Download 1. Diseases and Conditions of the Circulatory System

HD_CS: Diseases and Conditions of the Circulatory System
2. Welcome
2.1 Welcome
1. Diseases and Conditions of the Circulatory System
1.1 Match the following
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1
Correct
Choice
Condition involving the arteries supplying the
Coronary Artery Disease
myocardium
Chest pain due to ischemia during or shortly
Angina Pectoris
after exertion
Death of myocardial tissue caused by the
Myocardial Infraction
development of ischemia
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1.2 Match the following
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3
Correct
Choice
Sudden, unexpected cessation of cardiac
Cardiac Arrest
activity
Most prevalent cardiovascular disorder in the
Hypertensive Heart Disease
United States which is the result of chronically
elevated pressure throughout the vascular
system
A condition of abnormally high blood pressure
Essential Hypertension
in the arterial system
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1.3 Match the following
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5
Correct
Choice
A life threatening condition which is a severe
Malignant Hypertension
form of hypertension
An acute or chronic inability of the heart to
Congestive Heart Failure
pump enough blood throughout the body to
meet the demands of homeostasis
Results in enlargement of the right ventricle as
Cor Pulmonale
a sequela to primary lung disease
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1.4 Match the following
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7
Correct
Choice
A condition of fluid shift into the extravascular
Pulmonary Edema
spaces of the lungs
A non-inflammatory disease of the cardiac
Cardiomyopathy
muscle resulting in enlargement of the
myocardium and ventricular dysfunction
An acute or chronic inflammation of the sac
Pericarditis
enclosing and protecting the heart
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1.5 Match the following
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9
Correct
Choice
Inflammation of the muscular walls of the
Myocarditis
heart
Inflammation of the lining and the valves of
Endocarditis
the heart
A systemic inflammatory and autoimmune
Rheumatic Fever
disease involving the joints and cardiac tissue
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1.6 Match the following
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11
Correct
Choice
Cardiac manifestations that follow rheumatic
Rheumatic Heart Disease
fever
An acquired or congenital disorder that can
Valvular Heart Disease
involve any of the four valves of the heart
Hardening of the cusps of the mitral valve
Mitral Stenosis
which prevents a complete and normal
opening for the passage of blood from the left
atrium to the left ventricle
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1.7 Match the following
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13
Correct
Choice
Mitral valve fails to close completely and
Mitral Insufficiency
allows blood from the left ventricle to flow
back into the left atrium
one or more of the cusps of the valve
Mitral Valve Prolapse
protrudes back into the left atrium during
ventricular contraction
Any deviation from the normal heartbeat
Arrhythmias
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1.8 Match the following
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15
Correct
Choice
Collapse of the cardiovascular system,
Shock
including vasodilation and fluid shift,
accompanied by inefficient cardiac output
Inadequate output of blood by the heart
Cardiogenic Shock
Compression of the heart muscle and
Cardiac Tamponade
restriction of heart movement caused by
blood or fluid trapped in the pericardial sac
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1.9 Match the following
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17
Correct
Choice
Clots of aggregated material (usually blood)
Emboli
A thickening and hardening of the arteries that
Atherosclerosis
occurs when plaque of cholesterol and lipids
form in the arterial tunica intima
Weakening and resulting local dilation of the
Aneurysms
wall of an artery
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1.10 Match the following
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19
Correct
Choice
Inflammation of a vein occuring most often in
Phlebitis
the lower legs
Inflammation of a vein with the formation of a
Thrombophlebitis
thrombus on the vessel wall
Swollen, tortuous, and knotted veins that
Varicose veins
usually occur in the lower legs
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1.11 Match the following
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21
Correct
Choice
Inflammation of the peripheral arteries and
Thromboangiitis Obliterans
veins of the extremities with clot formation.
A vasospastic condition of the fingers, hands,
Raynaud’s Disease
or feet causing pain and numbness
Reduction in the quantity of either RBSs or
Anemia
hemoglobin in a measured volume of blood,
reducing the blood’s ability to carry oxygen to
the cells
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1.12 Match the following
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23
Correct
Choice
A blood dyscrasias in which leukocyte levels
Agranulocytosis
become extremely low
Abnormal increase in the amount of
Polycythemia
hemoglobin, the RBC count, or the hematocrit,
causing an absolute increase in RBC mass
Malignant neoplasms of the blood forming
Leukemia
organs that produce an abnormal,
uncontrolled, clonal proliferation of one
specific type of blood cell in the lymphoid or
myeloid cell lines
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1.13 Match the following
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25
Correct
Choice
Characterized by an overproduction of
Acute lymphocytic leukemia
immature lymphoid cells in the bone marrow
and lymph nodes
Neoplasm that involves the lymphocytes
Chronic lymphocytic leukemia
A rapidly progressive neoplasm of cells
Acute myelogenous leukemia
committed to the myeloid line of development
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1.14 Match the following
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27
Correct
Choice
Slowly progressing neoplasm that arises in a
Chronic myelogenous leukemia
hematopoietic stem cell or early progenitor
cell, resulting in an excess of matureappearing but hypo functional neutrophils
Hereditary bleeding disorder resulting from
Classic Hemophilia
deficiency of clotting factors
A condition of simultaneous hemorrhage and
Disseminated Intravascular Coagulation
thrombosis
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1.15 Match the following
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29
Correct
Choice
Abnormal collection of lymph usually in the
Lymphedema
extremities
Inflammation of lymph vessels
Lymphangitis
Malignant neoplasms that arise from
Lymphoma Coagulation
uncontrolled proliferation of the cellular
components of the lymph system
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1.16 Match the following
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31
Correct
Choice
Cancer of the body’s lymphatic system, in
Hodgkin’s Disease
which the involved cells proliferate and
interfere with normal functioning by collecting
in masses in various parts of the body
A number of heterogeneous neoplasms of the
Non Hodgkin’s Lymphoma
lymphoid cells that exhibit a wide variety of
clinical signs and symptoms, ranging from
slow, indolent growth to rapidly fatal
progression
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1.17 Results
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33
Results for
1.1 Match the following
1.2 Match the following
1.3 Match the following
1.4 Match the following
1.5 Match the following
1.6 Match the following
1.7 Match the following
1.8 Match the following
1.9 Match the following
1.10 Match the following
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34
1.11 Match the following
1.12 Match the following
1.13 Match the following
1.14 Match the following
1.15 Match the following
1.16 Match the following
Result slide properties
Passing Score
80%
Success (Slide Layer)
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35
Failure (Slide Layer)
