Patho T 3

Two side by side. 2 upper atria (atrium) and 2 lower ventricle

Four chambers of the heart.

Tachy/cardia = becomes abnormally fast hr

Brady/cardia = Becomes abnormally slow hr

Tachycardia + Bradycardia

Plaque deposits, narrowing of lumen.

Atherosclerosis

hardening of the arteries

Arteriosclerosis

supplies myocardium, Arteries become narrowed by atherosclerosis deposits overtime, causing temporary cardiac ischemia and eventually MI.

Coronary Artery Disease

angina pectoris (chest pain), severe pain of MI, burning, squeezing, crushing and radiating in arms

Symptoms of Coronary Artery Disease (CAD)

Vasodilators and other types of medications, angioplasty (vessel repair).

Treatment of Coronary Artery Disease (CAD)

Chest pain due to ischemia during or shortly after exertion (activity). Results from reduced O2 supply to myocardium

Angina Pectoris

left sided chest pain, pain in left arm, dyspnea, increase in BP, arrhythmias

What are the symptoms for Angina Pectoris?

Results from insufficient O2 supply like atherosclerotic plaque, thrombus and myocardial muscle spasm.

Myocardial Infarction

Coronary thrombosis

Most common cause of MI

severe substernal or left sided chest pain, crushing, burning, vague discomfort, and irregular heartbeats

Symptoms of Myocardial infarction (MI)

O2 administrated, medication - morphine for pain, aspirin, vasodilation by nitroglycerin. Emergency surgery stent

Treatments of Myocardial Infarction (MI)

Sudden, unexpected cessation of cardiac activity, results from anoxia (absence of O2 in tissue) or interruption of electrical stimuli to the heart.

Cardiac Arrest - Causes

Electrocution, drowning, severe trauma, massive hemorrhage or drug overdose

Causative Factors for Cardiac Arrest:

Etiology **unknown** but many factors are thought to contribute to the condition, abnormally high BP in arterial system.

Essential hypertension.

Headaches, epistaxis (nosebleed), light headedness, syncope

Symp of Essential hypertension

life threatening condition, severe form of HTN.

Malignant hypertension.

Severe headache, blurred vision, dyspnea, extreme stress

Symp of Malignant Hypertension

Acute or chronic inability of the heart to pump enough throughout the body to meet the demands of homeostasis.

Congestive Heart Failure (CHF)

increasing dyspnea & respiration rate, anxiety, neck vein distend, Edema in ankles and feet (the heart is not pumping hard enough = extra fluid stays in ankles and feet).

Symp of congestive heart failure (CHF)

ACE inhibitors, diuretics, vasodilators.

Treatments of congestive heart failure (CHF)

Condition of fluid shift into the extravascular spaces of the lungs.

Pulmonary Edema

Dyspnea, coughing, orthopnea, increase pulse and respirations.

Symp of Pulmonary Edema

Non inflammatory disease of the cardiac muscle resulting in enlargement of the myocardium and ventricular dysfunction.

Cardiomyopathy

degeneration of myocardial fibers

Dilated Cardiomyopathy;

small left ventricle

Hypertrophic Cardiomyopathy;

thickening of myocardium

Restrictive Cardiomyopathy;

Acute or chronic inflammation of pericardium (serosa), the sac enclosing and protecting the heart

Pericarditis

Inflammation of the muscular walls of the heart

Myocarditis

Inflammation of the lining and the valves of the heart

Endocarditis

Systemic inflammatory and autoimmune disease involving the joints and cardiac tissue, generally preceded by sore throat, caused by group A B-hemolytic streptococcus.

Rheumatic Fever

Acquired or congenital disorder that can involve any of the four valves of the heart. Can occur in form of insufficiency or stenosis (narrowing/hardening). Mitral valve is most involved in valvular heart disease.

Valvular Heart Disease

Hardening of the cusps of the mitral valve that prevents a complete and normal opening for the passage of blood from left atrium to the left ventricle.

Mitral Stenosis

Occurs when one or more cusps of the mitral valve protrude back into the left atrium during ventricular contraction.

