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Pathophysiology > Cont > Flashcards

Cont Flashcards

1
Q

Describe volatile acids

A

Can be excreted by respiration

Ex. CO2

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2
Q

Describe fixed acids

A

Cant be excreted by respiration

Ex. Lactic acid

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3
Q

Describe the normal arterial blood pH

A

-Slightly basic because the slight H+ deficit leaves room to neutralize the biproducts od metabolic reaction

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4
Q

What is more common, acidosis or alkalosis?

A

Acidosis

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5
Q

Describe respiratory acidosis

A
  • When you retain CO2 (volatile acid)

- Happens when you are not able to ventilate

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6
Q

Describe respiratory alkalosis

A
  • Hyperventilation (decreased CO2 in the blood)

- Treatment is to regulate breathing (paper bag)

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7
Q

Describe metabolic acidosis

A
  • Most common
  • low pH
  • Increased acidity in blood due to fixed acids
  • pH less than 7.5
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8
Q

Examples of metabolic acidosis

A
  • Diabetic ketoacidosis
  • Lactic acidosis
  • Shock patients
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9
Q

Describe metabolic alkalosis

A
  • Not common
  • Severe vomiting
  • Antacids
  • Body depresses respiration cause you want to retain CO2
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10
Q

Describe the buffer system

A
  • First defense against excess acid

- Quickly acts to restrain a change in pH

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11
Q

How is hemoglobin buffered

A

Hydrogen in blood cells

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12
Q

How are most body cells buffered?

A

Cellular proteins

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13
Q

What is the equation for bicarbonate

A

H + HCO3 -> H2CO3 -> CO2 + H2O

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14
Q

What organ secretes the majority of acids

A

The kidney

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15
Q

What generates new bicarbonate molecules to replenish the stock?

A

Kidney

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16
Q

What gets rid of excess CO2

A

Lungs

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17
Q

Active process associated with inflammation or increased metabolic activity

A

Hyperemia

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18
Q

Characteristics of hyperemia

A
  • Physiological response
  • Due to increased functional demand
  • Can be due to hormonal influence
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19
Q

Examples of hyperemia

A
  • Hot flashes
  • Fever
  • Sunburn
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20
Q

Passive hyperemia process associated with impaired venous flow due to hydrostatic forces

A

Congestion

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21
Q

What sort of blood is characteristic of congestion?

A

Poorly oxygenated dark blood

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22
Q

What causes pulmonary congestion?

A
  • Heart failure

- Ascites (from the hepatic portal veins)

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23
Q

What is an example of local congestion

A

Venous obstruction of a limb

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24
Q

Where is chronic passive congestion common?

A

-In the liver due to right heart failure

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25
Q

This is the activity of the blood vessel endothelium, platelets, and plasma coagulation

A

Hemostasis

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26
Q

What are the goals of hemostasis

A
  • Keep blood in a fluid clot free state
  • Form a clot to stop the bleeding at the site of vascular injury
  • Balance pro and anticlotting forces
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27
Q

What is the normal hemostatic reaction?

A
  • Vascular disruption
  • Temporary constrict blood vessels and vasodilate
  • Blood gets exposed to tissue factors and causes platelets to become sticky
  • Platelets adhere to the edges of the wound and become a thrombotic plug
  • Blood that is exposed to the tissues help form a permanent plug
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28
Q

What is the first element of the coagulation process?

A

Endothelial Cells

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29
Q

What do endothelial cells have that help maintain balance of the pro and anticlotting forces

A

-Antithrombotic and anticoagulant activity

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30
Q

What is the 2nd element of the coagulation process?

A

Platelets

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31
Q

Where do platelets originate from?

A

Megakaryocytes

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32
Q

What are the 2 main functions of platelets?

A
  • Form the thrombotic plug and attract more platelets

- Initiate the clotting cascade

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33
Q

What is the 3rd element of the coagulation cascade?

A

Coagulation

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34
Q

When does coagulation start?

A

-When plasma or platelets come in contact with something unfamiliar

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35
Q

What does coagulation cause?

A

-Fibrinogen (Factor 1) to become fibrin and form a gel like substance that plugs the hole

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36
Q

What are the 2 pathways of the coagulation cascade?

A
  • Extrinsic Coagulation Pathway

- Intrinsic Coagulation Pathway

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37
Q

Describe the extrinsic pathway

A

Starts when the coagulation factor 2 comes in contact with tissue factor in extravascular tissue
-Operates in clinical circumstances

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38
Q

Describe the intrinsic pathway

A
  • Initiated when factor 7 comes in contact with a foreign surface
  • Ex. When blood comes in contact with lab wear
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39
Q

What pathway(s) are activated during hemostasis?

