Patho Ch 12
Dr. Trang was unable to confirm her diagnosis of a client with myocarditis with an ECG. What might she order to get a clearer picture of the abnormalities? Echocardiogram Stress ECG Holter monitor MRI
Holter monitor
85% of _________________ occur in B cells that help fight infection in the body.
Non-hodgkin's lymphoma
Lucille calls your medical clinic asking to speak with the nurse. You are an LPN who takes the call. Lucille is asking how long angina pain should last before she becomes alarmed. What will you tell her? "If you have had the pain 30 minutes or longer, let me call 911 for you." "Lucille, take one of your nitroglycerin tablets and let me know tomorrow how you are feeling." "Until you have the angina pain for about an hour, do not be too alarmed." "Rest for about 30 minutes to see if the pain decreases."
"If you have had the pain 30 minutes or longer, let me call 911 for you."
Describe the four types of anemias.
1. Iron deficiency is inadequate reserves of iron on the body and the formation of unusually small, hemoglobin-poor RBCs and is the most common blood condition in the US. 2. Folic acid deficiency is the appearance of abnormally large RBC (megaloblasts) that form when there isn't enough stores of folic acid in the body. 3. Pernicious is characterized by the appearance of abnormally large RBC that form when there isn't enough vitamin B12 in the body. 4. Aplastic is caused but insufficient or nonexistent RBC production. The bone marrow stops the production of RBC, WBC and platelets causing low/no immunity.
Describe congestive heart failure.
A condition in which the pumping ability of the heart is progressively impaired to the point that it no longer meets the bodies needs
How might you compare/contrast a heart attack with cardiac arrest to a friend who is confused about the difference? A heart attack signals blockage of blood flow to a part of the heart muscle; cardiac arrest is sudden loss of heartbeat, pulse, and respiration. In a heart attack, the heart stops beating; the heart continues to beat in cardiac arrest. Survival of a heart attack is less likely than for cardiac arrest. A heart attack causes loss of heartbeat, pulse, and respiration; cardiac arrest occurs when there is blockage of blood to part of the heart muscle.
A heart attack signals blockage of blood flow to a part of the heart muscle; cardiac arrest is sudden loss of heartbeat, pulse, and respiration.
What complementary therapies might be useful in treating any of the leukemias? Any therapies to reduce effects of chemotherapy Biological therapy using biological response modifiers Gene therapy Stem cell transplant
Any therapies to reduce effects of chemotherapy
What are the three common types of aneurysms in men over age 60? Abdominal, thoracic, and aortic Abdominal, aortic, and peripheral Abdominal, thoracic, and peripheral Thoracic, pulmonary, and peripheral
Abdominal, thoracic, and peripheral
What characterizes endocarditis? Serious pleuritic pain Severe left-sided heart failure Abnormal vegetations on the heart valves Blood flowing back into the left ventricle causing hypertrophy
Abnormal vegetations on the heart valves
What is the most common type of leukemia in young children?
Acute lymphocytic leukemia
What are the identifying characteristics of the four types of leukemia? Acute myeloid (myelogenous) Acute lymphocytic (lymphoblastic) Chronic myeloid (myelogenous) Chronic lymphocytic (lymphoblastic)
Acute myeloid (myelogenous) (AML) - hyperproliferation of abnormal, immature white cell precursors called blasts. Blasts accumulate in the bone marrow, blood and body tissues. Most common type of nonlymphocytic leukemia and occurs mostly in men over 50. Acute lymphocytic (lymphoblastic) - similar to AML except that there is abnormal growth of lymphocyte precursors called lymphoblasts. Children account for 80% of ALM. Chronic myeloid (myelogenous) - characterized by the proliferation of abnormal white cell precursors called granulocytes in the bone marrow. Granulocytes enter the blood and invade other body tissues. CML usually affects older adults. Chronic lymphocytic (lymphoblastic) - characterized by the accumulation of immature, ineffective B lymphocytes. CLL is the most common in the US and affecting those over 55
Who are the individuals most at risk for essential hypertension?
