Circulatory & Hemodynamic disorder Flashcards
What is edema?
H2O shifts from intravascular / intracellular to the interstitial space
What is hyperemia?
Active increase in flow
What is congestion?
Decreased out flow
Increased venous hydrostatic pressure
What is hemostasis?
A physiological response to seal an injured vessel and prevent bleeding
What is thrombosis?
Blood clots that blocks blood flow
What is embolus?
Abnormal detached traveling intravascular mass
What is infarction?
Area of Necrosis after blood flow decreased
What is shock?
Cardiovascular collapse / failure of circulation
What is hydrostatic pressure?
Hydrostatic pressure is the force created the pumping of the heart that pushes plasma out to interstitial place
Arrange the following by highest hydrostatic pressure to lowest.
Arteries / Capillaries / Veins
Arteries > Capillaries > Veins
What is colloid osmotic pressure?
Colloid osmotic pressure is the force that holds water in the vessel, mainly by Albumin & sodium
Which factor mainly determines the difference between exudate and transudate?
Membrane permeability
Determine if the following factors has to increase or decrease in order to causes edema.
Vascular permeability
Intravascular hydrostatic pressure
Intravascular osmotic pressure
Lymphatic drainage
Vascular permeability (I)
Intravascular hydrostatic pressure (I)
Intravascular osmotic pressure (D)
Lymphatic drainage (D)
What is effusions?
Increased fluid in body cavities
What is anasarca?
Total body edema
What does left and right heart failure cause?
Left heart failure : Lung edema
Right heart failure : Ascites
Why causes cardiac edema?
And how to stop it?
Left heart failure
-> Lung edema
-> Right heart failure
-> Ascites
-> Reduced blood pressure in arteries
-> Renin - angiotensin
Drugs that promote urine production breaks the cycle of keeping fluid in the body
What causes hepatic edema?
Portal hypertension
Hypoalbuminemia : Reduce albumin production
What causes Renal edema?
Sodium retention
Glomerulopathy
->Leakage of protein through glomerulus
-> Hypoalbuminemia
Which bacteria could release toxin that destroy endothelial cells and causes exudate?
E. coli
What are the 5 types of congestions?
Acute local congestion
Chronic local congestion
Acute general congestion
Chronic general congestion
Hypostatic congestion
What causes acute local congestion?
Torsion
What happens where spleen had congestion before?
Spleen enlargement
Hemosiderin-laden macrophage
Brown induration ( Fibrosis )
Siderotic plaques
What causes chronic local congestion?
Tumor, abscess, cirrhosis (Hard liver)
What causes acute general congestion?
Acute heart failure
Hydrothorax
What causes chronic general congestion?
Chronic heart disease
What happens to Liver after right heart failed?
Liver congestion
Explain liver congestion
Vena cava congestion causes congestion in central vein
Central vein area receives less O2 than portal triad due to the presence of hepatic artery
What is the difference in lung between acute general congestion and chronic general congestion?
Acute general congestion : Lung edema
Chronic general congestion : Hemosiderin-laden macrophages
What are the 3 components for hemostasis?
Endothelium & ECM
Platelets
Coagulation factor
What are the 3 main groups of coagulative factor?
Contact group:
HMWK (High molecular weight kininogen)
Vitamin K dependent group
Fibrinogen group
What are the function of endothelium, normal (3) & after injury (2)
Normal
-> Anti - platelets
-> Anti - coagulant
-> Pro - fibrinolytic
After injury
-> Pro - thrombotic
-> Anti - fibrinolytic
Steps for hemostasis
Transient vasoconstriction
-> Reduce blood loss
Platelet aggregation
-> primary hemostasis
(ECM, platelets)
Coagulation to form mesh work of fibrin
-> Secondary hemostasis
(Endothelium, TF, platelets membrane, coagulative factors, Ca++)
Fibrinolysis to remove plug and repair
(Endothelium, Plasminogen -> Plasmin (removes fibrin) -> Thrombomodulin)
What are the 3 coagulation inhibitors?
Protein C - protein S - thrombomodulin system
Antithrombin lll binds on heparin sulfate
TFPI ( Tissue factor pathway inhibitor )
What are the 3 steps in fibrinolytic system?
tPA ( Tissue plasminogen activator )
-> Plasminogen => Plasmin
Degradation cross-link fibrin -> FDP ( Fibrin degradation products ) by plasmin
FDP inhibits thrombin & platelet aggregation
What are the 2 fibrinolytic inhibitors?
PAI -1 ( Plasminogen activator inhibitor -1 )
Antiplasmins
What are the 4 disorders of hemostasis?
Septicemic disease
Hepatic damage
Vitamin K related
Thrombocytopenia
What is the name of vitamin C related hemorrhage? And its mechanisms?
Scurvy
X Procollagen => Fibril
-> Weak vessels
What is the definition of hematoma?
Hemorrhage within organs
What is Warfarin poisoning?
