Question

Discuss the Disturbances in Oxygen Transport; Hematologic and Peripheral Vascular Disorders

Answer 1

Disturbances in Oxygen Transport

Hypoxic hypoxia happens when arterial blood PO2 reduces e.g. hypoventilation, impairment of diffusion caused by pulmonary edoema, mismatch of ventilation-perfusion, or anatomical blood shunt past the area of gas exchange). In terms of O2 transport, the key disadvantage is reduced arterial blood oxygenation (hypoxemia), and therefore the problem lies with the respiratory system.

Anemic hypoxia occurs when the blood's oxygen carrying capacity reduces and, thus, this defect is directly related to the blood. This means that for binding oxygen, fewer haemoglobin molecules (or oxygen-binding sites) are available. This can be caused by many factors. With reduced hematocrit or true anaemia, the most common example exists. This also decreases the ability of the blood to carry oxygen as the haemoglobin concentration within RBCs decreases.

Histotoxic hypoxia refers to a decline in mitochondrial production of ATP due to a defect in oxygen use by the cell. Cyanid poisoning is an instance of histotoxic hypoxia. Since the reaction of oxygen with cytochrome c oxidase is inhibited by the presence of cyanide, there is a profound decrease in tissue oxygen consumption. Other chemicals disrupt the transport chain of mitochondrial electrons (e.g., rotenone, antimycin A) and have similar effects on tissue oxygenation.

Hematologic Disorders

Hematologic conditions include red blood cells , white blood cells , platelets, bone marrow, lymph nodes, and spleen conditions. A number of disabilities can be encountered by children, some are genetic while others are acquired

About Hematologic Disorders

Hematologic disorders can affect child’s spleen, lymphatic system, or blood vessels.

· Spleen issues may have multiple causes. The spleen is often very large or ceases functioning properly, leading to low platelets (thrombycytopenia) and low blood counts (anaemia).

· A variety of symptoms may be caused by lymphatic disorders, such as lymphatic malformations. Benign masses arising from improperly-developed lymph channels are lymphatic malformations. They can increase in size and cause repeated infections if left untreated.

• Vascular malformations and hemangiomas, which are non-cancerous tumours, may cause abnormally shaped blood vessels.
• Abnormally shaped blood cells, such as idiopathic thrombocytopenic purpura (ITP), sickle cell disease and hereditary spherocytosis, may result in a number of conditions. Low blood counts (anaemia), low platelet counts (thrombocytopenia) may result in these conditions and cause many symptoms, including shortness of breath, rapid heart rate, paleness, loss of energy, and easy bruising.

Diagnosis and Treatment

Start with a physical examination and medical history to diagnose haematological disorders. But usually, by conducting a full blood count, classify blood disorders. This blood test tells us about the amounts of red blood cells , white blood cells , platelets and haemoglobin. Bone marrow biopsy, taking a bone marrow sample and sending it for examination to the laboratory.

Medications and blood transfusions treat hematologic conditions, but if it does not work, surgically remove the spleen (splenectomy), the mass in the lymphatic system, or the malformation. Whenever practical, perform this procedure using a minimally invasive technique (laparoscopy).

Peripheral Vascular Disorders

The decreased supply of blood to a portion of the body other than the brain or heart is a peripheral vascular disorder. It is caused by a blood vessel that has been narrowed or blocked. Atherosclerosis, which is the build-up of fatty deposits that narrow a blood vessel, normally an artery, is the main cause. The narrowed blood vessel restricts blood supply to the part of the body connected with it.

Peripheral vascular disease generally affects the leg and kidney blood vessels and, less frequently, the arms. Peripheral vascular disorder is sometimes referred to as peripheral artery disease, occlusive disease of the peripheral artery, or peripheral atherosclerosis.

Symptoms of peripheral vascular disease

· Intermittent pain (claudication) that may feel like cramping, tiredness of the muscles or heaviness (usually in the legs)

· Worsening pain (usually in the legs) during exercise

· Pain relief at rest (typically in the legs)

· Coldness of the affected area of the body

· Numbness

· Pins and needles

· Muscle weakness

· Blue or purple skin tinge

· Wounds that will not recover (vascular ulcers)

· Blackened skin or skin loss areas (gangrene).

Causes of peripheral vascular disease

Atherosclerosis, the accumulation of fatty deposits inside the blood vessel that decreases blood flow to the region, is the cause in most cases. This usually happens in the body when a blood vessel kinks or subdivides.

· Diabetes-high damage to blood sugar and weakens blood vessels, causing narrowing of them.

· Obstruction: inside the blood vessel, a blood clot (thrombus) can lie.

· Infection can lead to blood vessel scarring and narrowing. For instance, syphilis or salmonellosis may lead to peripheral vascular disease.

· Arteritis-arterial inflammation. Arteritis can be caused by some autoimmune disorders.

· Blood vessel defects: blood vessels at birth can be unusually small. The cause is unidentified.

Risk factors of peripheral vascular disease

Peripheral vascular disease risk factors include:

· Diabetes. This is the most critical risk factor

· Smoking tobacco

· Age progression

· Peripheral vascular disorder, stroke or coronary artery disease family history

· Stroke, cardiovascular disease or heart attack medical history

· Overweight or obese

· Sedentary way of life

· High pressure in the blood (hypertension)

· Elevated cholesterol in the blood (hypercholesterolemia).

Diagnosis of peripheral vascular disease

• Medical History

• Physical test

• History of the family

• Using a stethoscope to listen for signs of diminished blood flow into a blood vessel, pulse regulation

• Ankle/brachial index (ABI) test that compares the arms and legs' blood pressure readings to check for differences

• Exercise examination, typically carried out on a treadmill while taking blood pressure to check for a decrease in blood pressure inside the affected part of the body

Treatment of peripheral vascular disease

· Medications such as statins to reduce LDL cholesterol and antihypertensive medications to reduce blood pressure to help combat atherosclerosis.

· Drugs for the treatment of blood clots may include various drugs (including anticoagulants and antiplatelet drugs) to prevent the development of blood clots and drugs (including thrombolytics) that dissolve existing blood clots.

· Angioplasty: This operation, typically performed under sedation and local anaesthetic, involves threading a thin tube (catheter) through a small incision, typically in the leg, into the narrowed blood vessel. The small balloon on its tip is inflated when the catheter hits the narrowed or blocked spot. This enlarges the blood vessels and increases the flow of blood. As a temporary measure, angioplasty is generally considered.