African Americans, chronically stressed, obese, diet high in salt and saturated fats
Describe what happens in a TEE?
Anesthetic spray is used to numb the throat and then an IV is started to sedate the patient. An ultrasound device is passed through the mouth into the esophagus and then a TEE transducer is placed at the end of a flexible tube that will transfer images from the transducer to the monitor .
What is it called when there is a local dilation of an artery due to weakening of its walls? Mitral valve insufficiency Aneurysm Arteriosclerosis Atherosclerosis
Aneurysm
What is the possible cause of low reticulocyte counts in blood tests? Aplastic anemia Pernicious anemia Acute myeloid leukemia Chronic myeloid leukemia
Aplastic anemia
Compare and contrast atherosclerosis and arteriosclerosis.
Arteriosclerosis is the widespread thickening of the walls of small arteries and arterioles that results in the loss of elasticity. Atherosclerosis is the accumulation of yellowish plaque of cholesterol, lipids, and debris on the inner layers of arteries Arteriosclerosis is a a type of atherosclerosis.
What is the name of the condition characterized by accumulation of yellowish plaques of cholesterol, lipids, and cellular debris in the inner layers of large and medium-sized arteries? Atherosclerosis Thrombophlebitis Coronary artery disease Myocardial infarction
Atherosclerosis
What condition may now be diagnosed with a facial scan? Congestive heart failure Angina pectoris Atrial fibrillation Thoracic aortic aneurysm
Atrial fibrillation
What causes mitral valve insufficiency? Blood backflows into the left atrium. Blood backflows into the right atrium. Blood backflows into the aorta. Blood backflows into the left ventricle.
Blood backflows into the left atrium.
What phrase best describes mitral insufficiency? Blood from the left ventricle flows back into the left atrium Blood cannot flow from the left atrium to the left ventricle Blood flows back into the left ventricle, causing hypertrophy Blood from the right ventricle flows back into the right atrium
Blood from the left ventricle flows back into the left atrium
heart suddenly ceases to pump
Cardiac arrest
In which of the following can the Philadelphia chromosome be detected on diagnosis? Acute myeloid leukemia Acute lymphoblastic leukemia Chronic myeloid leukemia Chronic lymphocytic leukemia
Chronic myeloid leukemia
When someone is having atrial fibrillation, what complementary therapy might they try to reverse the fibrillation? Coughing Taking an aspirin and resting Establishing a cardioversion Drinking a strong cup of coffee
Coughing
What is the "classic" symptom of myocardial infarction? Severe and periodic dyspnea Crushing chest pain radiating to the left arm, neck, and jaw. Diastolic pressure greater than 90 mm Hg Systolic pressure greater than 180 mm Hg
Crushing chest pain radiating to the left arm, neck, and jaw.
What is the classic symptom of myocardial infarction, especially in men? Hematemesis, dysphagia Crushing chest pain that may radiate to the left arm, neck, and jaw Tachypnea and heart palpitations Claudication, limb numbness
Crushing chest pain that may radiate to the left arm, neck, and jaw
In your study of this chapter, can you identify characteristics, largely preventable, that may make a person more susceptible to cardiovascular diseases? Genetics, environment, and industrial toxins High-fat diet, distress, obesity, no exercise, and smoking Hypertension, lack of exercise, and high-stress employment Environment, congenital heart anomalies, and hypertension
High-fat diet, distress, obesity, no exercise, and smoking
Reed-Sternberg cells are present in which of the following? Lymphoblastic leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Acute myeloid leukemia
Hodgkin lymphoma
You are quite aware of the symptoms of an MI for men, but what kind of symptoms might women have? Crushing chest pain that does not radiate to the left arm or neck The signal of angina that disappears in 5 to 7 minutes Discomfort, nausea, shortness of breath, indigestion, and fatigue Fear, anxiety, and pain in the right arm, neck, and jaw
Discomfort, nausea, shortness of breath, indigestion, and fatigue
In what type of cancer do you find Reed-Sternberg cells?