Mitral Valve Prolapse

Chest pain, dyspnea, dizziness, fatigue, syncope, severe anxiety

Symptoms Mitral Valve Prolapse (MVP)

Any deviation from normal heartbeat, that is the normal sinus rhythm

Arrhythmias

* disturbances in normal conduction system, pacemaker (SA node), atrioventricular node (AV), Bundle branches, and Purkinje fibers,
* Ischemia
* drugs

Arrhythmias may be caused by;

Collapse of the cardiovascular system, including vasodilation and fluid shift, accompanied by inefficient cardiac output. Life-threatening= immediate emergency

Shock

pale, cold, and clammy skin.

rapid, weak, and thready pulse.

Symp of shock

Clots of aggregated material (like blood).

Emboli

pulmonary venous obstruction, MI, CVA

Consequences of Emboli

Weakening and a resulting local dilation of the wall of an artery.

Aneurysm

buildup of atherosclerotic plaque that weakens the vessel walls

Common cause of Aneurysm

Abdominal/ back pain

Pulsating mass in the abdomen

Symp of Aortic Abdominal Aneurysm (AAA)

Result of inflammation of a vein with the formation of thrombus on the vessel wall

Thrombophlebitis

immediate intervention.

**Blood thinners:** prevent the clot from enlarging

**antibiotics**: prevent infection.

Treatment of Thrombophlebitis

Swollen, tortuous, knotted veins that usually occur in lower legs, develop slowly.

Varicose Veins

Rest periods throughout the day, engaging in exercise and submerging legs in warm water, support stockings and move legs frequent intervals.

Treatment for Varicose Veins

Vasospastic condition of the fingers, hands or feet causes pain, numbness and sometimes discoloration in these areas. Condition is made worse by smoking.

Raynaud Disease

Condition in which there is a reduction in the quantity of either RBCs or hemoglobin in a measured volume of blood, reducing the bloods ability to carry oxygen to the cells.

Anemia:

* Iron-deficiency anemia
* Folic acid deficiency anemia
* Aplastic anemia
* Sickle cell anemia

What are the 4 classifications of anemia:

insufficient iron intake due to hemorrhage or condition of slow bleeding such as bleeding hemorrhoids. 

Anemia: most common (iron deficiency anemia)

iron supplements - B12 (green leafy vegetables, salmon, liver)

Treatments for Anemia

chronic hereditary hemolytic form of anemia in the US, African Americans.

**Treatment**: no cure, for sickle cell.

sickle cell anemia + Treatment

blood dyscrasia (disorder) in which leukocyte levels become extreme low.

Agranulocytosis (Neutropenia)

drug toxicity and hypersensitivity can accompany aplastic or megaloblastic anemia, tuberculosis, uremia, or malaria

Causes for Agranulocytosis (Neutropenia)

Cancer of the lymphatic system in which the involved cells proliferate and interfere with normal functioning by collecting in masses in various parts of the body.

Hodgkin lymphoma

painless enlargement of the lymph nodes in the neck or mediastinum, fatigue, pruritus (itching), fever, and night sweats.

Symptoms of Hodgkin Lymphoma

An over production of immature lymphoid cells (lymphoblasts) in the bone marrow and lymph nodes.

Classified into two:

* B cell ALL
* T cell ALL

Acute Lymphocytic Leukemia

Bone pain, sore throat, fever, weakness, heapto/megaly, enlarged lymph nodes.

Symptoms for Acute Lymphocytic Leukemia

the blood or blood product transfused has antibodies to the recipients RBC's or recipient has antibodies to donors RBC's.

Transfusion Incompatibility Reaction

**Antihistamines:** used for mild reactions and anaphylaxis (Rapid allergy reactions)

Treatment for Transfusion Incompatibility Reaction

Hereditary bleeding disorder resulting from deficiency of clotting factors.

x linked genetic disorder in males.

transmitted by the mother to her son.

Classic Hemophilia

* Assists body in maintaining its functional integrity
* battles infection by bacteria, fungi and parasites
* protect the host from environment

Functional components of the immune system

when homeostasis is maintained and immune system reacts correctly

Immunocompetencies:

* **IgM**: attached to B cell; released into plasma during immune response
* **IgG:** blood plasma
* **IgA:** saliva, mucus, tears, breast milk
* **IgD:** Attached to B cells
* **IgE:** Produced by plasma cells in mucous membranes and tonsils

the five classes of Immunoglobulins:

* **IgM**: Causes antigens to clump together
* **IgG:** Neutralizes toxins: crosses the placenta to provide immunity for newborns
* **IgA:** Protects mucous membranes on body surfaces: immunity for newborns
* **IgD:** Receptor sites for antigens: Binding w/ antigen results in B-cell activation
* **IgE:** Binds to mast cells and basophils, causing release of histamine: Allergic reactions

Functions of the five classes of Immunoglobulins:

* Cytotoxic T-cells
* Helper T-cells
* Suppressor T-cells
* Memory T-cells

\

Some T cells seek out foreign invaders:

**- T cells (Cell-Mediated)**: are a major component of the type of acquired immunity, coated to seek out foreign invaders.