1.18 Learning Objectives
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36
1.19 Learning Objectives (cont’d.)
1.20 Learning Objectives (cont’d.)
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37
1.21 Learning Objectives (cont’d.)
1.22 Learning Objectives (cont’d.)
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38
1.23 Learning Objectives (cont’d.)
1.24 Start 4
Notes:
Circulation of blood to the organs and tissues of the body is the primary function of the
circulatory system. The heart is at the center of the circulatory system. Its steady
beating pumps about 5 quarts of blood through a complete vascular circuit of the body
every minute in an adult; this is called the cardiac cycle. This circuit comprises a network
of vessels: the arteries, veins, and capillaries.
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39
1.25 Orderly Function of the Circulatory System (cont’d.)
Notes:
The heart consists of two side-by-side pumps, each divided into two chambers: two
upper chambers called atria, and two lower chambers called ventricles. As venous
blood returns to the heart from the body, it enters the right atrium, passes through
the tricuspid valve, and with atrial contraction, enters the right ventricle. Heart valves
prevent the blood from flowing backward.
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40
1.26 Coronary Artery Disease
Notes:
Coronary artery disease is a condition involving the arteries that supply the myocardium
(heart muscle), in which the arteries become narrowed due to atherosclerotic deposits
over time, causing temporary cardiac ischemia and eventually heart attack.
 In advanced coronary artery disease the patient experiences angina pectoris and pain
of myocardial infarction is described as burning, squeezing, crushing, radiating to arm,
neck, or jaw. Nausea, vomiting, and weakness also can be experienced.
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41
1.27 Coronary Artery Disease (cont)
Notes:
The pathology of coronary artery disease includes deposits of fat-containing substances
called plaque in the lumen (or opening) of the coronary arteries which results in
atherosclerosis. Atherosclerosis is commonly called “hardening of the arteries.” This
picture shows a visual of the coronary arteries. People at higher risk for CAD are those
who have a genetic predisposition to the disease, those older than 40 years of age, men
slightly more than women. Other factors including a history of smoking, residence in an
urban society; the presence of hypertension, diabetes or obesity and people with high
cholesterol.
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42
1.28 Angina Pectoris
Notes:
Angina pectoris is chest pain due to ischemia during or shortly after exertion. It is the
result of reduced oxygen supply to the myocardium. Patients experiencing symptoms of
angina for the first time require immediate assessment as it could represent a lifethreatening condition. Angina pectoris is caused by narrowing of coronary arteries as
blood flow to the myocardium is compromised. Treatment consists of cessation of the
strenuous activity and the placing of nitroglycerin tablets under the skin.
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43
1.29 Coronary Artery Disease (cont’d.)
Notes:
Myocardial infarction is the death of myocardial tissue caused by the development of
ischemia. An MI results from insufficient oxygen supply, such as occurs when a
coronary artery is occluded by atherosclerotic plaque, thrombus, or myocardial muscle
spasm. The patient has sudden, severe, substernal or left-sided chest pain. In the
case of an MI, pain is not relieved by rest or nitroglycerin. Treatment with aspirin,
oxygen, and morphine should be given as soon as possible. About 65% of deaths
caused by MI occur in the first hour. The prognosis is determined by immediate
defibrillation and mortality depends on the extent of damage to the heart muscle and
the occurrence of complications.
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44
1.30 Hypertensive Heart Disease
Notes:
Hypertensive heart disease is the most prevalent cardiovascular disorder in the United
States. It is the result of chronically elevated pressure throughout the vascular system.
Atherosclerosis, arteriosclerosis, renal disease and any condition that creates increased
vascular pressure cause the heart to work harder as it pumps against the increased
resistance.
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45
1.31 Hypertensive Heart Disease
Notes:
There are two types of hypertensive heart disease, essential hypertension and
malignant hypertension. In essential hypertension, the patient has few if any symptoms
until permanent damage has occurred. The etiology or cause is unknown but many
factors are thought to contribute to the condition. Age, heredity, smoking, obesity,
sedentary lifestyle, poor dietary habits, and hyperactive personality to type A
personality are possible factors. Elevated blood pressure readings are the first
indication of hypertension.
Malignant hypertension is a life-threatening condition as it is a severe form of
hypertension. Symptoms include severe headache, blurred vision, and dyspnea. The
symptoms may have a sudden onset. The etiology is unknown so it is difficult to prevent.
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46
1.32 Congestive Heart Failure
Notes:
 Congestive heart failure (CHF) is an acute or chronic inability of the heart to pump
enough blood throughout the body to meet the demands of hemostasis. CHF usually
has an insidious onset with the patient experiencing gradually increasing dyspnea. As
the condition progresses, neck veins distend and edema is noted in the ankles. A
common cause of congestive heart failure is myocardial infarction. Some causes of
chronic CHF are hypertension, CAD, COPD, cardiac valve damage, arrhythmias, and
cardiomyopathy. Usually CHF responds well to medical interventions. People with
chronic CHF are vulnerable to major organ impairment and complications.
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47
1.33 Congestive Heart Failure (cont’d.)
Notes:
 What are the symptoms, causes, and treatments of left- and right-sided heart failure?
 Refer to Figure 10-21 (p. 443).
1.34 Congestive Heart Failure (cont’d.)
Notes:
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48
Cor pulmonale, also known as right-sided heart disease, results in enlargement of the
right ventricle as a sequel to primary lung disease. Cor pulmonale causes the patient to
experience dyspnea, distended neck veins, and edema of the extremities. The liver is
enlarged and tender. Right-sided heart failure is an outcome of acute or chronic
pulmonary disease and pulmonary hypertension. The diseased pulmonary blood vessels
impair the flow of blood to pulmonary tissue.
