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General Pathology > Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock > Flashcards

Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock Flashcards

1
Q

This is the active process of increasing blood volume within tissues. It is done by arteriolar dilation, causes tissue erythema (redness), and results from inflammation or exercise.

A

Hyperemia

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2
Q

This is the passive process of increasing blood volume within tissues. It is done by decreasing venous outflow, causes tissue cyanosis (blue), and results from venous obstruction.

A

Congestion (congestive heart failure, DVT (deep vein thrombosis), testicular torsion)

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3
Q

This this type of congestion is characterized by alveolar capillary engorgement, edema, and hemorrhage.

A

Acute pulmonary congestion (Acute respiratory distress syndrome (ARDS))

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4
Q

This type of congestion is characterized by the alveolar septa becoming fibrotic and the presence of alveolar macrophages and hemosiderin (“heart failure cells”)

A

Chronic pulmonary congestion (congestive heart failure (CHF))

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5
Q

This type of congestion is characterized by a “nutmeg liver”, steatosis, fibrosis (cirrhosis), hemorrhage, and necrosis.

A

Congestive hepatophy (hepatic congestion (CHF)

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6
Q

This is an abnormal accumulation of interstitial fluid within tissues or cavities.

A

Edema

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7
Q

What are the two opposing forces involved in fluid balance?

A
  • Hydrostatic pressure: BP, pushes H2O out

- Osmostic pressure: plasma proteins, pulls H2O in

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8
Q

An increase in this type of pressure is characterized by an increased intravascular pressure most likely caused by impaired venous return.

A

Hydrostatic pressure

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9
Q

This is determined by plasma proteins, specifically albumin. It can be caused by a decrease in albumin production (cirrhosis, hepatitis) or increased loss of albumin (nephrotic syndrome).

A

Reduced plasma osmotic pressure (leads to generalized edema)

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10
Q

What are some additional causes of edema?

A
  • Lymphatic obstruction (lymphedema)
  • Retention of sodium
  • Inflammation
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11
Q

What are the features of edema?

A
  • It can occur in any tissue
  • Decrease in wound healing
  • May indicate pathology (inflammation, left ventricular failure, renal failure, cerebral edema)
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12
Q

This type of edema is characterized by transudate (protein-poor) fluid and no osmosis.

A

Pitting edema

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13
Q

This type of edema is characterized by exudate (protein-rich) fluid and osmosis.

A

Non-pitting edema

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14
Q

This term is used to describe an extravasation of blood from vessels. External or internal bleeding.

A

Hemorrhage

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15
Q

This term is used to describe an accumulation of blood within tissue.

A

Hematoma

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16
Q

How is the severity of hemorrhage determined?

A
  • The extent and site of it

- Rate and volume of blood lost

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17
Q

This type of hemorrhage is often found in people with decreased platelets and Vitamin C. The areas are often 1-2 mm large.

A

Petechiae

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18
Q

This type of hemorrhage is caused by trauma, vasculitis, fragile vessels, or Kaposi sarcoma (AIDS). The areas are often 3-5 mm large.

A

Purpura

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19
Q

This type of hemorrhage often starts off with a reddish/blue color due to the presence of hemoglobin, transitions to a greenish color as hemoglobin is broken down into bilirubin, and then a yellowish color as bilirubin is broken down into hemosiderin. The areas are typically 1-2 cm large.

A

Ecchymosis

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20
Q

This term is used to describe clot formation inside a vessel.

A

Thrombosis

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21
Q

What three factors compose virchow’s triad?

A

Endothelial injury, abnormal blood flow, and hypercoagulability

22
Q

These types of thrombi occur at the site of injury and grows against the flow of blood. They can result in infarction.

A

Arterial thrombi

23
Q

These types of thrombi occur at the site of stasis and grow in the direction blood flow. They can result in congestion, tenderness, and pitting edema.

A

Venous thrombi

24
Q

These types of thrombi occur on the heart valves and can either be sterile or infective (bacteria, fungi).

A

Vegetations

25
Q

What are some factors that contribute to an acquired version of clotting disorders?

A

Smoking, pregnancy, obesity, irregular heart valves, immobilization, trauma/surgery, etc.

26
Q

What are some inherited mutations that result in coagulation disorders?