Hodgkins
What is the name of the neoplastic malignancy of the lymphatic system characterized by painless enlargement of the lymph nodes and spleen? Lymphosarcoma Hodgkin lymphoma Lymphedema Chronic leukemia
Hodgkins lymphoma
When there is inflammation with abnormal vegetations in the membrane lining the heart valves, what is the disease called? Pericarditis Myocarditis Endocarditis Mitral insufficiency
Endocarditis
Gerald has an artificial heart valve and needs to have dental work, including a root canal and a crown. Are there any precautions that Gerald should take to prevent endocarditis? Gerald should realize that these procedures can be painful and ask for pain medication. No precautions are necessary because his artificial heart valve has replaced his defective valve. For protection from any bacterial infection from the procedures, antibiotic therapy should begin prior to the procedure. Gerald should be attached to a heart monitor during the procedure to make certain there are no irregularities.
For protection from any bacterial infection from the procedures, antibiotic therapy should begin prior to the procedure.
Where are varicose veins most likely to occur? Large veins in the arms Greater and lesser saphenous veins Small veins in the upper thighs Small arterioles of the lower legs
Greater and lesser saphenous veins
Lucille is working in a lab examining blood cells in the microscope. She is seeing many unusually small, hemoglobin-poor RBCs that are lighter in color than usual. What might she be viewing? Megaloblasts due to inadequate stores of folic acid in the body Megaloblasts due to inadequate levels of vitamin B12 Starvation of RBCs because of bone marrow inadequacy Iron-deficiency anemia due to inadequate reserves of iron in the body
Iron-deficiency anemia due to inadequate reserves of iron in the body
What is the initial treatment of pernicious anemia? Injections of folic acid Bone marrow transplant Injections of vitamin B12 High doses of vitamin B
Injections of vitamin B12
What are automated external defibrillators (AEDs)? Instruments used to shock the heart back into a slower rhythm Used to resuscitate someone after 10 minutes of CPR Sophisticated instruments used by medical professionals to start the heartbeat Instruments programmed to give an electric shock only when necessary; can be used by anyone
Instruments programmed to give an electric shock only when necessary; can be used by anyone
What are the treatments for the following types of anemias? Iron deficiency Folic acid deficiency Pernicious Aplastic
Iron deficiency - depends on the severity, but may be treated orally or parental iron supplements and diet Folic acid deficiency - Folic acid may be taken orally or parenterally (depending on patients condition) Pernicious typically treated with a vitamin B12 in injection daily or weekly then gradually once a month Aplastic - Bone marrow or peripheral stem cell transplant is the treatment of choice, but immunosuppressive therapy or RBC transfusion
Lymphangitis and cellulitis may accompany _________________.
Lymphedema
What is an abnormal accumulation of lymph, usually in the extremities, called? Sickle cell anemia Hodgkin disease Chronic myelocytic leukemia Lymphedema
Lymphedema
What is the common medication taken sublingually or topically for angina pectoris? Nitroglycerin preparations Specific antibiotics Antidiuretics Antispasmodic medicatoin
Nitroglycerin preparations
Lymphosarcoma can also be called: Hodgkin lymphoma Non-Hodgkin lymphoma Acute lymphoblastic leukemia Chronic lymphocytic leukemia
Non-Hodgkin lymphoma
According to the medical community, what constitutes stage I essential hypertension? 120 systolic pressure and 80 diastolic pressure Over 140 systolic pressure and over 90 diastolic pressure Obesity, sedentary lifestyle, and being African American Over 160 systolic pressure and over 100 diastolic pressure
Over 140 systolic pressure and over 90 diastolic pressure
Nadine had rheumatic fever as a child. Now in her 60s, Nadine is showing signs of sharp pleuritic pain that increases when she takes deep breaths, and she says her heart is "racing." What condition might she be experiencing? Pericarditis Endocarditis Myocarditis Neuritis
Pericarditis
What is the major danger of both the abdominal and thoracic aortic aneurysms? The formation of a thrombus Endovascular stent-graft surgery is dangerous and difficult for clients Allowing the "wait and watch" approach for small aneurysms The possible rupture of the aneurysm, causing hemorrhage and shock
The possible rupture of the aneurysm, causing hemorrhage and shock
Keith has been diagnosed with AML; he is 74 and suffers from diabetes and hypertension. What might his prognosis be? Excellent with proper treatment Good, with remission lasting many years Fatal within 1 to 2 months after symptoms begin Poor; generally a survival of only 1 year after diagnosis
Poor; generally a survival of only 1 year after diagnosis
Which type of angina affects more women than men? unstable stable Prinzmetal's ventricular
Prinzmetal's
Describe the two stages of essential hypertension. Your Answer:
Stage 1 hypertension exists if systolic pressure (contraction) persists over 140mm Hg and diastolic pressure (relaxation) persists over 90mm Hg. Stage 2 is the most severe and is when systolic pressure of 160mm Hg or higher or a diastolic pressure of 100mm Hg or higher.