1.35 Pulmonary Edema
Notes:
Pulmonary edema is a condition of fluid shift into the extravascular spaces of the lungs.
Pulmonary edema causes patients to experience dyspnea and coughing, orthopnea,
increased cardiac and respiratory rates, and often bloody frothy sputum. Blood
pressure may fall and the skin becomes cold and clammy. Symptoms often occur at
night after the patient lies down. Causes include left-sided heart failure, mitral valve
disease, pulmonary embolus, systemic hypertension, arrhythmias, and renal failure;
Head trauma, drug overdose and exposure to high altitudes are other causes.
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49
1.36 Cardiomyopathy
Notes:
Cardiomyopathy is a noninflammatory disease of the cardiac muscle resulting in
enlargement of myocardium and ventricular dysfunction. Cardiomyopathies are divided
into three groups: dilated which is a degeneration of myocardial fibers and can be the
result of chronic alcoholism, an autoimmune process, or viral infections. Hypertrophic
cardiomyopathies are thought to be genetic and are considered idiopathic. - the left
ventricle wall hypertrophies as does the ventricular septum, resulting in a small and
elongated ventricular septum. Restrictive cardiomyopathies occur when any infiltrative
process of the heart causes fibrosis and thickening of the myocardium.
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50
1.37 Inflammatory Heart Diseases
Notes:
Here are three different inflammatory heart diseases, pericarditis, myocarditis, and
endocarditis.
1.38 Pericarditis
Notes:
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Pericarditis is an acute or chronic inflammation of the pericardium, the sac enclosing
and protecting the heart. The space between the outer pa ri e tal layer of the
pericardium and the inner visceral layer of the heart wall normally is filled with a small
amount of thin, lubricating serous fluid. When blood or inflammatory exudate is
released into the pericardial sac or pericardial space, friction and irritation between the
layers result in pericarditis. Associated manifestations include….. Pericarditis can
occur…
1.39 Myocarditis
Notes:
Inflammation of the muscular walls of the heart. Myocarditis is frequently a viral,
bacterial, fungal or protozoal infection or a complication of other diseases such as
influenza, diphtheria, mumps, and most significantly, rheumatic fever; it is occasionally
idiopathic. It may also be associated with an MI; or exposure to certain toxic agents such
as lithium use, cocaine, alcoholism, radiation, or chemical poisoning. Prognosis…
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1.40 Endocarditis
Notes:
Endocarditis is inflammation of the lining and the valves of the heart. Endocarditis is
usually secondary to infections elsewhere in the body, the result of preexisting heart
disease, or the consequence of an abnormal immunologic reaction. The patient may
have vague or pronounced symptoms which could include fever, chills, night sweats,
weakness, anorexia and fatigue. The condition is characterized by vegetative growths on
the cardiac valves that may be released into the bloodstream in the form of emboli.
These emboli can lodge in vessels and cause symptoms of ischemia in the heart, lungs,
kidneys, brain, or extremities. Early diagnosis and treatment with antibiotics usually
bring complete recovery. Untreated cases can have a poor prognosis.
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53
1.41 Rheumatic Fever
Notes:
Rheumatic fever is a systemic inflammatory and autoimmune disease involving the
joints and cardiac tissue. It is generally preceded by sore throat caused by group A betahemolytic streptococcus. The patient is usually a child who experiences a fever and
polyarthritis, including joint pain, edema, redness, and limited range of motion. Joints
involved include finger, knee, and ankle joints with inflammation transient among these
joints. In addition, the patient experiences carditis, cardiac murmurs, cardiomegaly, and
even congestive heart failure. The cardiac manifestations that follow rheumatic fever
usually affects mitral and aortic valves
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1.42 Valvular Heart Disease
Notes:
Valvular heart disease is an acquired … This condition can occur in the form of either
insufficiency or stenosis. Valve insufficiency is the failure of the valves to close
completely, allowing blood to be forced back into the previous chamber as the heart
contracts. Stenosis, a hardening of the cusps of the valves that prevents the complete
opening of the valves, impedes the blood flow into the next chamber. The mitral valve
is involved most often.
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55
1.43 Mitral Valve Disease
Notes:
As mentioned in the previous slide, the mitral valve is most often involve in valvular
heart disease. Mitral stenosis: hardening of the cusps of the mitral valve that prevents a
complete and normal opening for the passage of blood from the left atrium into the left
ventricle. The mitral or bicuspid valve, lies between the left atrium and the left ventricle.
Mitral stenosis causes patients to have exertional dyspnea and fatigue as well as they
may have a cough and palpitations followed by hemoptysis. In severe cases, patients
may become cyanotic.
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1.44 Mitral Insufficiency
Notes:
In Mitral valve insufficiency, the mitral valve fails to close completely and allows blood
from the left ventricle to flow back into the left atrium. The patient with mitral
insufficiency experiences dyspnea and fatigue. A heart murmur can be heard as the
blood leaks back into the left atrium as a result of the valve's faiolure to close
completely. The valve may fail to close because of scar tissue, resulting from
inflammation and vegetations due to rheumatic fever, mitral valve prolapse, coronary
artery disease or MI, cardiac dilation.
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1.45 Diseases and Conditions of the Circulatory System
Notes:
Mitral valve prolapse is a most often a benign condition which occurs when one or more
of the valve cusps do not close completely. Patients are usually asymptomatic. Mitral
valve prolapse is usually discovered during a routine physician examination where a
click-murmur syndrome is heard on auscultation of the heart. The few patients that
experience symptoms report chest pain, dyspnea, dizziness, fatigue, syncope and usually
have severe anxiety.
