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Basic Human Pathology > Ch 4: Hemodynamic Disorders > Flashcards

Ch 4: Hemodynamic Disorders Flashcards

1
Q

define hemostasis

A

blood clotting at the site of an injury

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2
Q

define edema

A

accumulation of fluids in the tissues

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3
Q

define effusions

A

accumulation of fluids in cavities

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4
Q

what are the two main conditions that cause an increase in hydrostatic pressure and therefore edema

A

deep vein thrombosis
congestive heart failure

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5
Q

define peau d-orange breast cancer

A

blockage of subareolar lymphatics due to cancer
causes the breast to appear like an orange

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6
Q

what are the three most common sites for edema

A

subcutaneous tissues
lungs
brain

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7
Q

what is non-pitting (dependent) edema

A

accumulation of protein rich fluid

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8
Q

what is pitting edema

A

accumulation of protein poor fluid

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9
Q

what are interlobular septal markings in a lung indicative of

A

edemic change
likely excess fluid in the lymphatics that present with severe pulmonary edema

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10
Q

define hydrothorax

A

effusion in pleural cavity

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11
Q

define hemothorax

A

effusion in pleaural cavity containing blood

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12
Q

define hydropericardium or pericardial effusion

A

effusion in pericardium

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13
Q

define hemopericardium

A

effusion into the pericardium containing blood

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14
Q

define hydroperitoneum

A

effusion into the peritoneal cavity (ascites)

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15
Q

define hemoperitoneum

A

effusion into the peritoneal cavity containing blood

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16
Q

what is hyperemia

A

arteriolar dilation causes increased blood flow
tissue appears red due to engorgement of oxygenated blood (erythema)

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17
Q

what is congestion

A

impaired outflow of venous blood from tissue
tissue spreads a blue-red color (cyanosis) due to deoxygenated hemoglobin

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18
Q

what is “nutmeg liver”

A

chronic passive congestion of the liver
shows central congestion with hemorrhagic necrosis

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19
Q

what are the three required things for each step in the coagulation cascade

A

enzyme
substrate
cofactor

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20
Q

what is Coumadin used as

A

anticoagulant

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21
Q

what is vitamin K used as

A

cofactor

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22
Q

disorders of primary hemostasis affect what

A

platelets

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23
Q

what is affected in disorders of secondary hemostasis

A

clotting factors

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24
Q

what are the two vWF deficiency disorders

A

von Willebrand disease
Bernard-soulier syndrome

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25
Q

what are three factors that affect platelet adhesion

A

platelet changes shape from disc to spike
platelet releases granular contents
platelet aggregate

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26
Q

mutations in which clotting factor lead to hemophilia A

A

clotting factor 8

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27
Q

what does the prothrombin time (PT) test do

A

coagulation test that assess factors 2, 5, 7, 10, and fibrinogen

28
Q

what does the partial thromboplastin time (PTT) test do

A

coagulation test that assess factors 2, 5, 8, 9, 10, 11, 12, and fibrinogen

29
Q

define hematoma

A

extravasated blood creates palpable mass of blood

30
Q

what is henoch-schonlein purpura

A

deposition of circulating immune complexes within vessels
small blood vessels in your body become inflamed and bleed

31
Q

what is factor 5 leiden

A

most common inherited hypercoagulability disorder
protein C resistance and mutation in single nucleotide

32
Q

what is prothrombin gene mutation

A

second most common inherited hypercoagulative disorder
elevated prothrombin levels due to G nucleotide substitution for A
increases risk of venous emboli

33
Q

what is heparin-induced thrombocytopenia (HIT) syndrome

A

adverse drug reaction caused by emergence of antibodies that activate platelets
unfractionated heparin is given
PF4 is released and binds to the heparin
this complex causes release of IgG which then binds to this complex
new complex binds to Fc receptor and platelet which causes it to be removed

34
Q

what is anti-phospholipid antibody syndrome

A

immune system mistakenly attacks proteins in the blood

35
Q

what are lines of Zahn

A

grossly apparent laminations of thrombi
caused by platelet and fibrin layers alternating with darker red-cell rich layers

36
Q

what are arterial (white) thrombi

A

usually occlusive
caused by endothelial injury which leads to platelet activation
clot is under endothelial cells
clot has lots of fibrin and platelets

