GCU BIO 322- PATHOPHYSIOLOGY
QUESTIONS & ANSWERS 100%
SOLVED
Polycythemia - ANSWERExcess RBC in circulation
Blood is more viscous, lead to decrease in flow of blood that can deprive organs of
oxygen
Anemia - ANSWERDecreased RBC in circulation
Causes: Impaired erythrocyte production, blood loss, increased erythrocyte
destruction
Signs & Symptoms: Fatigue, Weakness, Dizziness, Pallor (pale) skin and MM,
smooth tongue (beefy red tongue due to Vitamin B12 deficiency)
GERD (gastroesophageal reflux disease) - ANSWER-A digestive disease in which
stomach acid or bile irritates the food pipe lining.
-Causes: abnormal esophageal sphincter, foods, smoking, EtOH, medication, stress
-S/S: heartburn worse at night, chest pain, cough
-Esophagitis -> Barrett's Esophagus -> Metaplasia
-Testing: endoscopy, barium X-ray
-Tx: prop upper body when sleeping, eat smaller meals that are less fatty, antacids,
H2 blockers
Anemia of Acute Blood Loss - ANSWERLow RBC, Hg, Hct,
Normal MCV and normal MCHC (Normocytic, Normochromic)
Anemia of Chronic Blood Loss (Iron Deficiency Anemia) - ANSWERLow RBC, Hg,
Hct, MCV, MCHC (Microcytic hypochromic)
B9 Deficiency Anemia (Folic Acid) - ANSWERLow RBC< Hg, Hct
High MCV (Macrocytic normochromic)
Normal MCHC
B12 Deficiency Anemia - ANSWERLow RBC, Hg, Hct
High MCV (macrocytic normochromic)
Normal MCHC
Platelet Plug - ANSWERPlatelet Activation (vWF)
Platelet Aggregation (vWF)
Platelet Degranulation
,Celiac Disease - ANSWER-an inherited autoimmune disorder characterized by a
severe reaction to foods containing gluten
-Sensitivity to gliadin (fat soluble part of gluten)
-Etiology: FHx, Caucasian, European, women > men
-Patho: atrophy of intestinal villi leading to decreased absorption of some vitamins,
proteins, fats and carbs -> diarrhea, weight loss, low energy
-S/S: abd pain, N/V, bloating, gas, indigestion, fatty stools, anemia, Dermatitis
herpetiformis (Itchy blistery skin rash)
-Testing: Low Vit K levels - fat malabsorption, biopsy, blood tests (Anti-gliadin Ab,
anti-endomysial Ab, tissue transglutamase Ab)
-No cure!
Microcytic anemia - ANSWERSmall erythrocytes
Lack of maturation time or low levels of iron
Macrocytic anemia (megaloblastic anemia) - ANSWERCells are larger than normal
Lack certain nutrients necessary for successful DNA replication
Mean corpuscular hemoglobin (MCH) - ANSWER27-34 pg
Determined by dividing total mass of hemoglobin by number of red blood cells
MCHM (concentration) determines hemoglobin concentration
Hypochromic: lower amount of hemoglobin appear washed out and pale
Normochromic: normal cell color
Normochromic anemia: decrease in the number of cells through blood loss or
premature destruction of erythrocytes
Hyperchromic
Macrocytic Anemia - ANSWERLack of Vitamin B12 and folic acid (a B vitamin
necessary for cell maturation and DNA repair)
Thalassema - ANSWERGroup of genetic disorders that affect hemoglobin
Risk factors for anemia - ANSWERNutritional deficits (iron and Vitamin B), intestinal
disorders preventing the ability to absorb nutrients, chronic health problems,
pregnant, gastrointestinal bleeding, genetic risks (sickle cell disease)
Signs and Symptoms of Anemia - ANSWERIncrease in heart rate and cardiac output
Shunting of blood flow to vital organs such as heart and brain
Pulmonary function increase through increased respiratory rate
Pallor of the skin and mucous membrane
Cyanosis is not present
Headache, dizziness, light-headedness, fatigue
Tachycardia and ejection murmur
iron deficiency anemia - ANSWERReduction in dietary iron or loss of iron
Malabsorption of iron through GI tract or reduced dietary intake
Occurs through hemorrhage, menstrual blood loss in females, and gastrointestinal
bleeding in male and female
Gradual reduction in hematocrit and hemoglobin
Cells become microcytic and hypochromic
,Microcytic hypochromic anemia (decrease MCV or mean corpuscular volume,
decrease MCH or mean corpuscular hemoglobin, decrease MCHC)
Decreased mean corpuscular volume - microcytic
Decreased mean corpuscular hemoglobin concentration- hypochromic
Fatigue, tachycardia, palpitations, tachypnea, pallor, koilonychia, angular cheilitis,
tongue is pale smooth and shiny, pica disease
CBC shows decrease in red blood cells, Hb, Hct, MCV, MCH, MCHC
Cobalamin deficiency (Vitamin B12) - ANSWERVitamin B12 is a water soluble
vitamin necessary for cell metabolism
