4.5 Embolism

Question 1

Types of embolism (5)

Answer 1

1. Thromboembolus (>95%)
2. atherosclerotic embolus
3. fat embolus
4. gas embolus
5. amniotic fluid embolus

Question 2

atherosclerotic embolus

-how to identify in histology?

Answer 2

• plaque that dislodges

- characterized by presence of cholesterol clefts in histology

Question 3

fat embolus

• associated with what problems
• how to identify in histology?

Answer 3

• associated with long bone fractures and soft tissue trauma
• fat often enters pulmonary vessels, causing dyspnea
• histology: large fat globules in vessel lumen.

Question 4

gas embolus

-associated disorder

Answer 4

• Decompression sickness–“bends” (joint, muscle pain) and “chokes” (resp symptoms)
• bubbles of nitrogen

Question 5

amniotic fluid embolus

Answer 5

• amniotic fluid, full of fetal skin cells, enters maternal circulation.
• SOB, CNS symptoms, DIC (amniotic fluid has tissue thromboplastin)

Question 6

why are most pulmonary embolisms clinical silent?

Answer 6

1. lung has dual blood supply (pulm and bronchial arteries)

2. embolism too small (self-resolves)

Question 7

when does pulmonary embolism cause sudden death?

Answer 7

-requires large saddle embolism that blocks both pulm arteries at once. Heart cannot pump!