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58
1.46 Cardiac Arrhythmias
Notes:
Cardiac arrhythmias are any deviation from the normal heartbeat; that is, the normal
sinus rhythm. They are often called irregular heartbeats. Arrhythmias result when
there is interference with the conduction system of the heart, resulting in an
abnormality of the heartbeat. It could be from the pacemaker or sinoatrial node,
atrioventricular node, bundle branches and Purkinje fibers. Ischemia and drugs cause
many arrhythmias. Symptoms include palpitations, rapid heartbeat (tachycardia),
skipped heartbeats, slow heart rate (bradycardia), syncope, and fatigue.
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59
1.47 Shock
Notes:
Shock is the collapse of the cardiovascular system, including vasodilation and fluid shift,
accompanied by inefficient cardiac output. In Cardiogenic shock there is inadequate
output of blood by the heart when the myocardium fails to pump effectively. Shock
causes inadequate perfusion of organs and tissues.
1.48 Causes of Shock
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Notes:
Causes of shock include… The final effect of shock is that the vital organs -- heart, brain,
lungs, kidneys -- do not receive sufficient oxygen and nutrients to sustain life.
1.49 The Vascular System
Notes:
The vascular system, a closed transport system composed of arteries, arterioles,
capillaries, venules, and veins, is responsible for supplying tissues with blood containing
oxygen and nutrients.
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1.50 Functions of Vascular System
Notes:
Besides being a transport system responsible for supplying blood tissues with blood
containing oxygen and nutrients, it also conveys waste products and carbon dioxide to
the appropriate organs for excretion. Arteries carry blood away from the heart, veins
transport blood back to the heart, and capillaries are the point of exchange at the
cellular level.
1.51 Vascular Conditions
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62
Notes:
Emboli are clots of aggregated material (usually blood) that can lodge in a blood vessel
and inhibit the blood flow. Signs and symptoms of emboli depend on the location of the
occluded vessel and the magnitude of the area of tissue served by the vessel. The initial
symptom is severe pain in the area of the embolus. Emboli in arteries of extremities
cause the area to become pale, numb, cold to touch, as well as arterial pulses are absent
below the occlusion. The patient also experiences nausea, vomiting, fainting, and
eventually shock. Emboli are usually blood clots, but the offending embolus also may be
composed of air bubbles, fat globules, bacterial clumps, pieces of tissue, including
placenta.
1.52 Diseases and Conditions of the Circulatory System
Notes:
 . The most common offender of an embolus is a venous thrombosis, a blood clot that
has formed in the deep veins of the legs as a result of venous stasis. A portion of the
thrombus breaks loose from the clot and travels through the venous system until it
becomes lodged in a vessel that is too narrow to allow passage, often in the lungs.
Prognosis varies and depends on the location of the emboli
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1.53 Vascular Conditions (cont’d.)
Notes:
Arteriosclerosis is a condition that occurs when the walls of the arterioles thicken, with
loss of elasticity and contractility. Atherosclerosis is a thickening and hardening of the
arteries that occurs when plaques of cholesterol and lipids form in the arterial tunica
intima. Atherosclerosis is responsible for most myocardial and cerebral infarctions. The
patient is often asymptomatic. The first symptoms may be angina pectoris, dizziness,
elevated blood pressure, and shortness of breath.
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1.54 Risk Factors of Atherosclerosis
1.55 Diseases and Conditions of the Circulatory System
Notes:
 An aneurysm is a weakening and resulting local dilation of the wall of an artery.
Symptoms can be insidious or sudden, acute onset; symptoms depend on the location
and size of aneurysm and extent of dilation. Abdominal aortic aneurysm is the most
common form and is typically discovered on routine physical examination. A
complication of any aneurysm is leakage from the wall of the artery or sudden rupture
of the weak area. A common cause of aneurysms is a buildup of atherosclerotic
plaque that weakens the vessel wall. Most diagnosed aortic aneurysms should be
treated with surgical repair before they rupture.
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1.56 Vascular Conditions (cont’d.)
Notes:
Here are three vascular conditions that most often occur in the lower legs. Phlebitis is
an inflammation of a vein, occurs most often in the lower legs, but any vein may be
affected. Thrombophlebitis is the result of inflammation of a vein with the formation of
a thrombus on the vessel wall. Varicose veins are swollen, tortuous, and knotted veins.
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66
1.57 Thromboangiitis Obliterans
Notes:
Thromboangiitis Obliterans, also called Buerger's disease, is an inflammation of the
peripheral arteries and veins of the extremities with clot formation. The patient
experiences intense pain in the affected area, usually the legs or instep of the foot,
which is aggravated by exercise and circulation is not restored to the affected area,
atrophy, ulcers and gangrene can develop.
The primary cause of Buerger's disease is long-term smoking of tobacco. The ischemic
tissue dies, and gangrene follows. This condition affects mostly males and those of
Jewish descent.
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1.58 Vascular Conditions (cont’d.)
Notes:
Raynaud's disease is a vasospastic condition of the fingers, hands, or feet. It causes pain,
numbness, and sometimes discoloration in these areas. This bilateral condition is
precipitated by cold and causes a white discoloration, followed by blue as venous blood
remains, and finally red or purple when circulation is restored. The attacks are
occasionally triggered by stressful events. Raynaud's disease is much more common in
women than men. When the disorder is primary it is called Raynaud's disease; when it
is secondary to another disease, it is called Raynaud's phenomenon.
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1.59 Elements and Functions of Blood
Notes:
Blood is composed of formed elements, red blood cells (erythrocytes), white blood cells
(leukocytes), platelets (thrombocytes), and a liquid portion (plasma). It is responsible
for transporting vital elements, including oxygen, nutrients, and hormones to the body
cells. It also plays a part in the removal of waste products, in the inflammatory response
and in the function of the immune system to help maintain homeostasis.
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1.60 Blood Dyscrasias
Notes:
Blood is synthesized by the hematopoietic system in the bone marrow (myeloid) and
lymphoid tissue found in the lymph nodes, spleen, thymus, bone marrow, and
gastrointestinal tract. The reticuloendothelial system is Deviations or malfunctioning in
this system results in various blood dyscrasias, either by impairment in the formation of
the blood components or by unusual destruction of the cells.