Obtained through dietary sources (food derived from animal sources)
Synthesis of DNA is disrupted with Vitamin B12
Macrocytic condition with misshapen erythrocytes
Macrocytic, Normochromic - increase MCV, increase MCH, normal MCHC
Anemia, smooth and beefy red tongue, CNS symptoms
Altered mental state: mania, psychosis, irritability, depression, personality changes
Folic acid deficiency - ANSWERObtained through fruits and leafy greens necessary
in synthesis and repair of DNA
Macrocytic anemia can result
Synthesis of red blood cells
Folate sources: beans, lentils
Megaloblastic anemia
NO neurologic changes
NO beefy red tongue
Spina bifida in infants
Low RBC, Hgb and Hct
High in MCV, MCH
Sickle Cell Disease - ANSWERAutosomal recessive disorder that results in
misshapen form of hemoglobin
Inherit from both parents
Found on chromosome 11
Cells more prone to grouping and can result in hypoxia
Vasoocclusive phenomenon
Life span of cells is 10 days to 20 days
Cells can group together in lung or brain and lead to pulmonary obstruction and
stroke
Causes tissue ischemia and then pain in back, chest, and extremities, jaundice
Swelling, tenderness, rapid respiratory rate and hypertension
CBC shows low hemoglobin, low hematocrit, low MCV, high MCHC - microcytic
hyperchromic anemia
Howell-Jolly bodies
Intrinsic Pathway of Clotting (Factor XII) - ANSWERInitiated by Factor XII coming
into contact with exposed collagen
Factor XII causes prolonged clotting
Usually presents no symptoms and is benign
PTT is high
PT is also high
Autosomal recessive disorder
, Slow (Factors VIII hemophilia A + Factor IX hemophilia B)
Tissue Factor (Extrinsic Pathway) - ANSWERFast (Factor VII + Tissue Factor)
Stimulates platelet aggregation
Platelet Type Bleeding - ANSWERLabs show increased bleeding time (BT)
Superficial bleeding (petechia) from skin and mucosal surfaces
Epistaxis, purpura (larger spots than petecha)
vWD or Thrombocytopenia (Low platelets)
Factor Type Bleeding - ANSWERHemophilia
Hematoma (bruising)
Labs show normal BT, platelet plugs are still effective
Hemophilia A - ANSWERFactor VIII deficiency
4x as common as hemophilia B
Genetic disorder- X-lined recessive.
More common in male as they only have 1 X chromosome
Symptoms: bleed longer than other people, occurs internally, into joints and muscles,
or externally from minor cuts, dental procedures, injuries
Mild Hemophilia A: bleeding typically occurs after serious injuries, trauma, or surgery
Moderate: bleeding episodes after injury
Severe: bleeding following an injury and frequent spontaneous bleeding episodes
often in joints and muscles
Labs show increased aPTT (Intrinsic pathway), normal PT (extrinsic pathway),
normal BT, PLT count normal
Hemophilia B (Christmas disease) - ANSWERFactor IX deficiency
X linked recessive
Severe mucosal bleeding from tongue or gum, bruising
Prolonged PTT, normal PT, platelet counts and bleeding time
von Willebrand Disease - ANSWERMain glycoprotein involved in hemostasis is von
Willebrand factor (vWF)
vWF aids in protein binding, allowing platelets to ahead to injury
vWF levels can increase with stress, exercise, acute inflammatory processes,
pregnancy
Disease apparently with diagnostic testing for other conditions or emergent surgery
where excessive bleeding occurs postop
Autosomal dominant
Platelet Type Bleeding (epistaxis, petechia, easy bruising)
Prolonged bleeding time (BT)
Increase aPTT (intrinsic pathway), normal PT (extrinsic pathway), normal platelet
count, vWF levels
DIC - Disseminated Intravascular Coagulation - ANSWERHypercoagulation,
thrombosis, and hemorrhage simultaneously
Lead to ischemia and multiple end organ failure
Clotting consumes platelets and clotting factors leading to hemorrhage
Causes: sepsis, viruses, cancer, placental abruptions, severe burns, major trauma
QUESTIONS & ANSWERS 100%
SOLVED
Polycythemia - ANSWERExcess RBC in circulation
Blood is more viscous, lead to decrease in flow of blood that can deprive organs of
oxygen
Anemia - ANSWERDecreased RBC in circulation
Causes: Impaired erythrocyte production, blood loss, increased erythrocyte
destruction
Signs & Symptoms: Fatigue, Weakness, Dizziness, Pallor (pale) skin and MM,
smooth tongue (beefy red tongue due to Vitamin B12 deficiency)
GERD (gastroesophageal reflux disease) - ANSWER-A digestive disease in which
stomach acid or bile irritates the food pipe lining.