A
  • Factor V (decreases antithrombotic)

- Prothrombin (increases thrombotic)

27
Q

This term is used to describe an obstruction of a vessel by a thrombosis.

A

Thromboembolism

28
Q

This is a detached intravascular mass, which travels throughout the system until it becomes lodged and occludes a vessel.

A

Embolism (clinically silent and lethal)

29
Q

What are some examples of solid, liquid, and gaseous emboli?

A

Solid: fat (marrow), plaque debris, tumor fragment
Liquid: amniotic fluid (labor)
Gaseous: nitrogen (decompression/caisson disease), air (needle)

30
Q

This condition is due to an embolic occlusion of a pulmonary artery. 95% are caused by deep vein thrombosis in the femoral vein.

A

Pulmonary embolism

31
Q

What are some risks of pulmonary emboli?

A
  • Previous pulmonary emboli
  • Bedrest
  • Burns
  • Surgery (knee, hip)
32
Q

Systemic thromboemboli are within what system? Arterial or Venous?

A

Arterial system

33
Q

80% of systemic thromboemboli arise from what type of thrombi?

A

Cardiac mural (wall) thrombi

34
Q

What are some other causes of systemic thromboemboli?

A
  • Aortic aneurysm

- Atheromas (any artery)

35
Q

What is the fate of thrombi?

A

They enlarge (propagation), embolize, dissolve, organize (ingrowth of cells), and recanalization

36
Q

This term is used to describe emboli which cross from the venous system to the arterial system.

A

Paradoxical embolism

37
Q

What are some origins of paradoxical emboli? What can they cause?

A

Origins:

  • Originates as a deep vein thrombosis
  • Crosses to the arterial system through Atrial or ventricular septal defect

Results in stroke

38
Q

This term is used to describe vascular occlusion, which can eventually lead to ischemia and necrosis.

A

Infarction

39
Q

What is the severity of infarction determined by?

A
  • Rate
  • Tissue type
  • Collateral blood supply
40
Q

What are the categories of infarction?

A
  • Red (hemorrhagic): organs which have collateral blood supplies
  • White (anemic): organs which do not have collateral blood supplies
41
Q

These cells produce platelets.

A

Megakaryocytes

42
Q

What is the traditional definition of shock?

A

Peripheral vasoconstriction

43
Q

This is the common final pathway for mortal injury. Causes can be hemorrhage, trauma, burns, myocardial infarction, pulmonary embolism, and sepsis.

A

Shock

44
Q

This category of shock is characterized by the heart failing to pump blood to the rest of the body. Caused by myocardial infarction, arrhythmia, and cardiac tamponade.

A

Cardiogenic shock

45
Q

This category of shock is characterized by a loss of blood/plasma. Caused by hemorrhage, severe burns, dehydration.

A

Hypovolemic shock

46
Q

Both cardiogenic and hypovolemic shock cause traditional signs and symptoms of shock, which are…

A

Cyanosis (cool/clammy) and sympathetic nervous system stimulation

47
Q

What are the traditional features of shock?

A
  • Cyanosis
  • Decreased urine output
  • Increased respiratory rate
  • Decreased level of conciousness
  • Hypotension
  • Release of aldosterone
  • Constriction of splanchnic vessels
48
Q

This type of shock is characterized by a systemic immune reaction and is often due to infection.

A

Septic shock

49
Q

This type of shock is characterized by a depression of the medulla or SNS ganglia, severe vasodilation, syncope, and bradycardia. It is most often a result of CNS trauma, spinal anesthesia, and adverse drug reactions.

A

Neurogenic shock

50
Q

This type of shock is characterized by severe vasodilation and bronchoconstriction and is most often a result of allergies (IgE-mediated).

A

Anaphylactic shock

51
Q

What are some treatments for shock?

A
  • Defibrillation, CPR, limit blood loss, I.V. fluid replacement
  • Elevate legs, increase fluid volume, vasoconstrictive meds
52
Q

What are the stages of progressive, multiorgan failure?

A

1) Nonprogressive: compensatory mechanisms
2) Progressive: hypoperfusion, anaerobic metabolism
3) Irreversible: severe cell/tissue damage

General Pathology (7 decks)

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