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RUSVM Pathology I JB1 > Circulatory Disturbances > Flashcards

Circulatory Disturbances Flashcards

1
Q

Ground substance of ECM consists of

A

Glycoproteins (Fibronectin and Laminin), Glycosaminoglycans, Proteoglycans, etc

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2
Q

Edema can be classified as

A

Inflammatory

Non-Inflammatory

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3
Q

Water distribution between plasma and interstitium is primarily determined by

A

Hydrostatic and Osmotic pressure differences between the two compartments

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4
Q

Thrombosis

A

Clot (thrombus) forms within a vessel which is not injured or only mildly injured

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5
Q

Endothelin released from vascular endothelium has what effect

A

Vasoconstriction

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6
Q

Coagulation Factors

A

Plasma proteins produced by the liver

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7
Q

Interstitial fluid accounts for ________% of total water weight

A

15%

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8
Q

Starling Equation

A

Illustrates the role of hydrostatic and osmotic forces in the movement of fluid across capillary membranes

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9
Q

Common name for this disease

A

“Mulberry Heart Disease”

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10
Q

Nutmeg Liver

A

Appearance of the parenchyma with animal suffering from chronic hepatic congestion

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11
Q

Coagulation Cascade

A

Amplifying series of enzymatic conversions; each step proteolytically cleaves an inactive proenzyme into an activated enzyme, culminating in thrombin formation

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12
Q

Histological appearance of what circulatory disorder

A

Edema

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13
Q

Interstitium is composed of

A

Extracellular Matrix (ECM)

Supporting Cells

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14
Q

Condition

A

Submandibular edema

_______________________

“Bottle Jaw”

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15
Q

Fat Embolsim can be the result of

A

long bone fractures

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16
Q

Pericardial Effusion

A

“Mulberry Heart Disease”

Inflammatory edema

Fibrin strands and cloudy appearance of pericardial fluid

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17
Q

Cardinal signs of inflammation

A

Reddening - Rubor

Edema - Tumor

Heat - Calor

Pain

Loss of Function

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18
Q

Example of what circulatory disturbance

A

Edema

________________

Inflammatory Edema

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19
Q

Pathogenesis of septic shock

A
  1. Endotoxin - producing gram negative bacilli
  2. LPS and other microbial substances induce injury and activation of the vascular endothelium
  3. Stimulate WBCs to release cytokines
  4. Vasodilation and prothrombotic diathesis
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20
Q

Describe what happens during the primary hemostasis step of normal hemostasis

A
  • Endothelial injury exposes highly thrombogenic subendothelial ECM allowing platetlets to adhere and be activated
  • Activation of platelets results in a dramatic shape change and release of secretory granules lead to further platelet aggregation to form the primary hemostatic plug
  • Secreted products recruit additional platelets
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21
Q

Hemostasis

A

Arrest bleeding by physiological properties of vasoconstriction and coagulation or by surgical means

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22
Q

Anti-coagulation factors secreted by endothelium

A

Prostacylin

Nitric Oxide

Tissue Plasminogen Activator (tPA)

Thrombomodulin

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23
Q

Condition

A

Hydrothorax

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24
Q

Gingivitis and blood shot eyes are an example of what circulatory disturbance

A

Hyperemia

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25
Q

Pro-coagulation factors secreted by endothelium

A

Thromboplastin

Platelet Activation Factor (PAF)

Von Willebrand Factor

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26
Q

Describe what happens during the secondary hemostasis step of normal hemostasis

A
  • Tissue factor is exposed at the site of injury
  • Thrombin cleaves circulating fibrinogen into soluble fibrin creating a fibrin meshwork deposition
  • Thrombin also induces further platelet recruitment and granule release
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27
Q

Venous Infarcts

A

Intensely hemorrhagic as blood backs up into the affected tissue behind the obstruction

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28
Q

In which direction does hydrostatic pressure move fluid?