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1.61 Blood Dyscrasias (cont’d.)
Notes:
Anemia is defined as a condition in which there is a reduction in the quantity of either
red blood cells or hemoglobin, reducing the blood's ability to carry oxygen to the cells.
Depending on the severity of the anemia, one or many symptoms may occur, including a
pallor or a pale appearance, fatigue, dizziness, shortness of breath, and irregular
heartbeats.
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1.62 Diseases and Conditions of the Circulatory System
Notes:
 Anemias are classified by the color of the red blood cells as hypochromic,
normochromic, or hyperchromic and by size as microcytic, normocytic, or macrocytic.
They are also classified by the causative factor.
1.63 Blood Dyscrasias (cont’d.)
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Notes:
There are many different types of anemias. Iron deficiency anemia …
1.64 Blood Dyscrasias (cont’d.)
Notes:
 Agranulocytosis, also called neutropenia, is a blood dyscrasia in which leukocyte levels
become extremely low, drastically reducing the body's response to bacterial infection.
This condition can have a rapid onset. The patient experiences severe fatigue and
weakness, followed by a sore throat, ulcerations on the oral mucosa, dysphagia,
elevated body temperature, weak and rapid pulse, and chills. The most common
causes are drug toxicity and hypersensitivity.
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1.65 Blood Dyscrasias (cont’d.)
Notes:
Polycythemia is an abnormal increase in the amount of hemoglobin, the red blood cells
count, or the hematocrit causing an absolute increase in the red blood cell mass.
Symptoms include headaches, dyspnea, irritability, mental sluggishness, dizziness,
syncope, night sweats, and weight loss. For many patients, lifelong phlebotomies to
reduce the red blood cell count and hematocrit are a required protocol.
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1.66 Leukemias
Notes:
Leukemias are malignant neoplasms of the blood-forming organs (Bone marrow, spleen,
and lymph nodes) that produce an abnormal uncontrolled clonal proliferation, by that I
mean growth and expansion of one specific type of blood cell in the lymphoid or
myeloid cell lines. Leukemias are classified by the cell type and the degree of
differentiation of the neoplastic cells.
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1.67 Leukemias (cont’d.)
Notes:
Acute lymphocytic leukemia, abbreviated ALL, is an overproduction of immature
lymphoid cells (lymphoblasts) in the bone marrow and lymph nodes. The patient may
report bone pain, weight loss, sore throat, fatigue, night sweats and weakness. Bleeding
of the gingiva may be noted. There is a tendency toward increased bruising and
recurrent infections. As the leukemic cells infiltrate the spleen, liver, lymph nodes, and
nervous system, they interfere with the normal functioning of these organs. Acute
lymphocytic leukemia affects children and those older than 65. It accounts for 20% of
adult leukemias and is the most common childhood leukemia. The 5 year survival rate is
78% to 85%.
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1.68 Leukemias (cont’d.)
Notes:
Chronic lymphocytic leukemia, abbreviated CLL, is a neoplasm that involves the B
lymphocytes. It is a slow progressing disease that results in the accumulation of matureappearing, but hypofunctional, lymphocytes. Patients often have no symptoms initially,
nearly 95% of cases are discovered incidentally during routine blood work. The survival
times from diagnosis range from 2 to 20 years and the survival rate is 73%.
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1.69 Leukemias (cont’d.)
Notes:
Acute myelogenous leukemia, also known as acute myeloid, myelocytic, or granulocytic
leukemia, is a rapidly progressive neoplasm of cells committed to the myeloid line of
development. There is a rapid accumulation of myeloblasts in the bone marrow,
peripheral blood, and other tissues. AML is the most common adult leukemia and
accounts for about 20% of childhood leukemia as well. The overall 5 year survival rate is
highly dependent on prognostic indicators and ranges from 15% to 70%.
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1.70 Leukemias (cont’d.)
Notes:
 Chronic Myelogenous Leukemia (CML): also known as chronic myeloid or myelocytic
leukemia is a slowly progressing neoplasm resulting in an excess of mature-appearing
but hypofunctional neutrophils. Up to 50% of patients are asymptomatic at diagnosis.
It accounts for 15-20% of cases in adults, most often in adults over the age 40. The
overall 5-year survival rate is 35% with bone marrow transplant as the only chance for
a complete cure.
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1.71 Lymphatic System
Notes:
The lymphatic system is composed of lymphatic vessels, lymphatic tissue (lymph nodes,
tonsils, thymus, and spleen), and lymph. The lymphatic vessels originate at the capillary
level and along the venous system, progress to empty into the right and left subclavian
veins.
1.72 Lymphatic System (cont’d.)
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Notes:
The lymph nodes, collections of lymphatic tissue, filter foreign material such as bacteria
and viruses from the lymphatic circulation. Lymphocytes are produced mainly in the
lymph nodes as part of the body's defense mechanism.
1.73 Lymphatic Diseases
1.74 Lymphatic Diseases (cont’d.)
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Notes:
Lymphomas are malignant neoplasms that arise from uncontrolled proliferation of the
cellular components of the lymph system. The dysfunctional cells may be B cells, T cells,
or rarely both. Lymphomas are divided into two main categories, Hodgkin's disease and
the other types that are grouped as non-Hodgkin's lymphoma.
1.75 Lymphomas
Notes:
Hodgkin's disease is a cancer of the body's lymphatic tumors arise in the tissue of the
lymph nodes and spread to other lymph nodes, the spleen, the liver, and the bone
marrow. The initial symptoms of Hodgkin's disease are painless enlargement of the
lymph nodes in the neck or mediastinum, fatigue, alcohol-induced pain, and pruritis.
Hodgkin's disease represents 15% of all lymphomas. There are two peaks of incidence,
one in patients in their 20s and the other in those over the age of 50.