What is atrial fibrillation? It is a condition where the right atria and right ventricle beat irregularly. It is a condition where blood stagnates in the ventricles, then clots and causes a CVA. The two atria beat irregularly, rapidly, and out of rhythm with the ventricles. The two ventricles beat irregularly, rapidly, and out of rhythm with the atria.
The two atria beat irregularly, rapidly, and out of rhythm with the ventricles.
Describe atrial fibrillation.
The two atria in the heart beat irregularly, rapidly and out of rhythm with the lower ventricles. The heart rate can be as high as 175 bpm. During atrial fibrillation blood can stagnate in the atria and clot and cause a CVA.
Lymphosarcomas or non-Hodgkin lymphomas are seen in more persons per year than any of the blood and lymph cancers. What do you recall about these diseases? They are caused by decreased production of lymphocytes. They are characterized by five different types They likely occur in the body's T cells, which are important in fighting infection The usual cancer staging is unimportant in the lymphosrcomas.
They are characterized by five different types
What is the primary purpose of lymph nodes? They help to carry blood to and from the heart. They filter microorganisms and abnormal cells from the body They destroy old RBCs when no longer necessary. They produce T lymphocytes to help control cell-mediated immunity.
They filter microorganisms and abnormal cells from the body
What are the three types of bone marrow transplant and describe each one.
autologous - self donor allogeneic - donor and recipient have the same genetic type umbilical transplant - tested cells, typed and frozen until time for transplant
Essential hypertension may include what kind of vague signs and symptoms? Tinnitus and light-headedness Angina and weight loss Tachycardia and dyspnea Pallor and tachypnea
Tinnitus and light-headedness
Why is it important for clients to move around and exercise their legs as soon after surgery as possible?
To prevent the formation of a clot (thrombophlebitis) which can result a pulmonary embolism
Cardioversion may be used in: congestive heart failure atrial fibrillation unstable angina cardiac arrest
atrial fibrillation
You are a smoker, take oral contraceptives, and are 50 pounds overweight. Your employment keeps you at a desk all day. What can you do to prevent thrombophlebitis? Have your partner use a condom and stop smoking. Lose about 10 pounds, get regular exercise and wear support hose. Wear support hose, take several "walk" breaks during the day, try to lose weight and stop smoking Have your PCP prescribe clotting medications.
Wear support hose, take several "walk" breaks during the day, try to lose weight and stop smoking
Which of the following helps keep blood from leaking out of blood vessels? prothrombin fibrinogen albumin globulin
albumin
In which type of bone marrow transplant do the donor and the recipient have the same genetic type? autologous allogenic umbilical cord blood transplant synergenic
allogenic
What three commonly prescribed medications categories are used in myocarditis?