A

Moves fluid out of vasculature

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29
Q

Classification of hemorrhage

A

Paintbrush hemorrhage

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30
Q

Describe the basic mechanism of normal hemostasis

A
  1. Vasoconstriction
  2. Primary hemostasis
  3. Secondary hemostasis
  4. Thrombus and antithrombotic events
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31
Q

Example of what circulatory distrubance

A

Edema

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32
Q

Hemothorax

A

Blood in the thoracic cavity

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33
Q

Condition

A

Colonic Torsion

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34
Q

Increased blood hydrostatic pressure can be the result of

A

Generalized - Right sided CHF

Localized - Tightly bandaged limb resulting in venous occlusion

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35
Q

Role of vascular endothelium in hemostasis

A
  • Anti-thrombotic and pro-fibrinolytic in normal state
  • Pro-thrombotic and anti-fibrinolytic during injury
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36
Q

Hemorrhage by Rhexis

A

Due to a substantial rent or tear in the vascular wall (or heart)

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37
Q

Example of what circulatory disturbance?

A

Hemorrhage

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38
Q

Iron (Perl’s) Stain

A

Highlights hemosiderin - laden macrophages within alveoli

_____________________

Stains blue

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39
Q

Pathological hyperemia is usually caused by

A

Inflammation

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40
Q

Substances released from vascular endothelium that modulate perfusion

A

NO

Endothelin

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41
Q

Types of hyperemia

A

Physiological

Pathological

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42
Q

Condition - Fibrin thrombi within glomerular capillaries

A

Disseminated Intravascular Coagulation (DIC)

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43
Q

Describe the histologic appearance of edema

A
  • Clear or pale eosinophilic staining
    • Dependent on inflammatory vs non-inflammatory
  • Spaces distended
  • Blood vessels filled with RBC
  • Lymphatics dilated
  • Collagen bundles separated
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44
Q

Difference betwen hemorrhage and hyperemia/congestion

A

Hemorrhage the blood is outside the vessel wall

Hyperemia/Congestion the blood is within the blood vessels

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45
Q

Tissue Factor - Factor III-Thromboplastin

A

Membrane bound procoagulant glycoprotein synthesized by endothelium. Acts in conjunction with Factor VII as the major in vivo pathway to activate the coagulation cascade, eventually culminating in thrombin

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46
Q

Nitric Oxide when released from vascular endothelium has what effect

A

Relaxation and vasodilation

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47
Q

Hemoptysis

A

Coughing up of blood or blood-stained sputum from the lungs or airways

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48
Q

End results of shock

A

Hypotension

Impaired tissue perfusion

Cellular hypoxia

DIC and multi-organ system failure

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49
Q

Thrombosis

A

Formation or presence of a solid mass within the cardiovascular system

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50
Q

Secretory granules secreted during primary hemostasis

A

ADP and TXA2

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51
Q

Thrombomodulin

A

Has anticoagulent activity

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52
Q

Structural molecules of the ECM include

A

Collagen, Reticulin and Elastic Fibers

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53
Q

Edema

A

Abnormal accumulation of excess extracellular water in interstitial spaces or in body cavities

_____________________

Fluid is outside both vascular fluid compartment and cellular fluid compartment

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54
Q

Thromboplastin

A

Promotes blood coagulation

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55
Q

Disseminated Intravascular Coagulation (DIC)

A

Systemic reaction in which there is generalized activation of the blood coagulation system

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56
Q

Etiology

A

Histophilus somni infection

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57
Q

Pathological form of hemostasis is

A

Thrombosis

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58
Q

Example of what circulatory disturbance

A

Thrombosis

___________________

Saddle Thrombosis

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59
Q

Acute Respiratory Distress Syndrome (ARDS)

A

Sudden, diffuse and direct - increase in vascular permeability.

High fatality rate

Pneumonia if animal survives

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60
Q

Clinical significance of hemorrhage is determined by

A

location and severity

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61
Q

Hydrothorax

A

Fluid in the thoracic cavity

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62
Q

Condition

A

Chronic Hepatic Congestion

_______________________

Nutmeg Liver

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63
Q

Example of what circulatory disturbance

A

Congestion

_________________

Pulmonary congestion

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64
Q

Tissue Plasminogen Activator (tPA)

A

Regulates fibrinolysis

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65
Q

Describe what happens during the vasoconstriction step of normal hemostasis

A
  • Brief period of arteriolar vasoconstriction occurs mostly as a result of reflex neurogenic mechanism
  • Augmented by local secretions of factors such as endothelin
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66
Q

