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Tim's Cards > Clinical Pathology II > Flashcards

Clinical Pathology II Flashcards

1
Q

Define Shock:

A

Hypoperfusion of tissues with blood

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2
Q

What are the 3 mechanisms of shock (Hypoperfusion of tissues with blood)?

A

Pump Failure

Loss of Fluid

Septic (G- bacteremia)

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3
Q

Septic Shock is caused by what?

A

G- bacteria

Specifically LPS

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4
Q

What is the most common cause of death in ICU’s?

A

Septic Shock

*LPS

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5
Q

Name 6 G- bacteria that can cause Septic Shock:

A

E. coli

Proteus

Serratia

Pseudomonas

K. pneumoniae

Bacteroides

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6
Q

What are the 3 Progressive Phases of Shock?

*Septic, fluid loss, pump failure

A

Nonprogressive Stage (perfusion maintained through reflex compensation - reversible)

Progressive Stage (Hypoperfusion, Acidosis, Tissue Hypoxia)

Irreversible Stage (survival not possible - body shuts down)

***Disseminated Intravascular Coagulation common

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7
Q

What are 2 ways Metabolic Acidosis in the Progressive stage of shock exacerbates the condition?

*What can this lead to?

A

low pH dilates arterioles, bools blood in microcirculation, worsens cardiac output

Depresses heart

*ARDS (acute respiratory distress syndrome) and pulmonary edema

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8
Q

What is the demarcation between stage 2 and stage 3 shock?

Progressive and Irreversible

A

No Urinary Output

*renal vessels constrict

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9
Q

Would Staph aureus cause Septic Shock?

A

No. G+

No LPS.

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10
Q

Where do Pulmonary Thromboemboli originate?

What are they called?

How do they get to the lungs?

A

Veins

Venous emboli

Venous circulation

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11
Q

When thromboemboli gets to lungs, where does it lodge?

A

Pulmonary Arteries

NOT pulmonary veins

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12
Q

T/F

Venous Emboli lodge in the Pulmonary Veins

A

False

*Arteries

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13
Q

How is a Thrombus formed?

A

Fibrinogen polymerizes to Fibrin

Meshwork thin filaments binds cellular elements

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14
Q

A Thrombus ______

An Embolus ______

A

Is Stationary

Moves

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15
Q

What are the 2 layers that make up the “Lines of Zahn” in a Thrombus?

*note, not all thrombi have these - some are “Red”

A

Red: Cellular elements

White: Fibrin

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16
Q

Pathology of Shock - Describe what occurs in the following:

Adrenal gland:

Brain:

Kidneys:

Spleen:

A

Adrenal: Bilateral hemorrhage (waterhouse Fredrichsen syndrome)

Brain: Encephalopathy (fever, brain death)

Kidneys: Acute Renal Failure (tubular necrosis)

Spleen: Congestion/hyperplasia

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17
Q

Describe what occurs in the following organs in Shock:

Lungs:

Liver:

Heart:

Stomach:

A

Lung: ARDS

Liver: Hemorrhagic necrosis

Heart: Focal myocardial necrosis

Stomach: Stress ulcers

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18
Q

Describe what occurs in the following organs in Shock:

Intestine:

Splanchnic (abdominal cavity):

A

Intestine: Superficial hemorrhagic necrosis

Abdomen: Vasodilation and pooling

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19
Q

Acute hyperemia:

Chronic hyperemia:

A

Active (blushing - arteriole dilation)

Chronic Passive Congestive (Liver and Lungs)

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20
Q

What causes Acute hyperemia?

What causes Chronic hyperemia?

A

Arteriole dilation

Venous back pressure

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21
Q

What is the name of the macrophage that break down RBC inside the lungs?

A

Heart Failure Cells

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22
Q

How do we get a Paradoxical Embolism?

(what must you have to shunt clot from right side to left side of heart?

A

Open Foramen Ovale in heart

***or other interventricular septal defect

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23
Q

Fat Embolism Syndrome is the result of what?

A

Trauma

*platelets adhere to fat globules after rupture

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24
Q

Starting with the most important, what are 4 organs involves when dealing with Arterial Emboli?

A

Brain (most important)

Spleen

Kidney

GI tract

25
Q

98% of Septic Shock is cause by ____ because of the action of ______.

