- feeling of heaviness, sometimes painful

- ankle engorgement: blockage

- homan’s sign is not reliable for DVT
-positive : pain when dorsi-flexion

Bagtak (calf): gastrocnemius

VASCULAR DISORDERS
Heparin - anticoagulant - low molecular weight
heparin (LMWH)

- thrombus formation which went to pulmo veins

- prevent thrombus from becoming embolus

- anticoagulants stopped one wk before surgery

At risk: fat people, bed-ridden people

VIRCHOW’S TRIAD: immobilization (stasis blood flow,
higher risk), injury (clot), coagulation factors

WOF: bleeding, thrombocytopenia (low pltlt), drug

* what is phlegmasia cerulea dolens interaxns
- blockage: inc in pressure > free-flowing blood
pupunta sa area na yung causing pressure = sudden
venous hypertension

- deep veins
-edema and swelling, deep vein prominent
-tenderness: inflammation
-superficial veins
-redness, warm, swelling

- sometimes familial (hereditary)

- lower extremities
‘portous’ form? *clarify the term sa google - presence of peripheral arteries - duple
untrasonogaphy
- no backflow na because closed na ang valves - - inc o2 demand:
incompetent valves affect backflow > portous form

- compression stocking? *clarify ulit

- para mag help sa incompetent valves
- pag gising, suotin na

Statin drugs: prevent atherosclerosis

Endovascular mgt - treat underlying cause

*gnawing pain - ngutngut, pain na parang throbbing Stent: tunnel na iiwan sa affected area
na di mawala Atherectomy - get rid of the blockage in
*dull pain - di ma pinpoint san banda atherosclerosis
- muscle sa leg - milking of veins para may normal
flow Claudication: cant work bc of pain
- nocturnal cramps Bypass
- necrosis sa wound

- mt circulation: ambulate

- fatal if will burst, do not palpate if abdominal

ARTERIAL DISORDERS

- wall should be stronger to avoid abnormal dilation

of vessels ‘ weakening of walls ‘

- age: wear and tear

- genetics: weakened blood vessels
- HPN, tobacco use

Ballooning - aortic aneurysm

- burst: lots of bleeding
- aneurysm: sac-like

Supine - more pressure

Aphonia - cant smell?

Systolic bruit - sound of blood rushing - coldness, pain, pallor - wala ng flow sa fingertips
Abdomial or back pain - IMPENDING RUPTURE Trigger: emotion and sensitivity to cold
- ubos ang blood so low BP ACROCYANOSIS - cyanosis of extremeties

‘-statin’ medxs
Stent graft: surgery
No palpation, bending -- can increase pressure
- pallor muna before bluish
-WHITE-BLUE- RED

-calcium-channel blockers - relieve vasospasm

- avoid nicotine

- necrotise na
A. k.a - THROMBOANGIITIS OBLITERANS
-segment thrombus formation
-tobacco-use is strongly associated 139/89 - pre hypertension
-ischemia > necrosis 140/90 - may htn na

Kuha ka everyday same time

- one complication of htn is kidney failure

-secondary may cause

-primary walang cause, usually genetic

- blood components: ‘solid’ portion of blood

Blood forming tissues: bone marrow, spleen (collects
blood waste after cell death), lymph system

LVH - heart overworked

-epistaxis is good sign - ma relieve daw (bleeding ma
release ang blood, pressure)

Transient ischemic attack - sign, marelieve for 24 hrs

- medication na
If di marelieve within 24 hrs then CVA na

Plasma - ‘liquid’
- lifestyle modification ‘thaw’ blood : plasma nasa taas, other components
- watch for food will settle

PM:
 Fight platelet aggregrates: antiplatelet medication -
prevent CVA, MI, and other thrombus formation

Erythropoiesis - rbc production

-mountanous places - thin air- kidney produce
erythropoietin > stimulate bone marrow to produce Extrinsic - bleeding outside (wounds)
rbc Factors - important in clotting mechanism - if
missing, clotting mechanism will not work
Hemolysis - rbc destruction
- sometimes sets in earlier
- release bilirubin
- 120 days - rbc lifespan - apoptosis

Granulocytes - may granules

Neutrophils - main phagocytes of inflammation Infection - rbc migrate to area

Eosinophil - main phagocytes of parasitic infection Bleeding - platelet will go to area to close wound
Basophil - allergic reaxns - inflammatory

Agranulocytes
Lymphoccytes- t-cells b-cells
Monocytes

Liver - largest organ, easiest to be injured in a blunt

- hemostasis - stopping of bleeding
trauma
Liver fx
1. Hematologic - liver synthesis of plasma protein
and clotting factors of ALBUMIN
- Clears damaged and non-functioning rbc
- Spleen talaga ang main na nagalinis ng rbc

