

Platelet inhibitors examples

Asprin, ADP receptor inhibitors, glycoprotein platelet inhibitors, phosphodiesterase inhibitors

Fibrinolytics effect and indication

Facilitate clot dissolution, reopen occluded vessels

Fibrinolytics suffix

-ase

Signs/symptoms of skin disease

Pruritus, xerosis, urticaria, edema, changes in appearance

Primary skin lesions

Present at birth or acquired during a lifetime due to various factors

Primary lesions examples

Bulla, macule, patch, nodule, papule, plaque, pustule, vesicle, wheal

Bulla

Circular, free fluid filled, >1cm

Macule

Change in color of skin, circular, flat, <1cm

Patch

Larger macule, >1cm

Nodule

Circular, elevated, solid, >1cm

Papule

Superficial, solid, <1cm

Plaque

Superficial, elevated, flat topped, >1cm

Pustule

Circular, collection of leukocytes

Vesicle

Circular, free fluid filled, up to 1cm

Wheal

Firm, edematous plaque, infiltration of dermis, lasts a few hours

Secondary lesions

Changes in skin that result from primary lesions

Secondary lesions examples

Crust, excoriation, denuded-loss of epidermis, lichenification, scale, fissure

Crust

Variously colored masses of exudate on skin

Excoriation

Loss of epidermis, mechanical means

Denuded-loss of epidermis

Bodily fluid, friction

Lichenification

Thickening and hardening of skin, exaggerated skin lines, dermatitis

Scale

Dry buildup up dead skin cells

Fissure

Crack or split

Psoriasis

Chronic skin condition producing red lesions covered with silvery scales, caused by shortened life cycle of skin

Impetigo

Superficial skin infection caused by staphylococci or sterptococci

Impetigo clinical manifestation

Macules develop into vesicles develop into pustules, break and form crust

Cellulitis

Rapidly spreading acute inflammation with infection of skin and subcutaneous tissue

Malignant melanoma risk factors

Genetics, red hair, freckles, sunburns

Malignant melanoma common sites

Men: head and neck, women: legs

ABCDE method of skin cancer detection

Asymmetry, border, color, diameter, evolving

Kaposi's sarcoma

Malignancy of vascular tissue, common with AIDS

Skin infectious disease considerations for immunocompromised older adults

May show tachypnea, confusion, hypotension prior to fever

Integumentary infection disease signs/symptoms

Purulent drainage, skin rash, bleeding from gums/into joints

Cardiovascular infection disease signs/symptoms

Tachycardia, petechial lesions, hypotension

CNS infection disease signs/symptoms

Confusion, headache, photophobia, memory loss, myalgia

GI system infection disease signs/symptoms

Nausea, vomiting, diarrhea

Genitourninary infection disease signs/symptoms

Dysuria, hematuria, oliguria, urgency/frequency

Upper respiratory infection disease signs/symptoms

Cough, nasal drainage, oxygen desaturation, sputum production

Standard transmission precautions

Gloves/handwashing

Airborne transmission precautions

Private room, respiratory protection

Droplet transmission precautions

Private room, mask, social distancing (3 feet)

Contact transmission precaution

Private room, gown and glove, dedicated use of noncritical care items

Infectious mononucleosis (HPV4/mono)

Acute infectious disease caused by EBC, causes lymphoid proliferation

HPV4 frequency

Primarily affects young adults and children, 80% of acute infections have mono carried in throat

Bacteria

Single celled microorganism, mostly harmless

Virus

Viral DNA/RNA core, require host cell

Both infection and virus examples

Bronchitis, ear infection, sinus infection

Antibiotics common MOAs

Inhibit cell wall/membrane (Penicillin), inhibition of protein synthesis, inhibition of DNA/RNA

Common side effects of antibiotics

Allergic reactions, tendon damage, neuropathies, nephrotoxicity, UV sensitivity

Fluroquinolones suffix

-oxacins

Aminoglycosides suffix

-micin

PTs address what with infectious diases

Wound care, prevention, education, monitoring

Virus prevention

Vaccines

HIV most common treatment

ART, antiretroviral therapy

HIV treatment considerations

Treatment of opportunistic infections

Interferons MOAs

Signal healthy cells to make antiviral proteins, signal cancerous cells to die, activate immune cells

Interferons

Endogenous proteins produced by cell in response to a virus

Interferons as anti-viral

Peginterferon alfa 2-a

Interferons as anti-cancer

Alfa-2b

Interferons as immunomodulators/disease modifying drug (DMD)

Beta-1A, Beta-1B

Innate immunity

Non specific, first line of defense

Acquired immunity

Immunity that is present only after exposure and is highly specific.

Humoral acquired immunity

B-cells, antibodies protects against extracellular microbes

Cell mediated immunity

Type of immunity produced by T cells that attack infected or abnormal body cells

SLE clinical manifestations

Butterfly rash, arthritis, photosensitivity

CFS/IDS

Unexplained fatigue for >/=6 months, combination of factors