**- B cell (Humoral):** coated with immunoglobulins - which gives them the ability to recognize foreign proteins and stimulate an antigen-antibody reaction

T and B cells:

Antigen-antibody complex inactivates the pathogen and stimulates phagocytes. Activation of complement system involves proteins

Immunity

results when a person has had previous exposure

Active immunity

bypasses the body's immune response to afford the benefit of immediate antibody availability.

Passive immunity

* Increased susceptibility to bacterial infections resulting from a B cell deficiency.
* Increased susceptibility to viral, fungal and protozoan infections, usually from T cell deficiency. Some are genetic and present at birth

Immunodeficiency disease

progressive impairment of the immune system caused by the human immunodeficiency virus (HIV)

Acquired Immunodeficiency Syndrome (AIDS)

An acquired b cell deficiency that results in decreased antibody production and or function. History of chronic or reoccurent infections

Common Variable Immunodeficiency (CVID)

a condition near absent tonsils and adenoids lymphadenopathy and splenomegaly are missing.

Only affects males: X-linked

X-Linked Agammaglobulinemia

group of disorders characterized by persistent and recurrent candidal infections of the skin, nails, and mucous membranes

Chronic Mucocutaneous Candidiasis (CMC) 

Systemic therapy with antifungal agents

Treatment of Chronic Mucocutaneous Candidiasis (CMC) 

when autoantibodies develop and begin to destroy the body's own cells. Can occur when the immune system mistakenly misdirected against its own tissues.

Autoimmune diseases

an autoimmune condition of RBC destroyed by antibodies

\-fatigue, weakness, chills, fever, dyspnea and itching.

Autoimmune Hemolytic Anemia ( AHA)

Pernicious anemia is caused by chronic atrophic gastritis resulting in decreased gastric production of hydrochloric and a shortage of intrinsic factor.

Pernicious Anemia

Primary b12 injection

Treatment of Pernicious Anemia

An acquired disorder that results from an isolated deficiency of platelets considered idiopathic (unknown cause)

Petechiae- small spider like hemmorhages under the surface of the skin

Idiopathic Thrombocytopenic Purpura (ITP)

immune system attacks and destroys the collogen, resulting in damage to connective tissue. Genetic factors play a role.

Connective Tissue Diseases

No cure is known

Treatment for Connective tissue diseases

lupus

Systemic Lupus Erythematosus also know as..

chronic, inflammatory autoimmune disease characterized by unusual autoantibodies in the blood that target tissues of the body. Butterfly rash across the face

Systemic Lupus Erythematosus (SLE)

Acutely with fever, fatigue, joint pain, and malaise or may develop slowly over the years with intermittent fever, malaise, joint deformities and weight loss.

How does SLE begin?

Characterized by sclerosis and shrinking of the skin and certain organs, involved skin becomes taut, firm and edematous and is firmly attached to subcutaneous tissue

Scleroderma

Chronic, inflammatory, systemic disease that affects the joints = inflammation and edema of the synovial membranes surrounding a joint.

Rheumatoid Arthritis

Affects children (less than 16 years of age) begins between 2 to 5 years. With treatment it is generally good

Juvenile Rheumatoid Arthritis

Systemic, progressive, inflammatory disease affecting primarily spinal column

Ankylosis Spondylitis

Inflammatory disease of the central nervous system. Attacks the myelin sheath a fatty substance covering most nerves in the brain and spinal cord and causes scarring

Multiple Sclerosis

Chronic, progressive neuromuscular disease characterized by extreme muscular weakness and progressive fatigue. (ex: drooping eyelids, diplopia, difficulty with talking)

Myasthenia gravis

Inflammation in the walls of blood vessels, becomes necrotic when it obstructed by thrombus and infarct of adjacent tissue results

Vasculitis