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1.76 Non-Hodgkin Lymphoma (NHL)
Notes:
Non-Hodgkin's lymphoma describes a number of heterogeneous neoplasms of the
lymphoid cells that exhibit a wide variety of clinical signs and symptoms, ranging from
slow growth to rapidly fatal progression. There are three classifications. The indolent,
or slow growing lymphomas represent 35-40% of all non-Hodgkin's lymphomas. The
most common are follicular lymphomas, grades I and II. Grade III behaves as aggressive
and 50% of all non-Hodgkin's lymphoma and includes large B-cell lymphoma and
peripheral T-cell lymphoma. Highly aggressive lymphomas are rarer, representing 5% of
all non-Hodgkin lymphomss. These include Burkitt's lymphoma and adult T-cell
lymphoma.
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1.77 Transfusion Incompatibility Reaction
Notes:
A Transfusion incompatibility reaction results when the blood or blood product
transfused has antibodies to the recipient's red blood cells or the recipient has
antibodies to the donor's red blood cells. The characteristics of the most severe
transfusion reactions are hemolysis and agglutination. Prevention with careful typing
and cross-matching is the best form of treatment.
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1.78 Clotting Disorders
Notes:
Next, we will look at clotting disorders. Classic hemophilia is a hereditary bleeding
disorder resulting from deficiency of clotting factors. The condition can be mild,
moderate, or severe. First sign may be ecchymosis at birth or bleeding from a
circumcision. Ecchymosis - skin discoloration caused by the escape of blood into the
tissues from ruptured blood vessels Hemophilia is An X-linked genetic disorder in males, and is transmitted by the
asymptomatic carrier mother to her son. It cannot be cured but treatment prevents
crippling deformities.
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1.79 Clotting disorders
Notes:
Disseminated intravascular coagulation is a condition of simultaneous hemorrhage and
thrombosis. It is a syndrome that occurs secondary to other diseases. Oozing of blood
from needle puncture sites, mucous membranes, or incisions may be noted, as may
bleeding in the form of purpura, wound hematomas, or petechiae. Hematemesis,
hematuria, and bloody stools may be present. Disseminated intravascular coagulation
follows a major event, such as obstetric complications, septicemia, trauma, burns,
hypothermia, and extensive tissue destruction.
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86
1.80 Lesson Summary
Notes:
Patients with coronary artery disease often present with a burning, squeezing, crushing
pain in the chest that radiates to the arm, neck or jaw. The pathology of this disease
includes deposits of fat-containing plaque in the opening of the arteries which results in
atherosclerosis. Contributing factors for coronary artery disease include genetic
predisposition, age older than 40, smoking, residence in urban society, hypertension,
diabetes, obesity, and high cholesterol. Patients with angina pectoris and myocardial
infarction have similar symptoms of chest pain but the chest pain is relieved in angina
pectoris when the strenuous activity the patient is doing is stopped. This is not the case
with an MI. Treatment of a myocardial infarction should occur as soon as possible with
aspirin, oxygen, and morphine for the pain.
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87
1.81 Lesson Summary
Notes:
 Hypertensive heart disease is the most prevalent cardiovascular disorder in the United
States. This is due to any condition that creates increased vascular pressure which
causes the heart to work harder as it pumps against the increased resistance. In leftsided congestive heart failure the left ventricle does not empty and blood backs up in
pulmonary circulation and pulmonary congestion occurs. In right-sided congestive
heart failure the right ventricle cannot empty and blood backs up in systemic
circulation and edema in the legs and digestive system occurs. We learned that
cardiomyopathy is a noninflammatory disease of the cardiac muscle caused by chronic
alcoholism, an autoimmune process, viral infections, or can be genetic. Pericarditis is
inflammation of the pericardium, the sac enclosing and protecting the heart,
myocarditis is inflammation of the muscular walls of the heart, and endocarditis is
inflammation of the lining and valves of the heart.
`
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88
1.82 Lesson Summary
Notes:
Rheumatic fever is a systemic inflammatory and autoimmune disease involving the
joints and cardiac tissue. The cardiac manifestations that follow rheumatic fever usually
affects mitral and aortic valves. Valvular heart disease can involve any of the four valves
of the heart and occurs in the form of either insufficiency or stenosis. The mitral valve is
involved most often. Cardiac arrhythmias are irregular heartbeats. This includes any
deviation from the normal heartbeat and is caused by ischemia or drugs. Shock is the
collapse of the cardiovascular system including vasodilation and fluid shift accompanied
by inefficient cardiac output. The patient has pale, cold and clammy skin as well as rapid,
weak, and a thready pulse and an altered level of consciousness.
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89
1.83 Lesson Summary
Notes:
Emboli are clots of aggregated material, usually blood, that can lodge in a blood vessel
and inhibit the blood flow. They cause severe pain. Arteriosclerosis is a group of
diseases characteristic by hardening of the arteries. One of its forms is atherosclerosis
which is a thickening and hardening of the arteries that occurs when plaques of
cholesterol and lipids form in the arterial tunica intima. An aneurysm is a weakening
and resulting local dilation of the wall of an artery. Aneurysms are often discovered
when they rupture with cat a strophic consequences. They can, however, be found by xray studies such as CT or MRI.
Thrombophlebitis is the result of an inflammation of a vein with the formation of a
thrombus on the vessel wall and varicose veins are swollen, tortuous, and knotted veins
occurring usually in the lower legs. Buerger's disease is an inflammation of the
peripheral arteries and veins of extremities with clot formation caused by smoking.
Raynaud's disease is a vasospastic condition of the fingers, hands, or feet causing pain,
numbness and sometimes discoloration.
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90
1.84 Lesson Summary
Notes:
Anemia is a condition in which there is a reduction in the quantity of either red blood
cells or hemoglobin, reducing the bloods ability to carry oxygen to the cells. Anemias
are classified by the color of the red blood cells as hypochromic, normochromic, or
hyperchromic and by size as microcytic normocytic, or macrocytic. They are also
classified by the causative factor. Some examples include iron-deficiency anemia, folic
acid deficiency, aplastic anemia and sickle cell anemia.