A

G-

LPS

26
Q

What are the 4 fates of Thrombi?

A

Lysis and resolution

Organization (vascular re-routing)

Recanalization

Embolism

27
Q

What is Waterhouse-Friderichsen Syndrome?

A

Adrenal Glands filled with blood due to shock

28
Q

What Infarcts are seen in solid organs like heart, kidneys, etc?

A

White Infarcts

29
Q

What infarct is typical of venous obstruction/congestion?

Where would it be found?

A

Red Infarcts

Intestines/testes

30
Q

Which type of Infarct is typical to an organ that has a Dual Blood Supply?

*Liver or lungs

A

Red Infarcts

31
Q

What type of Embolism can lead to a Secondary Abscess Formation?

A

Septic (Infected) Emboli

*abscess tends to heal poorly b/c of inadequate blood supply

32
Q

What is the most important Emboli?

A

Pulmonary

33
Q

Cardiogenic Shock can be caused by what 4 conditions:

A

MI

PE’s

Congestive heart failure

Myocarditis

34
Q

Hypovolemic Shock can be caused by what 3 conditions:

A

Diarrhea

Vomiting

Burns

35
Q

Septic Shock is caused by:

A

G- Bacteria

36
Q

Squames (fetal epithelial squamous cells) and Vernix Caseosa are found in what type of Embolus?

A

Amniotic Fluid Embolus

37
Q

Another name for Shock Lungs?

What causes this?

A

ARDS - Acute Respiratory Distress Syndrome

Pulmonary Edema due to Shock

***Hyaline Membrane

38
Q

Petechiae:

Purpura

Ecchymosis:

A

Less than 1 mm

1 mm to 1 cm

1 cm, large blotchy bruises

39
Q

Bone Marrow Emboli is the result of what?

A

CPR

40
Q

What causes blushing?

A

Acute hyperemia

41
Q

Name 2 organs that are involved in Fat Embolism Syndrome.

A

Lungs (ARDS)

Brain (cerebral edema)

42
Q

Oral Squamous Cell Carcinoma accounts for ____% of all malignant tumors in men and ____% of all malignant tumors in women.

A

5%

2%

43
Q

95% of oral cancers are…

A

Squamous Cell Carcinoma

44
Q

What is the average age of Oral Cancers?

A

50-70

*unusual before 40 (more in women)

45
Q

What is the single most common cancer in men in India?

A

Oral Cancers

Paan, Belel, Areca

46
Q

What are the 2 most common Risk Factors in Oral Cancer?

A

Tobacco

Alcohol

47
Q

What is the most common location for Oral Cancer?

A

Tongue

then lip, floor of mouth

48
Q

Where is Oral Cancer when caused by HPV or EBV?

A

Back of mouth

49
Q

What 2 viruses are implicated in Oral cancers preferring the back of the mouth?

A

EBV

HPV

50
Q

What are the 2 HPV serotypes that cause both oral and cervical cancer?

What 2 serotypes are associated with genital warts that can be transmitted orally?

A

16 and 18

6 and 8

51
Q

What is more common, Leukoplakia or Erythroplakia?

A

Leukoplakia

52
Q

T/F

Leukoplakia occurs in equal frequency in both sexes, mostly after 3rd decade.

A

True

*also, causes same as oral cancer

53
Q

Where does Leukoplakia most often occur?

A

Buccal mucosa

Tongue

Floor of mouth

54
Q

____% of Leukoplakias become malignant.

A

20%

55
Q

____% of Erythroplakias become malilgnant.

A

50%

56
Q

T/F

Leukoplakia and Erythroplakia have the same risk factors

A

True

57
Q

List 8 Risk Factors for Oral Squamous Cell Carcinoma

A

Tobacco

Alcohol

UV

Irritation/poor hygeine

Immunosuppression

Leukplakia/Erythroplakia

Pahn/Reverse Smoking

58
Q

Oral Squamous Cell Carcinoma can be related to Tobacco and Alcohol or HPV.
What are 2 major differences?

A

Location: Anterior traditional/Posterior HPV

HPV very sensitive to Radiation

59
Q

T/F

Mechanisms that repair are called Fibrosis in the Heart (fibroblasts) and Gliosis in the brain (astrogliocytes)

A

True

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