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PODT- Pathology > 14. Aneurysms & Aortic Dissection Oedema & Shock > Flashcards

14. Aneurysms & Aortic Dissection Oedema & Shock Flashcards

1
Q

Define the term aneurysm

A

Localised, permanent abnormal dilatation of blood vessel

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2
Q

Clinicopahtological characteristics of abdominal aortic aneurysm

A

Most common
Erosion and replacement of the media by an adjacent complicated atheroma
Thrombus formation may lead to emboli

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3
Q

Where would you find saccular aneurysms?

A

Brain

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4
Q

Where are leutic aneurysms found?

A

Ascending aorta or arch of aorta

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5
Q

What is a false aneurysm?

A

A blood filled space that forms round a blood vessel usually after injury/rupture.

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6
Q

What are the classical triad symptoms for abdominal aortic aneurysm?

A

Pain in the neck
Hypotension
Pulsatile abdominal mass

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7
Q

What happens in a dissecting aortic aneurysm?

A

Blood is forced through a tear in intima
Haemotoma in the media -propagated along blood vessel
Sharp tearing pain

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8
Q

What are the possible outcomes dissecting aortic aneurysm?

A

Blood ruptures through adventita- massive haemorrhage into the pericardium and other structures
Blood will re-enter the aortic lumen - Double barrelled aorta
Blood may extend down tributary arteries- compress lumen- results in end-organ infarction

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9
Q

Describe the parthenogenesis of AAA?

A

Degeneration of the media of the vessel
Cystic medial necrosis
Mucois degeneration, elastic fibre fragmentation

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10
Q

What are the risk factors assocaited with AAA?

A

Hypertension
Bicuspid aortic valve
marfan syndrome

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11
Q

What is marfan syndrome?

A

Point mutations in fibrillin gene prevent normal deposition of elastin in extracellular matirx

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12
Q

Characteristics of Berry Aneurysms?

A

occur in circle of willis
NOrmal muscular arterial wall replaced by fibrous tissue
Arise at points of branching
More common in young, hypertensive patients

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13
Q

What does the rupture of a berry aneurysm produce?

A

Saubarachnoid haemorrahage

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14
Q

What are the symptoms of Saubarachnoid haemorrahage?

A 
Thunderclap headache
Stiff neck
Nausea and vomiting 
Loss of consciousness 
Stroke like symptoms
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15
Q

Characteristics of Charcot-bouchard aneurysms

A 
Micro-aneurysms
Occur in intercerebral capillaries 
Rupture leads to intracerebral haemorrhage 
Associated with both 
-hypertension
-diabetic vascular disease
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16
Q

Define oedema?

A

Excess fluid in the intersitial tissues

17
Q

Define effusion

A

A collection of fluid in a potential space

18
Q

What are the 4 categories of pathogenesis of oedema?

A
  1. Inflammatory
  2. Venous
  3. Lymphatic
  4. Hypoalbuminaemic
19
Q

Describe the inflammatory pathogenesis of oedema

A

Increased vascular permeability

20
Q

Describe the venous pathogenesis of oedema

A

Increased intravenous pressure

21
Q

Describe the lymphatic pathogenesis of oedema

A

Obstruction of lymphatic drainage

22
Q

Describe the hypoalbuminaemic pathogenesis of oedema

A

Reduced plasma osmotic pressure

23
Q

What us pitting oedema?

A

redistribution of the excess fluid when pressure is applied leaving pits

24
Q

What is a pulmonary oedema?

A

Abnormal accumulation of fluid in the intra-alveolar spaces of the lungs

25
Q

What are the causes of pulmonary oedema?

A

Left ventricular failure
Renal failure
Acute respiratory distress syndrome
Pulmonary inflammation or infection

26
Q

What is a cerebral oedema?

A

Abnormal accumulation of fluid in brain parenchyma

One part of brain herniates from one anatomical part to another

27
Q

Define shock

A

A pathological process that results in inadequate blood flow to sustain normal organ function

28
Q

What are the causes of shock?

A

Cardiogenic shock- MI
Hypovolaemic shock-Haemorrhage
-Increased vascular permeability/dilatation

29
Q

What are the phases of shock?

A

Compensatory phase
Progressive phase
Irreversible phase
Failure of multiple organs

30
Q

What are compensatory mechanisms for shock?

A

Constriction of vessels in “non-vital” tissues to increase peripheral resistance
Increased heart rate
Dilation of cerebral vessels

31
Q

What signs will the clinical examination show for shock?

A

Cold
Clammy
Has an increased in heart rate

32
Q

What are the consequences of shock?

A

Renal failure
Acute respiratory distress syndrome
Cerebral infarction
Infarction

33
Q

What is acute tubular necrosis?

A

Kidney injury characterised by acute tubular cell injury and dysfunction
Leading to possible renal failure

34
Q

What are the features of acute respiratory distress syndrome?

A

A severe lung condition
Severe inflammation of alveolar walls
Accumulation of inflammatory cells and inflammatory proteinaceous material
Severely impaired oxygen transfusion
High mortality
Type II pneumocytes that line the alveoli die

PODT- Pathology (15 decks)

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