Question

Thrombocytopenia symptoms, complications, and lab values Sickle cell anemia causes, symptoms .Hypotension patho (RAAS system) Ulcer types and locations; symptoms . Hepatitis types and transmissions

Answer 1

• Thrombocytopenia

Platelets are one of the important constituent of blood. They help in coagulation and prevents bleeding. The normal range of platelets in blood is 1.5 to 4.5 lakh per microlitre.

Thrombocytopenia is defined as low level of platelets in blood. This can be due to impaired platelet production or increased destruction of platelets.

Symptoms include :

1. Excessive bleeding with minor injury

2. Bleeding gums and nosebleed

3. Bruises

4. purpura and petechiae

5. Fatigue

6. Splenomegaly

7. Heavy menstrual bleed

Laboratory testing in thrombocytopenia includes complete blood test, liver enzymes, blood film smears, ESR. The platelet count is below 150000 per microlitre in thrombocytopenia.

Complications include:

1. Haemorrhage due to severe blood loss

2. Bleeding in internal organs

3. Severe anemia

4. Kidney failure

5. Neurological deficits

• sickle cell anaemia

The red blood cells present in blood are biconcave discoid shaped cells. They are elastic in nature to easily pass through the blood vessels. In case of sickle cell anemia abnormality in haemoglobin leads to sickle shaped RBC that are rigid.

Cause: sickle cell anemia is a genetically inherited disease. It occurs when two abnormal copies of the haemoglobin genes are present, one from each parent.

Symptoms include chronic pain and bone pain known as sickle cell crisis, infections, anemia, swollen hands and feet, fatigue, retarded growth, delayed sexual development, CNS abnormalities.

• hypotension

The pressure exerted by the blood on the arterial wall during blood flow is known as blood pressure. Normal blood pressure is 120/80mmhg.

Blood pressure below 90/60 mmHg is known as hypotension.

Hypotension occurs when the heart is unable to pump with enough pressure, vasodilation, or decreased intravascular fluid.

If the heart cannot maintain enough blood volume into blood vessels due to excess load on heart, myocardial injury or valve defect, the blood pressure drops.

When blood pressure drops, renal blood flow reduces. This activates renin angiotensin aldosterone system. The renin is released from kidney which converts angiotensinogen in liver to angiotensin l. Angiotensin l is further converted to angiotensin ll. Angiotensin ll is a powerful vasoconstrictor. It also results in aldosterone secretion from adrenal medulla. Aldosterone causes increased absorption of sodium and water. All this leads increased BP and increased blood flow to kidney.

• Ulcers

Ulcers are defined as the break in continuity of skin or mucous membrane.

Some common types of ulcers are

1. Pressure ulcers due to pressure from underlying bone as seen in sacral region

2. Peptic ulcers seen in stomach

3. Mouth ulcers seen in snd around mouth

4. Genital ulcers seen in genital areas

5. Corneal ulcers seen in cornea of eye

Symptoms of ulcer includes :

symptoms depends upon the site of ulcer. Mouth ulcers are painful and cause burning sensation. Pressure ulcers are painful sand may bleed sometimes. Gastric or peptic ulcers cause indigestion, nausea and heartburn.

• hepatitis : hepatitis is an viral infectious disease. It involves the liver. Hepatitis can be divided into hepatitis A, hepatitis B and hepatitis C. Symptoms include  fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.
• Hepatitis A is caused due to hepatitis A virus. It is speead through fecal matter of infectedperson trough food, water or air contamination
• Hepatitis B is caused by hepatitis b virus. It is caused through body fluids like blood and semen. It can also spread from infected mother to fetus
• Hepatitis C is caused by hepatitis C virus. It is caused through contamination with body fluids from infected person. It can pass from infected mother to fetus.