-Causes: abnormal esophageal sphincter, foods, smoking, EtOH, medication, stress
-S/S: heartburn worse at night, chest pain, cough
-Esophagitis -> Barrett's Esophagus -> Metaplasia
-Testing: endoscopy, barium X-ray
-Tx: prop upper body when sleeping, eat smaller meals that are less fatty, antacids,
H2 blockers
Anemia of Acute Blood Loss - ANSWERLow RBC, Hg, Hct,
Normal MCV and normal MCHC (Normocytic, Normochromic)
Anemia of Chronic Blood Loss (Iron Deficiency Anemia) - ANSWERLow RBC, Hg,
Hct, MCV, MCHC (Microcytic hypochromic)
B9 Deficiency Anemia (Folic Acid) - ANSWERLow RBC< Hg, Hct
High MCV (Macrocytic normochromic)
Normal MCHC
B12 Deficiency Anemia - ANSWERLow RBC, Hg, Hct
High MCV (macrocytic normochromic)
Normal MCHC
Platelet Plug - ANSWERPlatelet Activation (vWF)
Platelet Aggregation (vWF)
Platelet Degranulation
,Celiac Disease - ANSWER-an inherited autoimmune disorder characterized by a
severe reaction to foods containing gluten
-Sensitivity to gliadin (fat soluble part of gluten)
-Etiology: FHx, Caucasian, European, women > men
-Patho: atrophy of intestinal villi leading to decreased absorption of some vitamins,
proteins, fats and carbs -> diarrhea, weight loss, low energy
-S/S: abd pain, N/V, bloating, gas, indigestion, fatty stools, anemia, Dermatitis
herpetiformis (Itchy blistery skin rash)
-Testing: Low Vit K levels - fat malabsorption, biopsy, blood tests (Anti-gliadin Ab,
anti-endomysial Ab, tissue transglutamase Ab)
-No cure!
Microcytic anemia - ANSWERSmall erythrocytes
Lack of maturation time or low levels of iron
Macrocytic anemia (megaloblastic anemia) - ANSWERCells are larger than normal
Lack certain nutrients necessary for successful DNA replication
Mean corpuscular hemoglobin (MCH) - ANSWER27-34 pg
Determined by dividing total mass of hemoglobin by number of red blood cells
MCHM (concentration) determines hemoglobin concentration
Hypochromic: lower amount of hemoglobin appear washed out and pale
Normochromic: normal cell color
Normochromic anemia: decrease in the number of cells through blood loss or
premature destruction of erythrocytes
Hyperchromic
Macrocytic Anemia - ANSWERLack of Vitamin B12 and folic acid (a B vitamin
necessary for cell maturation and DNA repair)
Thalassema - ANSWERGroup of genetic disorders that affect hemoglobin
Risk factors for anemia - ANSWERNutritional deficits (iron and Vitamin B), intestinal
disorders preventing the ability to absorb nutrients, chronic health problems,
pregnant, gastrointestinal bleeding, genetic risks (sickle cell disease)
Signs and Symptoms of Anemia - ANSWERIncrease in heart rate and cardiac output
Shunting of blood flow to vital organs such as heart and brain
Pulmonary function increase through increased respiratory rate
Pallor of the skin and mucous membrane
Cyanosis is not present
Headache, dizziness, light-headedness, fatigue
Tachycardia and ejection murmur
iron deficiency anemia - ANSWERReduction in dietary iron or loss of iron
Malabsorption of iron through GI tract or reduced dietary intake
Occurs through hemorrhage, menstrual blood loss in females, and gastrointestinal
bleeding in male and female
Gradual reduction in hematocrit and hemoglobin
Cells become microcytic and hypochromic
,Microcytic hypochromic anemia (decrease MCV or mean corpuscular volume,
decrease MCH or mean corpuscular hemoglobin, decrease MCHC)
Decreased mean corpuscular volume - microcytic
Decreased mean corpuscular hemoglobin concentration- hypochromic
Fatigue, tachycardia, palpitations, tachypnea, pallor, koilonychia, angular cheilitis,
tongue is pale smooth and shiny, pica disease
CBC shows decrease in red blood cells, Hb, Hct, MCV, MCH, MCHC
Cobalamin deficiency (Vitamin B12) - ANSWERVitamin B12 is a water soluble
vitamin necessary for cell metabolism
