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HIV is transmitted through what? direct contact with body fluids or blood An infection that can occur during HIV stage Pneumocystis Pneumonia Acute retroviral symptoms flu-like symptoms decreased CD4+ high viral load >1 million high transmission potential shallow, demarcated ulcers on mouth, anus, penis, and rectum When is it recommended to start HAART therapy? CD4+ <350
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HIV is transmitted through what?
direct contact with body fluids or blood
An infection that can occur during HIV stage
Pneumocystis Pneumonia
Acute retroviral symptoms
flu-like symptoms
decreased CD4+
high viral load >1 million
high transmission potential
shallow, demarcated ulcers on mouth, anus, penis, and rectum
When is it recommended to start HAART therapy?
CD4+ <
Normal CD4+ count
500-
CD4+ count in HIV
<
CD4+ count in AIDS
<
AIDS symptoms
lymphadenopathy
diarrhea
weight loss
fever
cough, SOB
Diagnosis of HIV/AIDS
what kind of anemia is iron deficiency anemia
microcytic
iron deficiency anemia
the supply of iron needed to produce hgb is inadequate
S/S of iron deficiency anemia
decreased H/H
gradual fatigue
increasing SOB
causes of iron deficiency anemia
NSAIDS
colon cancer
strict vegan
frequent blood donor
GI tract conditions (PUD, gastric cancer, Crohns, colitis)
types of microcytic anemia
iron deficiency anemia
blood loss anemia
Thalassemia
lead poisonings
Treatment of iron deficiency anemia
increase iron rich foods and vitamin C to help absorb it
Food high in iron
liver
red meat
fish
beans
raisins
eggs
almonds
green leafy veggies
GI tract blood loss
Thalassemia
blood disorder that causes less hemoglobin
it is inherited
Normocytic anemias
bleeding, nutritional anemia
anemia of renal insufficiency, hemolysis
anemia of chronic disease, a primary bone marrow disorder
examples of normocytic anemia
aplastic anemia
endocrine disorders (hypothyroidism)
acquired aphasia (parvo, HIV, medications)
Macrocytic anemias
megaloblastic anemia (vitamin B12 and folic acid deficiency)
pernicious anemia
drug induced
nutritional
MDS (myelodysplastic syndrome) or other bone marrow disorders
liver disease or alcoholism
hypothyroidism
hemolysis
megaloblastic anemia
a blood disorder characterized by anemia in which the red blood cells are larger than normal
common in alcoholics
foot slap gait common in folate deficiency (sensory ataxia)
Lhermitte's sign (neck pain shooting down back and into arms)
Lhermitte's sign
neck pain shooting down the back and into the arms
Pernicious anemia
vitamin B12 deficiency from the intestines lacking intrinsic factor to absorb B
there is enough of it in the body, just not being absorbed properly
Non-Hodgkin's Lymphoma
a malignant cancer of lymphoid cells within the lymph node in bone marrow, spleen, and liver
B-cells are the most common cells involved (80-85%) and the rest are T cells
Presentation of Non-Hodgkin's Lymphoma
fixed, painless lymphadenopathy in MULTIPLE lymph nodes
low grade fever
night sweats
unexplained weight loss
Risk factors for Non Hodgkin's lymphoma
occurs in children and adults
HIV infection
patients undergoing immunosuppression
Rheumatoid Arthritis (chronic inflammation)
Hodgkin's Lymphoma
caused by a clonal transformation of B cells which creates REED-STERNBERG CELLS
Presentations of Hodgkin's Lymphoma
painless lymphadenopathy of a SINGLE GROUP or CHAIN of lymph nodes
low grade fever
night sweats
unexplained weight loss
Risk factors for Hodgkin's Lymphoma
young adulthood and older than 55 years old
HIV infection
patients undergoing immunosuppression
Epstein Barr virus (mono)
Hx of Non-Hodgkin's Lymphoma
obesity
Leukemia
results from immature blast cells with two gene mutations
Chronic myelogenous leukemia
occurs in age 25-50 years old, involves pluripotent hematopoietic stem cells
S/S of CML
mild signs of anemia
splenomegaly
may be asymptomatic depending on WBC level
lab findings for CML
leukocytosis with variable WBC count
increased eosinophils
increased basophils
Lymphocytic leukemia
affects cells that become lymphocytes (B or T cells)
Acute Lymphocytic Leukemia (ALL)
most common form in children, involves immature B or T cells
S/S of ALL
CNS deficiencies
Lab findings in ALL
normocytic anemia
thrombocytopenia
variable WBC counts
PBS- less than 30% lymphocytes
Chronic Lymphocytic Leukemia (CLL)
most common form in older adults, involves immature B or T cells
Prognosis of 10 YEARS
S/S of CLL
nonspecific fatigue and malaise
hepatosplenomegaly
usually asymptomatic until end stage disease
Female hematocrit levels
36.1-44.3 g/dL
Platelet count
150-400 thousand/uL
MCV range
80-95 fL
SA node HR range
60-100 bpm
AV node HR range
40-60 bpm
What causes bradycardia?
a blocked pathway at or below the AV node
Scar tissue from prior MI or medications
Wolfe-Parkinson-White Syndrome
most common reentry tachycardia
Delta waves between PR and QRST spike
Abdominal Aortic Aneurysm (AAA)
arteries weaken and areas of the artery balloon outward
caused by atherosclerosis and HTN
S/S of AAA
pulsating abdominal mass
flank/back pain
once it ruptures, symptoms worsen: severe pain, worsening dyspnea, cardiovascular collapse due to life threatening bleeding
Diagnosis of AAA
if symptoms present, we can do CT, MRI, and arteriography (angiography)
Normal BP
<120 and <
Elevated BP
120-129 and <
Stage 1 HTN
130-139 or 80-
Stage 2 HTN
140 or >
HTN crisis
180 and/or >
diagnostic studies for valvular heart disease
transthoracic echo
transesophageal echo
right heart cath
Congenital aortic stenosis
symptoms usually develop before age 30
the valve can be unicuspid, bicuspid, or tricuspid with partially fused leaflets
rheumatic aortic stenosis
symptoms develop between age 30-
tissue inflammation results in adhesions and fusing of the commissures
fibrosis and calcification of the leaflet tips can occur because of turbulent flow
Degenerative aortic stenosis
patients are usually over age 70 with diabetes and hypocholesteremia
leaflets become inflexible because calcium deposits at the bases
normal aortic valve area (AVA)
3.5-4.0 cm