Example of circulatory disturbence

A

Edema

___________________

Pitting Edema

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67
Q

Example of what circulatory disturbance

A

Thrombosis

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68
Q

Condition

A

Pulmonary Edema

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69
Q

Extracellular Matrix is composed of

A

Structural molecules

Ground substance

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70
Q

Decreased plasma colloid osmotic pressure can be the result of

A
  • Proteins not absorbed from diet
  • Proteins not produced
  • Protein loss
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71
Q

Congestion

A

Passive venous engorgement - blood is not oxygenated

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72
Q

Embolus

A

Any detacehed intravascular mass which is carried by the blood to a site distal to the point of origin

73
Q

Most water leakage occurs in capillaries or post-capillary venues because they have

A

Semi-permeable membrane wall that allows water to move more freely than proteins

74
Q

Non inflammatory pulmonary edema can be the result of

A

Left Sided Congestive Heart Failure (CHF)

75
Q

Pathogenesis of thrombosis

A
  1. Endothelial injury
  2. Alteration in blood flow - turbulence or stasis
  3. Hypercoagulability
    1. Increase coagulation factors
    2. Decrease coagulation inhibitors
76
Q

Transcellular Fluid accounts for _______% of total water weight

A

5%

77
Q

Hemarthrosis

A

Blood within a joint space

78
Q

Classification of hemorrhage

A

Ecchymosis

79
Q

This condition is caused by

A

Copper deficiency

80
Q

Describe the fluid in non-inflammatory edema

A

“Protein Poor”

Low protein content ( <30g/L)

Low specific gravity ( < 1.025)

Low cellularity ( < 1.5x109L)

Less than 1500 cells per uL

81
Q
A

Epistaxis

82
Q

Classification of hemorrhage

A

Suffusive Hemorrhage

83
Q

Example of what circulatory disturbance?

A

Congestion

84
Q

Hemorrhage by Diapedesis

A

Hemorrhage due to a small defect in the vessel wall or RBCs passing through the vessel wall in cases of inflammation or congestion

85
Q

Classification of hemorrhage

A

Agonal Hemorrhages

86
Q

Example of what circulatory disturbance?

A

Congestion

87
Q

Paint Brush Hemorrhage

A

Looks like if red paint was hastily applied with a paint brush - most common on mucosal and serosal surfaces

88
Q

Example of what circulatory disturbance

A

Congestion

89
Q

Embolism

A

Pieces of a thrombus break off from the original mass and sail downstream to lodge at a distant site

90
Q

Hyperemia

A

Increase of arteriole mediated engorgement of the vascular bed - blood is oxygenated

91
Q

Ascites (Hydroperitoneum)

A

Fluid (transudate) within the peritoneal cavity

92
Q

Chronic pulmonary edema causes

A

Alveolar walls to become thickened - fibrosis

Congestion, micro-hemorrhages and accumulation of heart failure cells

93
Q

Nitric Oxide

A

Causes vasodilation, inhibits platelet adhesion and aggregation

94
Q

Prostacylin

A

Causes vasodilation, inhibits platelet aggregation

95
Q

Condition

A

Dissecting aneurysm

96
Q

Tissue Edema results from what in regards to starling pressures

A

Increased hydrostatic pressure

Decreased osmotic pressure

97
Q

Shock caused by blood maldistribution can be due to

A

Anaphylactic - Type I Hypersensitivity

Neurogenic

Septic

98
Q

Pathomechanisms of Edema

A
  • Increased blood hydrostatic pressure
  • Decreased plasma colloid osmotic pressure
  • Lymphatic obstruction
  • Increased vascular permeability
99
Q

This condition is usually the result of what?

A

Heart failure and associated edema

100
Q

Condition

A

Gastric Volvulus (Torsion)

101
Q

Endothelin

A

Potent endothelium - derived vasoconstrictor

102
Q

Pitting Edema

A

Pressure is applied to an area of edema a depression or dent results as excessive intersitial fluid is forced to adjacent areas

103
Q

Key players in the regulation of homeostasis, as the balance between anti and prothombotic activities of endothelium determines whether thrombus formation propagation or dissolution occurs

A

Endothelial Cells

104
Q

In which direction does osmotic pressure (of plasma protein) move fluid?

