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NUR231 Pathophysiology Exam 4| Questions Solved 100% Correct
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NUR231 Pathophysiology Exam 4|Questions Solved 100% Correct
hemophilia A pathology - ✔-inherited disorder associated with coagulation factor
deficiencies -factor VIII deficiency, affects 1 in 5000 male live births -X linked recessive
disorder affecting males primarily
hemophilia A clinical presentation - ✔Since factor VIII promotes clotting and adhesion of
platelets to the vessel wall, bleeding in the soft tissues, GI tract, and joints can occur.
Spontaneous joint bleeding typically occurs when the child begins to walk, causing
inflammation, pain, and swelling. If left untreated, joint fibrosis and contractures can occur.
hemophilia A diagnosis - ✔Although primarily hereditary, in 30% of new diagnoses there is no
family history, suggesting an alternative mutation in the factor VIII gene has occurred.
Functionally, 90% of people with hemophilia produce insufficient quantities of factor VIII,
while 10% produce a defective form.
hemophilia A treatment - ✔-Trauma
prevention -Aspirin and NSAIDs should be
avoided.
-Factor VIII replacement therapy is the current treatment method for when bleeding occurs and
can also be used as a prophylactic measure when repeated bleeding episodes have occurred.
Disseminated intravascular coagulation (DIC) pathology - ✔often occurs as a complication of
other conditions. The most common causes are obstetric disorders (50% of cases), massive
trauma, shock, sepsis, and malignant disease. DIC begins with the activation of the extrinsic or
intrinsic coagulation cascade, the result of an unregulated generation of thrombin, resulting in
systemic formation of fibrin. All the major anticoagulant levels are decreased. Microthrombi are
formed causing vessel occlusion and tissue ischemia, which can result in multiple organ failure.
As all available coagulation proteins and platelets are being used to form clots, severe
hemorrhage ensues.
, DIC clinical presentation - ✔-characterized by both widespread coagulation and bleeding
DIC diagnosis - ✔Laboratory values show a prolonged bleeding time (PT, PTT), and
decreased platelet count.
DIC treatment - ✔-focused on managing the primary disease, replacing clotting components,
and preventing further activation of clotting mechanisms
-Transfusions of fresh-frozen plasma, platelets, or fibrinogen-containing cryoprecipitate may
correct the clotting factor deficiency
How can anemias be classified according to size and color? - ✔Anemias can be
normochromic (normal color) or hypochromic (decreased color). Red cells can also vary in
size: normocytic (normal size), microcytic (small cells), and macrocytic (large cells).
sickle cell disease pathology - ✔-inherited
-result of a single mutation in the hemoglobin molecule. Under conditions of decreased
oxygen levels, the cell becomes sickled as the abnormal hemoglobin (HbS) begins to
aggregate (stick together). With proper oxygenation, the cells may return to normal shape.
However, after repeated episodes of deoxygenation, the cells remain permanently sickled.
sickle cell disease clinical presentation - ✔-chronic hemolytic anemia, pain, and organ failure
caused by abnormal hemoglobin S (HbS). HbS gene is a recessive trait and can manifest as
either sickle cell trait (heterozygous) or sickle cell disease (homozygous).
-The leading cause of hospitalization with sickle cell disease is from acute chest syndrome.
This is due to atypical pneumonia resulting from pulmonary infarction. People may present
with dyspnea, cough, and chest discomfort.
-The two major concerns of red cell sickling are chronic hemolytic anemia and blood
vessel occlusion
-Vessel occlusion causes tissue ischemia and subsequent pain
-Ischemia often leads to functional asplenia (spleen that does not work well) making the person
susceptible to bacterial infections
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