Obtained through dietary sources (food derived from animal sources)
Synthesis of DNA is disrupted with Vitamin B12
Macrocytic condition with misshapen erythrocytes
Macrocytic, Normochromic - increase MCV, increase MCH, normal MCHC
Anemia, smooth and beefy red tongue, CNS symptoms
Altered mental state: mania, psychosis, irritability, depression, personality changes
Folic acid deficiency - ANSWERObtained through fruits and leafy greens necessary
in synthesis and repair of DNA
Macrocytic anemia can result
Synthesis of red blood cells
Folate sources: beans, lentils
Megaloblastic anemia
NO neurologic changes
NO beefy red tongue
Spina bifida in infants
Low RBC, Hgb and Hct
High in MCV, MCH
Sickle Cell Disease - ANSWERAutosomal recessive disorder that results in
misshapen form of hemoglobin
Inherit from both parents
Found on chromosome 11
Cells more prone to grouping and can result in hypoxia
Vasoocclusive phenomenon
Life span of cells is 10 days to 20 days
Cells can group together in lung or brain and lead to pulmonary obstruction and
stroke
Causes tissue ischemia and then pain in back, chest, and extremities, jaundice
Swelling, tenderness, rapid respiratory rate and hypertension
CBC shows low hemoglobin, low hematocrit, low MCV, high MCHC - microcytic
hyperchromic anemia
Howell-Jolly bodies
Intrinsic Pathway of Clotting (Factor XII) - ANSWERInitiated by Factor XII coming
into contact with exposed collagen
Factor XII causes prolonged clotting
Usually presents no symptoms and is benign
PTT is high
PT is also high
Autosomal recessive disorder
, Slow (Factors VIII hemophilia A + Factor IX hemophilia B)
Tissue Factor (Extrinsic Pathway) - ANSWERFast (Factor VII + Tissue Factor)
Stimulates platelet aggregation
Platelet Type Bleeding - ANSWERLabs show increased bleeding time (BT)
Superficial bleeding (petechia) from skin and mucosal surfaces
Epistaxis, purpura (larger spots than petecha)
vWD or Thrombocytopenia (Low platelets)
Factor Type Bleeding - ANSWERHemophilia
Hematoma (bruising)
Labs show normal BT, platelet plugs are still effective
Hemophilia A - ANSWERFactor VIII deficiency
4x as common as hemophilia B
Genetic disorder- X-lined recessive.
More common in male as they only have 1 X chromosome
Symptoms: bleed longer than other people, occurs internally, into joints and muscles,
or externally from minor cuts, dental procedures, injuries
Mild Hemophilia A: bleeding typically occurs after serious injuries, trauma, or surgery
Moderate: bleeding episodes after injury
Severe: bleeding following an injury and frequent spontaneous bleeding episodes
often in joints and muscles
Labs show increased aPTT (Intrinsic pathway), normal PT (extrinsic pathway),
normal BT, PLT count normal
Hemophilia B (Christmas disease) - ANSWERFactor IX deficiency
X linked recessive
Severe mucosal bleeding from tongue or gum, bruising
Prolonged PTT, normal PT, platelet counts and bleeding time
von Willebrand Disease - ANSWERMain glycoprotein involved in hemostasis is von
Willebrand factor (vWF)
vWF aids in protein binding, allowing platelets to ahead to injury
vWF levels can increase with stress, exercise, acute inflammatory processes,
pregnancy
Disease apparently with diagnostic testing for other conditions or emergent surgery
where excessive bleeding occurs postop
Autosomal dominant
Platelet Type Bleeding (epistaxis, petechia, easy bruising)
Prolonged bleeding time (BT)
Increase aPTT (intrinsic pathway), normal PT (extrinsic pathway), normal platelet
count, vWF levels
DIC - Disseminated Intravascular Coagulation - ANSWERHypercoagulation,
thrombosis, and hemorrhage simultaneously
Lead to ischemia and multiple end organ failure
Clotting consumes platelets and clotting factors leading to hemorrhage
Causes: sepsis, viruses, cancer, placental abruptions, severe burns, major trauma