A

Moves fluid into the vasculature

105
Q

Condition

A

Pericardial Effusion

106
Q

Hemopericardium leads to

A

Fatal Cardiac tamponade

107
Q

Epistaxis

A

Bleeding from the nose

108
Q

Pulmonary congestion is usually the result of

A

Heart failure - associated with edema

109
Q

What happens at the conclusion of the coagulation cascade

A

Thrombin converts the soluble plasma protein fibrinogen into fibrin

110
Q

Hemoperitoneum

A

Blood in the peritoneal cavity

111
Q

Cardiogenic Shock

A

Failure of the heart to maintain normal cardiac output

112
Q

Example of what circulatory disturbance

A

Thrombus

_______________________

Mural thrombus

113
Q

Example of what kind of embolism

A

Fat Embolism

114
Q

Describe the gross appearance of edema

A

Wet

Gelatinous and heavy

Swollen organs

Fluid weeps from cut surfaces

May be yellow

115
Q

Example of what circulatory disturbance

A

Edema

116
Q

Inflammatory Edema

A

Increased vascular permeability - refers to as an exudate

117
Q

Total body water is _______% of total body weight

A

65%

118
Q

Submandibular Edema

A

“Bottle Jaw”

Commonly associated with sever GI parasitism and hypoproteinemia in sheep

119
Q

Suffusive Hemorrhage

A

Larger than ecchymosis and contiguous.

120
Q

Example of what circulatory disturbance?

A

Thrombosis

121
Q

Describe what happens in the thrombus and antithrombotic event step of normal hemostasis

A
  • Polymerized fibrin and platelet aggregates form a solid permanent plug to prevent any additional hemorrhage
  • Counter regulatory mechanisms and thrombomodulin are set into motion to limit the hemostatic plug to the site of injury
122
Q

Thrombus

A

Aggregate of platelets, fibrin and entrapped blood cells. Can result in occlusion of the vascular lumen and embolism. It is adhered to the vascular wall as opposite to blood clot

123
Q

Hypovolemic Shock

A

Fluid loss due to hemorrhage, vomiting, diarrhea

124
Q

Causes of physical hyperemia

A
  • Digestion
  • Exercise
  • Dissipation of heat
  • Neurovascular - facial hyperemia (blushing)
125
Q

Agonal Hemorrhages

A

Petechiae and ecchymoses associated with terminal hypoxia

126
Q

Hemorrhage

A

Escape of blood from the blood vessels

127
Q

Components necessary for normal hemostasis or thrombosis

A

Vascular wall

Platelets

Coagulation cascade

128
Q

Pathogenesis of Gastric Volvulus (Torsion)

A
  • Twisting of vessels obstructs gastric veins
  • Severe venous congestion (acute, local)
  • Ischemia (necrosis)
  • Loss of endothelial integrity
  • Hemorrhage
  • Shock
  • Death
129
Q

Platelet Activating Factor (PAF)

A

Causes activation of platelets and neutrophils

130
Q

Plasma accounts for ______% of total water weight

A

5%

131
Q

Intracellular Fluid accounts for _________% of total water weight

A

40%

132
Q

The Circulatory System consists of

A

blood, a central pump, blood distribution and collection networks, and a system for exchange of nutrient and waste products between blood and extravascular tissue.

133
Q

Pathogenesis of Nutmeg Liver

A
  • Low grade chronic hypoxia
  • Increased pressure of centralobular hepatocytes
  • Atrophy
  • Necrosis
134
Q

Chronic pulmonary edema is most commonly associated with

A

Cardiac failure

135
Q

Anasarca

A

Generalized edema with profuse accumulation of fluid within the subcutaneous tissue

136
Q

Von Willebrand Factor

A

Promotes platelet adhesion and activation of blood coagulation

137
Q
A

Hemoptysis

138
Q

Clinical significance of edema dependent on

A

Extent

Location

Duration

139
Q

What is the stain being used? What does it stain?