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91
1.85 Lesson Summary
Notes:
Agranulocytosis is a blood dyscrasia in which leukocyte levels become extremely low
drastically reducing the body's response to bacterial infection. The most common
causes are drug toxicity and hypersensitivity. Several different leukemias were
discussed in this module including acute lymphcytic leukemia, chronic lymphocytic
leukemia, acute myelogenous leukemia and chronic myelogenous leukemia. Some of
the common symptoms in the different types of leukemias include bone pain, weight
loss, sore throat, fatigue, night sweats, weakness, bleeding of gingiva, bruising,
recurrent infections.
We also went over lymphatic diseases - lymphedema is an abnormal collection of lymph,
usually in the extremities as well as lymphangitis which is an inflammation of the lymph
vessels. The signs and symptoms of transfusion incompatibility reaction results when
the blood or blood product transfused has antibodies to the recipient's red blood cells
or the recipient has antibodies to the donors red blood cells. Lastly, in this module we
covered clotting disorders of classic hemophilia which is a hereditary bleeding disorder
and disseminated intravascular coagulation which is another clotting disorder which
occurs secondary to other diseases.
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92
1.86 Congratulations
1.87 SELF 4
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
congestive heart failure
cerebral artery disease
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93
ischemia
X
coronary artery disease
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94
Incorrect (Slide Layer)
1.88 The condition in which the patient experiences chest pain with
exertion is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
X
angina pectoris
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95
coronary artery disease
myocardial infarction
congestive heart failure
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96
Incorrect (Slide Layer)
1.89 The most prevalent cardiovascular disorder in the United States is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
angina pectoris
X
coronary artery disease
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97
myocardial infarction
congestive heart failure
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98
Incorrect (Slide Layer)
1.90 The patient who complains of sudden onset of severe headache,
blurred vision, and dyspnea may be suffering from
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
congestive heart failure
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99
myocardial infarction
X
malignant hypertension
angina pectoris
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100
Incorrect (Slide Layer)
1.91 The patient who experiences gradually increasing dyspnea, anxiety,
and edema of the feet and ankles may be suffering from
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
X
congestive heart failure
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101
myocardial infarction.
malignant hypertension
angina pectoris
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102
Incorrect (Slide Layer)
1.92 Fluid shift into the extravascular spaces of the lungs with
accompanying dyspnea, coughing, and bloody, frothy sputum is indicative
of
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
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103
myocardial infarction
X
pulmonary edema
angina pectoris
none of the above
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104
Incorrect (Slide Layer)
1.93 Acute or chronic inflammation of the sac enclosing the heart is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
endocarditis
myocarditis
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105
X
pericarditis
rheumatic fever
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106
Incorrect (Slide Layer)
1.94 A systemic inflammatory disease of the joints and cardiac tissue that
follows a sore throat caused by group A beta-hemolytic streptococcus is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
endocarditis
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107
myocarditis
pericarditis
X
rheumatic fever
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108
Incorrect (Slide Layer)
1.95 Valvular heart disease can occur in what forms?
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
Insufficiency
Stenosis
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109
Contracture
X
a and b
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110
Incorrect (Slide Layer)
1.96 The valve most frequently involved in valvular heart disease is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
aortic valve
X
mitral valve
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111
pulmonary valve
tricuspid valve
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112
Incorrect (Slide Layer)
1.97 The patient with pale, cold, clammy skin, a rapid and weak pulse,
tachypnea, and an altered level of consciousness is experiencing
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
congestive heart failure
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113
X
shock
atherosclerosis
none of the above
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114
Incorrect (Slide Layer)
1.98 Cardiac arrhythmias may be caused by
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
X
disturbances in the normal conduction system of the heart
ischemia and drugs
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115
failure of the SA node
all of the above
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116
Incorrect (Slide Layer)
1.99 The patient experiencing crushing chest pain, dyspnea, diaphoresis,
and anxiety usually is suffering from
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
angina
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117
congestive heart failure
X
myocardial infarction
none of the above
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118
Incorrect (Slide Layer)
1.100 Noninflammatory disease of the heart muscle with enlargement of
the myocardium and ventricular dysfunction refers to
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
rheumatic fever
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119
mitral stenosis
X
cardiomyopathy
none of the above
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120
Incorrect (Slide Layer)
1.101 Interference with the conduction system of the heart may be the
source of
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
essential hypertension
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121
X
cardiac arrhythmias
atherosclerosis
all of the above
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122
Incorrect (Slide Layer)
1.102 Symptoms of cardiovascular disease include
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
chest pain, fatigue, and fainting
rapid heart beat and palpitations
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123
cyanosis, edema, and dyspnea.
X
all of the above
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124
Incorrect (Slide Layer)
1.103 Common symptoms of a myocardial infarction are
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
left-sided, crushing-type chest pain
irregular heartbeat, dyspnea, and excessive sweating
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125
nausea, anxiety, and denial
X
all of the above
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126
Incorrect (Slide Layer)
1.104 Possible consequences of emboli include
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
cerebral vascular accident
myocardial infarction
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127
pulmonary venous obstruction
X
all of the above
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128
Incorrect (Slide Layer)
1.105 A pulsating mass that is noted mid-abdomen indicates
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
an arrhythmia
palpitations
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129
X
aortic aneurysm
pulmonary embolus
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130
Incorrect (Slide Layer)
1.106 A vasospastic disease of the fingers, hands, or feet resulting in pain,
numbness, and sometimes discoloration is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
Buerger's disease
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131
X
Raynaud's disease
varicose veins
thrombophlebitis
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132
Incorrect (Slide Layer)
1.107 The condition in which a reduction in the quantity of either red
blood cells or hemoglobin exists is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
X
anemia
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133
thrombocytopenia
leukemia
agranulocytosis
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134
Incorrect (Slide Layer)
1.108 _____ is a hereditary bleeding disease resulting from a deficiency of
clotting factors.