37
Q

what are venous (red) thrombi

A

not usually occlusive (completely blocking the vessel)
form long cast that is prone to give rise to emboli
have more enmeshed (tangled) red cells
usually occur in lower extremities

38
Q

what’s the main difference between a post and pre-mortem thrombus

A

a pre-mortem thrombus will be tightly adherent to the vessel wall

39
Q

what is a mural thrombus

A

a thrombus that occurs in the heart chambers or in the aortic lumen
in heart: caused by abnormal heart contraction or heart injury
in aorta: caused by atherosclerotic plaques and dilation

40
Q

what are vegetations

A

thrombi on heart valves

41
Q

what is infective endocarditis

A

bacterial or fungal bloodborne infections cause valve damage
leads to development of large thrombotic masses
vegetations (thrombi on heart valves) are surrounded by bacteria and platelet/fibrin layers

42
Q

what is nonbacterial thrombotic endocarditis

A

sterile vegetations that develop on noninfected valves in hypercoagulable states

43
Q

what is propagation of a thrombus

A

when an older thrombus enlarges through the accumulation of additional platelets and fibrin
bigger size increases chances for vascular occlusion or embolization

44
Q

what is embolization of a thrombus

A

part of all of the thrombus is dislodged and transported elewhere in the vasculature

45
Q

what is dissolution/resolution of a thrombi

A

newly formed thrombi activates fibrinolytic factors that cause it to rapdily shrink and breakdown
older thrombi are more resistant to dissolving

46
Q

what is recanalization of a thrombus

A

the body makes channels within the thrombus to reestablish the continuity of the original lumen

47
Q

what are three endovascular interventions

A

clot busting drugs
angioplasty
inferior vena cava filter

48
Q

what is disseminated intravascular coagulation (DIC)

A

widespread thrombosis within the microcirculation that may be of sudden or insidious onset
platelets and coagulation proteins are consumed which leads to excessive clotting and bleeding that may co-exsist

49
Q

define embolus

A

detached intravascular mass carried by the blood from its point of origin to a distant site

50
Q

what are solid thrombi made of

A

cholesterol, atherosclerotic debris, or tumor

51
Q

what are liquid thrombi made of

A

fat droplets or bone marrow

52
Q

what are gaseous thrombi made of

A

air/nitrogen

53
Q

what does systemic embolization lead to

A

ischemic necrosis of downstream tissues

54
Q

what does pulmonary embolization lead to

A

hypoxia, hypotension, and right sided heart failure

55
Q

what is a pulmonary thromboembolism

A

pulmonary embolus that originates from a deep vein thrombus and travels through the right side of the heart before arresting in the lungs
kills about 100,000 people each year in the US

56
Q

what is a saddle embolus

A

embolic occlusion at the bifurcation of the main pulmonary artery

57
Q

what is a fat embolus

A

fat thrombus caused by injury, fractures, or resuscitation
typically presents with restlessness and trouble breathing

58
Q

what is an amniotic fluid embolism

A

a rupture of the amniotic membrane causes amniotic fluid to get into the maternal circulation
leads to shock and neurologic defects
80% mortality rate

59
Q

what is an air embolism

A

gas bubbles within the circulation
ex. during laparoscopic procedures or scuba divers

60
Q

what is decompression illness

A

caused by intra or extravascular bubbles that are formed as a result of reduction in environmental pressure

61
Q

what is caisson disease

A

persistence of gas emboli in the skeletal system
leads to ischemic necrosis
typically found in the femoral heads, tibia, and humeri

62
Q

what is infarction

A

area of ischemic necrosis caused by occlusion of the vascular supply to the affect tissue
typically occurs in the heart or brain

63
Q

what is a red (hemorrhagic) infarct

A

caused by a venous occlusion
blood collects in infarcted zone
ex. testicular torsion

64
Q

what is a white (anemic) infarct

A

arterial occlusion in solid organs with end-arterial circulations (heart, spleen, and kidney)

65
Q

what is the typical shape and location of an infarct

A

wedge shaped with the occluded vessels being at the apex and the organ periphery

66
Q

what causes cardiogenic shock

A

low cardiac output as a result of myocardial pump failure

67
Q

what causes septic shock

A

triggered by microbial infections and is associated with severe systemic inflammatory response (SIRS)

Basic Human Pathology (18 decks)

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