A

Iron (Perl’s) Stain

Hemosiderin-laden macrophages - “Heart Failure Cells”

140
Q

Hemostasis

A

Arrest bleeding by physiological or surgical means

141
Q

Clinical significance of edema

A

Tissue may become firm and distorted due to an increase in fibrous connective tissue after prolonged edema

142
Q

Heart Failure Cells

A

Hemosiderin - laden macrophages

Characteristic of left sided CHF

143
Q

Example of what circulatory disturbance

A

Congestion and Edema

144
Q

Condition

A

Intestinal volvulus

145
Q

T/F: There are infectious causes of thromosis/ thromboembolism

A

True

______________________

Bacterial valvular endocarditis

Thrombotic Meningioencephalitis

146
Q

Ecchymosis

A

Larger than petechia (up to 1 or 2 cm) as seen in bruise (contusion) or small hematoma

147
Q

Homeostasis

A

A tendency to stability in the normal body states

148
Q

Possible outcomes to thrombi

A

Lysis

Propagation

Embolization

Organization/ recanalization

149
Q

Classification of hemorrhage

A

Petechia

150
Q

Non-inflammatory Edema

A

Edema of CHF or liver failure, etc - refers to as a transudate

151
Q

This condition is usually the result of

A

Right sided congestive heart failure

152
Q

Infarction

A

Localized area of ischemic necrosis in a tissue or organ caused by occlusion of either the arterial supply or the venous drainage

153
Q

Describe the fluid in inflammatory edema

A

Protein rich ( > 30g/L)

Specific Gravity ( > 1.025)

Total nucleated cells ( < 7x109L)

Less than 7000 cells per uL

154
Q

Example of what circulatory disturbance

A

Infarction

155
Q

Types of shock

A

Cardiogenic Shock

Hypovolemic Shock

Blood Maldistribution

156
Q

Causes of hemorrhage

A

Trauma

Sepsis, viremia, bacteremia, toxic conditions

Abdominal neoplasia may lead to hemoperitoneum

Coagulation abnormalities

157
Q

Example of what circulatory disturbance?

A

Hemorrhage

158
Q

Subactue to chronic hepatic congestion is usually the result of

A

Right Sided Heart Failure

159
Q

What stain is being used? What does it stain?

A

HE-Stain

Brown pigment staining the cytoplasm of alveolar macrophages

160
Q

Condition

A

Thrombotic Meningoencephalitis (TME)

161
Q

Example of what circulatory disturbance

A

Edema

162
Q

Petechia

A

Up to 1-2mm in size, especially found on skin, mucosal and serosal surfaces

163
Q

Hemorrhagic Diathesis

A

Increased tendency to hemorrhage from usually insignificant injuries

164
Q

Inflammatory pulmonary edema can be the result of

A

Damage to pulmonary capillary endothelium

165
Q

Example of what circulatory disturbance

A

Infarction

_____________________

Arterial Infarct

166
Q

Shock - Cardiovascular Collapse

A

Final common pathway for a number of potentially lethal clinical events. Gives rise to systemic hypoperfusion.

167
Q

Describe the process of hematoma resolution

A

Hemoglobin (red/blue) enzymatically converted to bilirubin (blue/green) and eventually into hemosiderin (gold/brown)

168
Q

Verminous Thrombosis

A

Thrombus formation in the cranial mesenteric artery of horses with Strongylus vulgaris infection

169
Q

Role of vascular endothelium in inflammation

A
  • Regulate the traffic of inflammatory cells
  • Produce pro-inflammatory cytokines
  • Control angiogenesis and tissue repair
170
Q

Condition

A

Subacute Hepatic Congestion

______________________

“Nutmeg Liver”

171
Q

Condition

A

Pulmonary Edema

172
Q

Interstitium

A

Space between tissue compartments - microcirculation and the cells. Medium through which all metabolic products must pass between the micocirculation and the cells

173
Q

Describe an arterial Infarct lesion

A

Initially hemorrhagic but become pale as the are of coagulation necrosis becomes eviden

174
Q

Condition

A

Ascites or Hydroperitoneum

175
Q

Example of what circulatory disturbance

A

Congestion

176
Q

Condition

A

Hepatic Congestion

177
Q

Pathogenesis

A

Twisting of vessels obstructs gastric veins → severe venous congestion (acute,local, congestion) → ischemia (necrosis → loss of endothelial integrity → hemorrhage → shock → death

178
Q

Example of what circulatory distrubance

A

Thrombosis

_______________________

Verminous thrombosis

179
Q

Example of what circulatory disturbence

A

Edema

RUSVM Pathology I JB1 (18 decks)

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