Excessive amount of anticoagulant medication warfarin
Which disease causes cyanosis and hemorrhage in pigs?
African swine fever
What causes petechial hemorrhage in kidneys ( Turkey egg kidney )?
Hog Chloera ( Classical swine fever )
Why is arterial thrombus less life threatening than venous thrombus?
Arterial thrombus usually develops in the same direction as the blood flow due to the faster blood flow, this means that thrombus will be less likely to block the whole pathway
Why is arterial thrombus more pale than venous thrombus?
RBC within arteries are less likely to be caught within the thrombus due to faster blood flow
What is the line that alternates between fibrin and platelets found in early thrombus?
Line of Zahn
What mainly causes venous thrombus?
Chronic heart failure
What are the difference between thrombus and postmortem clotting?
Thrombus are attached to the wall of vessels so it is difficult to pull out
What is the different fate of small / medium / large thrombi?
Small : removed by fibrinolysis
-> plasmin
Medium : removed by phagocytosis
Large : fibroblast invasion + recanalization of capillaries
What is DIC?
Coagulation in all capillaries
Why does animals with DIC loses the ability to coagulate properly when there is a wound?
Coagulation factor are used all around the body so they are insufficient amount of them to coagulate properly
How to differentiate between DIC & amyloidosis in glomerulus?
Congo red staining for amyloid
Which of the following is a form of embolism?
Bacterial emboli
Tumor cell emboli
Fat / bone emboli
Air emboli
Parasitic emboli
Amniotic fluid
ALL :DDDD
Bacterial : Many many neutrophil
Fat / bone : Long bone fracture ( Cells in bone marrow get into blood after accidents)
Air : Dave the diver ( CO2 becomes air after leaving high pressure area )
Parasitic : Dirofilaria immitis
What are the two types of infarcts?
Hemorrhage & Anemia
What are the difference in color for hemorrhagic infarct & anemic infarct?
Red & White
Which 2 organs have dual vascular supply?
Lung, liver
Match the correct organ ( Lungs / Spleen / Kidney ) into ( Red infarct / White infarct ) and explain why.
Red infarct : Lung
White infarct : Spleen / Kidney
Lung has rich blood supply so when a vessel is blocked, blood supply is not completely cut off. However, blood will continue to enter the infarcted tissue ( Hemorrhage ) can causes a red appearance -> Red infarct
Spleen and kidney has a single dominant blood supply ( End arteries ), and if it is blocked, the lack of oxygenated blood -> White infarct
What 4 organs have end arteries?
Kidney, spleen, heart, brain
What are the 2 causes for red infarcts due to venous obstruction
Mass : Tumor, abscess
Torsion
What is the 2 similarities of splenic infarct and renal infarct?
End arteries obstruction
Triangular shape necrosis
Which parasite causes intestinal infarct?
Strongylus
What happens when cardiovascular collapse?
Shock
-> Systemic hypoperfusion of tissue
Which of the following are the causes of shock?
Hypovolemic
Cardiac
Septic & Toxic
Neurogenic
Anaphylatic
Hypovolemic : Vomiting, diarrhea
Cardiac : Chronic heart failure
(Both hypovolemic & cardiac : Lowered output)
Septic & Toxic : LPS, DIC
Neurogenic : Loss of vascular tone
Anaphylactic : IgE mediated vasodilation
What are the name of the two shock stages?
Non progressive / Compensated stage
Progressive stage
What are the mechanisms in compensated shock stage?
Release of catecholamines ( Sympathetic )
Activation of renin - angiotensin - aldosterone axis
-> Lower cardiac output -> Compensation from body ( Increase blood pressure, increase heart rate )
What are the effects from the mechanisms in compensated shock stage?
Tachycardia
Peripheral vasoconstriction
Cutaneous vasoconstriction
-> Pale skin color and cold skin
Renal fluid conservation
What happens in our body during progressive stage?
Tissue hypoperfusion
-> Hypoxia
—>Metabolic lactic acidosis
—–> Clumping of DNA
—–> Organelle damage
—–> Sudden vasodilation of capillaries
——-> Cardiac output (D even more)
What happens when irreversible shock stage?
Dead even hemodynamic defects are corrected
What are the order of shock?
Progressive, compensated, normal, irreversible
Normal > Compensated > Progressive > Irreversible
What happens with cardiac output in different shock stages?
Compensated (High)
Progressive (D)
Irreversible (byebye)
What happens with cardiac rate in different shock stages?
Compensated (High)
Progressive (High)
Irreversible (byebye)
What happens with vital perfusion in different shock stages?
Compensated (Normal)
Progressive (Normal)
Irreversible (byebye)
What happens with non vital perfusion in different shock stages?
Compensated (D)
Progressive (D)
Irreversible (byebye)
What happens with oxidative - phosphorylation in different shock stages?
Compensated ( Normal (high) )
Progressive (D)
Irreversible (byebye)
What happens with glycolysis in different shock stages?
Compensated ( Normal (low) )
Progressive (I)
Irreversible (byebye)
