What is disseminated intravascular coagulation (DIC)? - ANS- Is a life-threatening condition that involves both excessive bleeding and excessive clotting. Clotting factors are reduced to dangerous levels. Widespread, uncontrollable hemorrhage results. Very poor Prognosis, with a high fatality rate. Disseminated intravascular coagulation (DIC) signs and symptoms - ANS- • A low plasma fibrinogen level is present. • Thrombocytopenia occurs. • Prolonged bleeding time, and thrombin time are noted. • Accompanying the hemorrhage are the effects of low blood pressure or shock. • Multiple bleeding sites are common. • Petechiae or ecchymoses may be present on the skin or mucosa. • Mucosal bleeding is common, and hematuria may develop • Vascular occlusions are frequently present in small blood vessels but occasionally affect the large vessels as well, causing infarcts in the brain or other organs. • Respiratory impairment is evident as difficulty in breathing and cyanosis. • Neurologic effects include seizures and decreased responsiveness. • Acute renal failure with oliguria often accompanies shock. What is infective endocarditis? - ANS- Typically caused by strep or staph infection. Low-grade fever or fatigue. Anorexia, splenomegaly, congestive heart failure in severe cases. Infective Endocarditis (IE) signs and symptoms - ANS- • Anorexia • Splenomegaly • Osler nodes (painful red nodules on the fingers) are often present. • Septic emboli from the vegetations that cause vascular occlusion or infection and abscesses in other areas of the body will result in additional manifestations depending on the location of the secondary problem • Release of bacteria into the blood may lead to intermittent increased fever. • Congestive heart failure develops in severe cases. Acute endocarditis has a sudden, marked onset: • With spiking fever • Chills • Drowsiness • Heart valves are badly damaged causing severe impairment of heart function Infective Endocarditis (IE) diagnostic labs - ANS- echocardiogram What is acute rheumatic fever? - ANS- Acute stage—inflammation of the heart Acute Rheumatic Fever signs and symptoms - ANS- • Low-grade fever • Leukocytosis • Malaise • Anorexia, and fatigue • Tachycardia • Heart murmurs • Epistaxis and abdominal pain may be present Acute Rheumatic Fever treatments - ANS- Antibacterial agents such as penicillin V may be administered to eradicate any residual infection and prevent additional infection. Any future streptococcal infection should be promptly treated. Anti-inflammatory agents such as ASA or corticosteroids (prednisone) may be given. Acute Rheumatic Fever diagnostics labs - ANS- Elevated serum antibody levels remain after the infection has been eradicated. Leukocytosis and anemia are common. Heart function tests, may be required. Characteristic ECG changes develop. What signs and symptoms may be present in a patient with excessive blood loss? - ANS- • Abnormal Pain • Blood in the stool • Black, tarry stool • Blood in the urine • Vomiting blood • Chest Pain • Abdominal Swelling What is pernicious anemia? - ANS- Is a rare blood disorder characterized by the inability of the body to properly utilize vitamin B12, this is essential for the development of red blood cells. Pernicious Anemia signs and symptoms - ANS- • The tongue is typically enlarged, red, sore, and shiny. • The decrease in gastric acid leads to digestive discomfort, often with nausea and diarrhea. • The neurologic effects include tingling or burning sensations in the extremities or loss of muscle control/coordination, referred to as ataxia. • Fatigue • Shortness of breath • Rapid Heart Rate • loss of appetite • Diarrhea Pernicious Anemia treatment - ANS- Vitamin B12 injections Pernicious Anemia diagnostics labs - ANS- • The erythrocytes appear macrocytic or megaloblastic and nucleated on microscopic examination and are reduced in number in the peripheral blood. • The bone marrow is hyperactive, with increased numbers of megaloblasts. Granulocytes are hype segmented and are decreased in number. • The vitamin B12 level in the serum is below normal. In the Schilling test, an oral dose of radioactive vitamin B12 is used to measure absorption.