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
Disseminated intravascular coagulation
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135
Temporal arteritis
X
Hemophilia
Leukemia
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136
Incorrect (Slide Layer)
1.109 The chronic hereditary form of anemia found predominately in the
black race is called
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
X
sickle cell anemia
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hemolytic anemia
pernicious anemia
aplastic anemia
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138
Incorrect (Slide Layer)
1.110 Joint and bone pain, fever, weight loss, fatigue, weakness,
hepatomegaly, splenomegaly, and enlarged lymph glands are typical
symptoms of
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
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139
varicose veins
X
leukemia
Raynaud's disease
phlebitis
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140
Incorrect (Slide Layer)
1.111 The condition that results in painless gross swelling of an extremity
is
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
lymphangitis
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141
X
lymphedema.
Buerger's disease
none of the above
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142
Incorrect (Slide Layer)
1.112 Painless enlargement of the lymph nodes, severe itching, fever,
night sweats, weight loss, fatigue, and malaise are symptoms of
(Multiple Choice, 1 points, 1 attempt permitted)
Correct
Choice
lymphedema
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143
X
Hodgkin's disease
anemia
none of the above
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144
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1.113 Patients with coronary heart disease always experience pain
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
True
X
False
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145
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146
Incorrect (Slide Layer)
1.114 The cause of essential hypertension is unknown
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
False
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147
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148
Incorrect (Slide Layer)
1.115 Mitral stenosis usually is the result of rheumatic heart disease
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
False
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149
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150
Incorrect (Slide Layer)
1.116 Patients with mitral valve prolapse experience severe crushing chest
pain and syncope.
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
True
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151
X
False
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152
Incorrect (Slide Layer)
1.117 Myocardial infarction is the death of myocardial tissue caused by
ischemia
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
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153
False
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154
Incorrect (Slide Layer)
1.118 Causes of cardiac arrest include respiratory arrest, myocardial
infarction, trauma, electrocution, hemorrhage, and drug overdose.
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
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155
False
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156
Incorrect (Slide Layer)
1.119 Cardiomyopathy is a noninflammatory disease of the cardiac muscle
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
False
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157
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158
Incorrect (Slide Layer)
1.120 Sickle cell anemia is asymptomatic
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
True
X
False
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159
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160
Incorrect (Slide Layer)
1.121 Transfusion incompatibility reactions are always fatal.
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
True
X
False
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161
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162
Incorrect (Slide Layer)
1.122 Agranulocytosis (also called neutropenia) is a blood dyscrasia in
which leukocyte levels become extremely low.
(True/False, 1 points, 1 attempt permitted)
Correct
Choice
X
True
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163
False
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164
Incorrect (Slide Layer)
1.123 SELF CHECK
(Results Slide, 0 points, 1 attempt permitted)
Results for
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165
1.87 SELF 4
1.88 The condition in which the patient experiences chest pain with exertion is
1.89 The most prevalent cardiovascular disorder in the United States is
1.90 The patient who complains of sudden onset of severe headache, blurred vision, and
dyspnea may be suffering from
1.91 The patient who experiences gradually increasing dyspnea, anxiety, and edema of the feet
and ankles may be suffering from
1.92 Fluid shift into the extravascular spaces of the lungs with accompanying dyspnea, coughing,
and bloody, frothy sputum is indicative of
1.93 Acute or chronic inflammation of the sac enclosing the heart is
1.94 A systemic inflammatory disease of the joints and cardiac tissue that follows a sore throat
caused by group A beta-hemolytic streptococcus is
1.95 Valvular heart disease can occur in what forms?
1.96 The valve most frequently involved in valvular heart disease is
1.97 The patient with pale, cold, clammy skin, a rapid and weak pulse, tachypnea, and an altered
level of consciousness is experiencing
1.98 Cardiac arrhythmias may be caused by
1.99 The patient experiencing crushing chest pain, dyspnea, diaphoresis, and anxiety usually is
suffering from
1.100 Noninflammatory disease of the heart muscle with enlargement of the myocardium and
ventricular dysfunction refers to
1.101 Interference with the conduction system of the heart may be the source of
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166
1.102 Symptoms of cardiovascular disease include
1.103 Common symptoms of a myocardial infarction are
1.104 Possible consequences of emboli include
1.105 A pulsating mass that is noted mid-abdomen indicates
1.106 A vasospastic disease of the fingers, hands, or feet resulting in pain, numbness, and
sometimes discoloration is
1.107 The condition in which a reduction in the quantity of either red blood cells or hemoglobin
exists is
1.108 _____ is a hereditary bleeding disease resulting from a deficiency of clotting factors.
1.109 The chronic hereditary form of anemia found predominately in the black race is called
1.110 Joint and bone pain, fever, weight loss, fatigue, weakness, hepatomegaly, splenomegaly,
and enlarged lymph glands are typical symptoms of
1.111 The condition that results in painless gross swelling of an extremity is
1.112 Painless enlargement of the lymph nodes, severe itching, fever, night sweats, weight loss,
fatigue, and malaise are symptoms of
1.113 Patients with coronary heart disease always experience pain
1.114 The cause of essential hypertension is unknown
1.115 Mitral stenosis usually is the result of rheumatic heart disease
1.116 Patients with mitral valve prolapse experience severe crushing chest pain and syncope.
1.117 Myocardial infarction is the death of myocardial tissue caused by ischemia
1.118 Causes of cardiac arrest include respiratory arrest, myocardial infarction, trauma,
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167
electrocution, hemorrhage, and drug overdose.
1.119 Cardiomyopathy is a noninflammatory disease of the cardiac muscle
1.120 Sickle cell anemia is asymptomatic
1.121 Transfusion incompatibility reactions are always fatal.
1.122 Agranulocytosis (also called neutropenia) is a blood dyscrasia in which leukocyte levels
become extremely low.
Result slide properties
Passing Score
80%
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168
3. Course Home
3.1 Course Home
Notes:
You will complete the following in this module:
 READING ASSIGNMENT
Refer to your textbook and read assigned pages
 QUICK CHECK
Check your knowledge of key terms and definitions from this section
 LESSON
Instructor guided content
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169
 OPTIONAL SELF CHECK
Designed to evaluate your understanding of the material read and
reviewed in this section
4. Next Steps
4.1 Next Steps
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170