angiotensin-converting enzyme (ACE) in hibitors angiotensin II receptor blockers or inhibitors beta blockers
Which type of bone marrow transplant is done with the donor is the client? autologous allogenic umbilical cord blood transplant synergenic
autologous
slowed heartbeat
bradycardia
abnormal heart sound heard on auscultation
bruit
fluid in pericardium compresses the heart
cardiac tamponade
resets heart's rhythm to normal sinus
cardioversion
What is the leading cause of death in America?
coronary heart disease
relaxation of the heart
diastole
expansion of an organ or vessel
dilatation
Leukemia is classified according to: differentiation and grade. dominant abnormal cell type and severity. stage and severity. dominant cell type and grade.
dominant abnormal cell type and severity.
difficulty breathing
dyspnea
an escape of fluid
effusion
What heart problem is characterized by the formation of abnormal growths called vegetations on the heart valves in the endocardial lining or in the endothelium of a blood vessel.
endocarditis
inflammation of the heart valves and chambers
endocarditis
The cause of iron-deficiency anemia is: insufficient folic acid. inadequate levels of vitamin B12. unknown. excessive blood loss.
excessive blood loss
Growing evidence shows that women have what symptoms in a myocardial infarction?
fatigue, nausea and vomiting, shortness of breath
What are 5 risk factors for coronary artery disease?
heredity, obesity, stress, diabetes mellitus, smoking
What are 5 very common signs/symptoms of cardiovascular disease?
hypertension fatigue dyspnea chest pain edema
of unknown cause
idiopathic
Myocarditis is: inflammation of the membrane lining the valves and chambers of the heart inflammation of the sac-like membrane that surrounds and protects the heart muscle inflammation of the heart. inflammation of the cardiac muscle and conduction system.
inflammation of the cardiac muscle and conduction system.
Endocarditis is: inflammation of the membrane lining the valves and chambers of the heart inflammation of the sac-like membrane that surrounds and protects the heart muscle inflammation of the heart. inflammation of the cardiac muscle and conduction system.
inflammation of the membrane lining the valves and chambers of the heart
Pericarditis is: inflammation of the membrane lining the valves and chambers of the heart. inflammation of the sac-like membrane that surrounds and protects the heart muscle. inflammation of the heart. inflammation of the cardiac muscle and conduction system.
inflammation of the sac-like membrane that surrounds and protects the heart muscle.
capillaries in the villus of the small intestine
lacteal
inflammation of cardiac muscle
myocarditis
surgical puncture or tapping to promote drainage
pericardiocentesis
inflammation of the sac surrounding the heart
pericarditis
pinpoint hemorrhagic spots on the skin
petechiae
Differentiate between a sacculated, fusiform, and dissecting aneurysm.
sacculated - shaped like a sac fusiform - spindle shaped dissecting aneurysm. - layers of vessel wall are seperated
List the three forms of angina pectoris and label the form that is most serious.
stable angina unstable angina (most serious) variant or Prinzmetal's angina
When an aneurysm is small, which of the following is NOT a recommended treatment? stent-graft surgery wait-and-watch antihypertensives analgesics
stent-graft surgery
Mitral insufficiency or stenosis is usually secondary to untreated
streptococcal infection, MI or infective endocarditis
Bed rest, elevating the affected limb and applying heat is the treatment for: Varicose veins deep vein thrombosis aneurysms of the leg superficial thrombophlebitis
superficial thrombophlebitis
In serious cases of mitral insufficiency, what it the treatment of choice?
surgical replacement with artificial valve
Which of the following is NOT a type of bone marrow transplant? autologous allogenic ubilical cord blood transplant synergenic
synergenic
contraction of the heart
systole
abnormally rapid heart rate
tachycardia
ringing in the ears
tinnitus
What are the four valves of the heart?
tricuspid pulmonary mitral aortic
In over 50% of the cases, the cause of aplastic anemia is not known. True False
true
Which type of angina is the most serious? unstable stable prinzmetal's variant
unstable
drugs to relax and expand blood vessels
vasodilator
What are the 5 categories of Non-Hodgkin lymphoma?
well-differentiated poorly differentiated histiocytic mixed lymphatic undifferentiated or stem cell malignant lymphoma