Inc of wbc - not only infection but also tissue injury -

migration: chemotaxis

- only prod RBC during fetal life Leukopenia: typhoid fever

Neutropenia: destruction of neutrophils

LIVER: RUQ
SPLEEN: LUQ-

-pltlt decrease: dengue fever

First to bleed when low pltlt: stomach because of

acids - gastritis- hemoptosis
Pluripotential stem cell - stem cell of all stem cells
Pancytopenia - lahat sila nagbaba
Myeloid stem cells: prod granulocytes

Lymphoid stem cells - prod t cells, b cells, plasma

cells
- dev’t memory cells
- secondary to acquired infections

- ct scan w the system that produces it

 Chronic - slow bleeding, minute bleeding caused bby
problem, can be parasitic, seeping of blood
secondary to helminths, ulcer minute bleeding

- volume or size, or qty of hgb - ANEMIA

RBC - CARRY O2

Dec erythrocytes : kidney problem

Inc destruction of eryth: condition that cause early
demise of RBC

Thalassemia - Beta globin is lacking

Pallor-not enough hgb in blood

Fatigue&weakness - o2 is needed for activities
Dyspnea - lack o2, body will interpret
Palpi and tachy - compensatory mech
Headache, dizz, restlessness - lack o2 - look for iron-containing food
Slow thought - low o2 in brain -hemolysis - rbc death
Paresthesia - less feeling in areas lacking o2 (tingling,
numbness)

Acute - bleeding, hemorrhage

Serum ferritin- component of iron
Endoscopy/colonoscopy- check for bleeding

Iron excess- sluggish flow of blood - clog

Ulcer: treat to stop bleeding

- large rbc and not normally functioning

MEGA = BIG - LARGE
Forms:
- cobalamin and folic acid deficiency

BOTH Parents should have the component

Fetal hgb - alpha chain and yung ---- chain? - doesnt
carry the B chain, only alpha and f chain
Adult hgb - absent fetal hgb - composed of 2 alpha
and 2 beta chain
Adult 2 - alpha and delta

Adult (a1) - carries beta chain - thalassemia affected

by beta chain

- if both parents walang bchain then thalassemia risk

- result of malabsorption
- intrinsic factor - found at gastric mucosa - required
for cobalamin absorption

H2-histamine receptor blockers

Omeprasol - proton pump inhibitor
Ranitidin - given
Antacids

Children who no longer use fetal hgb usually dies

undiagnosed
Life threatening - lack of o2 sa body
-early demise of rbc - splenomegaly, hepatomegaly

Thalassemia minor : one component lang from

parent - beta chain can still be produced

Major: both walang production of beta chain -

manifests pag wala na ang fetal hgb
- decrease carrying o2 cpacity

-peripheral blood smear - daming bilog bilog Kidney illness: lack of erythropoietin

- affected and pluripotential stem cells - all blood

components affected: PANCYTOPENIA

CRITICIAL: hemorrhage and sepsis - body cannot

recover

Large amt: uric acid

 Big structure of rbc: cannot enter smaller vessels -
sickle cell: will cause obstruction

-depleted lahat: aplastic anemia

- immunosuppresant - sometimes and immune
sytem sumisira

Medication: actively monitor

- can also deposit in kidneys

Polycythema vera - yung sa hi altitude then mataas

ang rbc

G6PD - deficiency sa g6? haha ambot

- diet: bawal ang soy sauce, peanut - chronic
exposure

3rd maj cause of anemia ang hemolytic anemia

Membrane abN: structure

Extrinsic - nnormal rbc but dmged
- heart valve implants
- might cause blockage
- phlebotomy - drain the blood- parang blood
donation

Myelosuppressive agent - suppress myelogenous

from producing rbc

Agranulocytosis - severe neutropenia

Neutropenia can be acquired or congenital

KOSTMANN’S SYNDROME

Neutrophil - maj component for bacterial infection,

fights bacterial infection.

Chemo - expose all normal cells to certain substance

that destroy them - usually causes death to pt
Leukemia - immature wbc (?))
 Most common leukemia in children: ALL - good
prognosis
Most common leukemia of older adults: CLL - fatal -
mostly will die

AML and CML is not common

4 forms accdg to stem cell

ALL or AML: ma identify sa blood smear

Many immats cells - compressed

Bleeding tendencies: thrombocytopenia Lymphocytes: responsible for phagocytosis
 HIT:
Heparin: anticoagulant
- paradoxical effect - cause thrombosis
NEOPLASM - body develop antibody for heparin / allergy

HODGKIN’S DISEASE cancer of the - cervical lymph Dengue: microbleeding > answered by platelet >
node (neck) platelet depletion > when severe bleeding comes, no
platelet left
*ASK NOTES NAWALA ANG NET

Tagal ang bleeding, maliit yung aptt (?)

Stress - petechial rashes

TTP - microthrombi - lahat ng platelet magamit -

8QUIZ ON MONDAY TAPOS COVID DISCUSSION