7. Hemodynamics Flashcards
Describe an amniotic fluid embolism?
entry of amniotic fluid containing cells and debris into the maternal circulation through open uterine and cervical veins
When does amniotic fluid embolism normally occur?
At the end of labor when the pulmonary emboli are composed of the epithelial constituents (squamae) contained in amniotic fluid.
What are some acute clinical symptom of a mother that gives birth to a fetus with an amniotic fluid embolism?
Shortness of breath, cyanosis, and shock that is fatal and can lead to coma and death
What are some secondary risks predisposed by a mother that gives birth to a fetus with an amniotic fluid embolism?
A mother who survives the acute episode caused by amniotic fluid embolism is at risk for developing acute respiratory distress syndrome. Se also may die of Disseminated Intravascular Coagulation, a thrombotic microangiopathy.
What is the pathogenesis of DIC?
Disseminated Intravascular Coagulation forms from Fibrin thrombi that form in small blood vessels because of uncontrollable coagulopathy, which consumes fibrin and other coagulation factors. Once coagulation factors are depleted, uncontrollable hemorrhage ensues.
Chronic Heart Failure leads to increase of blood volume where in the body? What is the cause?
A generalized increase in venous pressure , often due to chronic heart failure, increases blood volume in many organs. This is known as Chronic Passive Congestion.
What organ is most vulnerable to Chronic Passive Failure and why? What is expected clinical manifestation? Histological finding?
The LIVER because the Hepatic Veins empty into the Vena Cava immediately INFERIOR to the HEART. PE : hepatomegaly Histology: Sinusoid Dilation and dark foci of centrilobular hepatocyte congestion
What PE finding, upon auscultation, would indicate fluid in the pleural spaces?
Bubbly Rales
How does increased pressure effect sinusoids and centrilobular hepatocytes?
It leads to sinusoid dilation and pressure atrophy of the centrilobular hepatocytes.
What disease forms a nutmeg liver?
Chronic Passive Congestion
What cellular pathology can develop from longstanding passive congestion?
Fibrosis. Only in the most extreme cases is the fibrosis sufficiently sever e to justify the label cardiac cirrhosis.
What is Melena? What is it a symptom of?
Melena is Black Stool and it is a symptom of upper GI bleeding.
What is the pathogenesis of Melena?
blood from ruptured esophageal varices r a peptic ulcer is partially digested by Hydrochloric Acid. Hemoglobin is transformed into a black pigment.
What term describes the black pigment “coffee-grounds” seen in melena?
Hematin
What is Hematobilia?
Bleeding into the biliary passages as a complication of trauma or neoplasia.
What is Hematochezia?
Passage of bloody stools caused by lower gastrointestinal hemorrhage
Peptic Ulcer Disease and Pancreatic Disease will cause what effect on stools?
These diseases can cause steatorrhea, the passage of fatty stools
What three factors can lead to both venous and arterial thrombosis?
Endothelial injury, stasis, and a hypercoaguble state
Where do most venous thromboses occur?
Deep veins of the legs
If a patient is immobilized such as a cervical traction, what is the most likely risk factor for deep venous thrombosis?
Stasis
What term refers to bleeding into the joint cavity? What clinical finding would be expected?
Hemarthrosis. It is associated with joint swelling. If repeated bleeding occurs, deformities may arise and the joint mobility may be limited
What complication of hempohilia can lead to deformities?
Hemarthrosis. It is associated with joint swelling. If repeated bleeding occurs, deformities may arise and the joint mobility may be limited
What is Hematocephalus?
An intracranial infusion of blood.
What are possible causes of Hypovolemic shock?
Hemorrhage, Fluid Loss from Severe Burns, Diarrhea, Excessive Urine Formation, Perspiration Trauma