Dr Any Johnston - basic notes
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| What is a normal PaO2 reading? | 80 - 100%
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| What is a normal PaCO2 reading? | 35 - 45%
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| What is a normal pH for blood? | 7.35-7.45
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| What is a normal sodium level for an adult? | 135 - 145mmol/L
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| What is a normal potassium level for an adult? | 3.5 - 5 mmol/L
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| What are some of the body's compensatory mechanisms for anaemia? | Increased pulmonary and cardiac function; Increased O2 extraction & selective tissue perfusion
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| What is relative anaemia? | A disruption of tissue O2 perfusion such as is caused in pregnancy with a diluting of RBC
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| What is absolute anaemia? | A disruption in haemoglobin
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| What are the signs and symptoms of anaemia? | Vasoconstriction, tachypnoea, pallor, dyspepsia (indigestion), tachycardia, transient murmurs, angina pectoralis, heart failure, muscle cramps, headache, lightheadedness, tinnitus
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| What is aplastic anaemia? | Decreased RBC due to bone marrow dysfunction
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| How does kidney dysfunction cause anaemia? | Decreased erythropoitin production
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| How does Vitamin B12 (cobalamin) cause anaemia? | Disruption of the DNA synthesis of RBC -> macrocytic cells
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| What is iron deficiency anaemia and what are some of the possible aetiologies? | RBC are hypochromic and microcytic. Causes include pregnancy, haemorrhage, chronic renal failure & haemodialysis
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| What is Thalassemia? | Increased cell lysis due to malformed RBC
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| What is sickle cell anaemia? | Abnormal beta-globulin chain (inherited disorder) leading to malformation of cells when deoxygenated
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| What is G6PD deficiency anaemia? | Lack of the G6PD enzyme which RBC need to function
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| What is haemolytic anaemia? | Any of the anaemias where RBC are destroyed, usually in the spleen and usually because of malformation
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| What is polycythaemia? | An excess of RBC's
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| What is polycythaemia vera? | Excessive activation of the red marrow stem cells causing increases in RBC, WBC & platelets
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| What is secondary polycythaemia? | Increased RBC due to low O2 perfusion or a renal tumour. The kidneys produce more erythropoietin.
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| What is relative polycythaemia? | No difference in the production of RBC, but the haematocrit is high because of fluid loss, eg dehydration, stress & smoking
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| What are petechiae? | Capillary haemorrhage into the skin or mucous membrane
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| What is purpura? | Groups / patches of petechiae - usually itchy
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| What is an ecchymosis? | A bruise (blood loss into tissue)
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| What is a haematoma? | A raised ecchymosis
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| What is haemarthrosis? | Bleeding into a joint
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| What is thrombocytopenia? | A lack of platelets, causing disruption of the clotting cascade
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| What is vonWillebrand's disease? | A lack of factor 7 in the clotting cascade
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| What is haemophilia? | Haemophilia A is a lack of Factor 8, and Haemophilia B (Christmas disease) is a lack of Factor 9
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| What can be a problem with a lack of Vitamin K? | Problems with the clotting cascade at Factors 2, 7, 9 & 10
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| What is a thrombus? | A stationary blood clot. In a vein there will be oadema and phlebitis. In an artery there will be iscaemia distal to the clot.
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| What is an embolus? | A freely moving material (clot, air, fat, gas) and lodging in a vessel. Pulmonary, cerebral, coronary most common.
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| What are varicose veins? | Vascular alteration in the superficial (usually leg) veins
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| What is chronic venous insufficiency? | Deep vein alteration causing blood pooling
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| What is an aneurysm? | Arterial dilation, changing the flow and weakening the wall. They include true, false and dissecting aneurysms.
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| What is an arteriovenous fistula? | Where an arteriole connects directly with a vein, shortcutting the capillary and reducing tissue perfusion.
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| What is CVD? | Cardiovascular disease = heart, stroke & vascular diseases often with underlying atheroschlerosis
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| What is the biggest cause of CVD? | Coronary Heart Disease (CHD) = inadequate blood supply -> inadequate O2 and nutrients to myocardium -> angina and tissue death (MI)
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| What is a transmural MI? | A myocardial infarct which occurs through the entire thickness of the (usually left)ventricle wall. Responsive to thrombolytic therapy.
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| What is a non-Q-wave MI? | It occurs in the subendocardial inner 1/3 to 1/2 of the ventricle wall. Better outcomes usually.
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| What happens 1 - 2 minutes after cell death in MI? | Depletion of ATP -> imparied ability to contract
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| What happens from 0 - 30 minutes after cell death in MI? | Hydropic swelling
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| What happens 40+ minutes after cell death in MI? | Irreversible cell damage
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| What happens from 4+ hours after cell death in MI? | Early coagulation and necrosis begins in subendocardial zone and spreading out before cardiac enzymes peak
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| What happens from 6+ weeks after cell death in MI? | Necrotic tissue is replaced with scar tissue
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| What is the usual ratio of necrosis to apoptosis in cells after an MI? | 20& necrotic:80% apoptotic
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| What is the 4 step treatment for management of blocked coronary arteries? | 1. Thrombolysis (eg streptokinase) 2. PTCA with anticoagulation or stent placement 3. Stent to prevent reocclusion 4. coronary artery bypass graft
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| What is a PTCA? | Percutaneous Transluminal Coronary Angioplasty
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| What is valve stenosis? | Incomplete valve opening, created different pressures in the heart chambers -> myocardial hypertrophy & calcification
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| What are two possible causes for incomplete mitral and aortic valve closure? | Rheumatic heart disease & endocarditis
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| What is rheumatic heart disease? | A complication of rheumatic fever following haemolytic streptococci infection
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| What is dilated cardiomyopathy? | Dilation of all 4 heart chambers. Caused by alcohol, genetic abnormality, pregnancy, postviral myocarditis. Transplant is the treatment.
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| What is hypertrophic cardiomyopathy? | Often seen in left ventricle, it is a non-uniform thickened muscle mass & septum -> negative inotropic action. Often has genetic component.
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| What is restrictive cardiomyopathy? | Stiff fibrotic ventricle -> reduced cardiac output -> left side congestive failure
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| What are the 2 basic classes of congenital heart disease? | Obstructive (stenosis or atresia of valves) & shunts (left -> right or right -> left)
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