A

Both extrinsic and intrinsic

40
Q

This is the escape of blood from a blood vessel

A

Hemorrhage

41
Q

This is the smallest hemorrhage

-Usually associated with platelet disorders

A

Petechiae

42
Q

This is a hemorrhage less than 1 cm

A

Purpura

43
Q

This is a hemorrhage greater than 1 cm

A

Ecchymosis

44
Q

This is a large localized collection of blood

A

Hematuria

45
Q

What commonly causes problems with coagulation factors?

A

The liver- because the liver makes coagulation factors

46
Q

What are other coagulation problems due to genetics

A

Hemophilia- Factor 7 deficiency

47
Q

What is the most common cause of coagulation factor deficiency?

A

Cirrhosis

48
Q

What is usually associated with cirrhosis?

A
  • Severe scarring

- Usually have bleeding problems due to underproduction of hepatic coagulation factors

49
Q

What is essential for the production of Factors 7, 9, 10

A

Vitamin K deficiency

50
Q

-This helps bond platelets

A

Von Willebrand Disease

51
Q

Where is von willebrand facto made?

A

-Made in the endothelial cells and megakaryocytes

52
Q

What are characteristics of Von Willebrands disease

A
  • Spontaneous bleeding of the mouth, nose, and mucus membranes
  • Lack of vWF interferers with platelet adhesion to the endothelium
53
Q

Characteristics of hemophilia

A
  • Factor 8 deficiency
  • X-linked gene deficiency
  • Can be mild to severe
54
Q

Do people with hemophilia have a normal bleeding time and platelet count and a normal prothrombin time?

A

Yes

55
Q

This assess the coagulation process

-The time it takes to clot after the addition of tissue factor

A

Prothrombin time

56
Q

This is the time it takes the clot after the addition of the artificial surface

A

Partial Thromboplastin time

57
Q

This measures platelet numbers only

-Does not determine if platelets function properly

A

Platelet count

58
Q

This detects defective platelet function

A

Platelet function analysis

59
Q

The time required for a patient to stop bleeding after a skin prick

A

Bleeding time

60
Q

This is a collection of cellular elements of blood that only forms under pathologic conditions

A

Thrombosis

61
Q

Is a thrombus formed fast or slow?

A

Slowly

62
Q

When is a thrombosis formed?

A

When platelets and WBC adhere to the endothelium

63
Q

What are 3 components that lead to thrombus formation?

A
  • Endothelial injury
  • Abnormal Local blood flow
  • Hypercoagulability
64
Q

What can happen if a thrombus gets too big

A

-It can occlude blood flow and cause death of downstream tissue

65
Q

This is when clotting forms without exposure to tissue

A

Disseminated Intravascular coagulation

66
Q

What does DIC lead to?

A
  • Clots

- Hemorrhages

67
Q

T/F- DIC is Always secondary to another underlying condition

A

True

68
Q

What are examples of underlying conditions that cause DIC

A
  • Sepsis

- Bacterial infections

69
Q

Is DIC fatal?

A

Usually

70
Q

What initially happens in DIC?

A

The body starts spontaneously clotting

-uses all the platelet and coagulation factors

71
Q

This is an intravascular object that travels in the blood stream from one place to another

A

Embolism

72
Q

What are examples of sources of emboli?

A
  • Pulmonary
  • Systemic
  • Marrow Fat
  • Air
  • Amniotic fluid
73
Q

These are fragments made in the deep veins and carried into the lungs
-Produce instant death

A

Pulmonary Thrombi

74
Q

These cling to the inner wall of a damaged heart muscle

-Travel to the lower extremity and the brain

A

Systemic thrombi

75
Q

This is common after a fracture or CPR

A

Marrow fat

76
Q

This is air bubbles in the arteriole tree

A

Air

77
Q

This fluid enters the maternal circulation

-Fetal debris lodges in the small vessels of the lungs

A

Amniotic fluid

78
Q

This is an area of ischemic necrosis

A

Infarct

79
Q

What are 2 types of infarcts

A
  • Red Infarct

- White infarcts

80
Q
  • When arteriole occusion occurs in dense solid tissue

- Seen in kidney, heart, and liver

A

White infarcts

81
Q

This is a venous or arteriole obstruction that occurs in loose spongy tissue

  • Seen in the lungs and liver
  • Have a dual blood supply
A

Red Infarcts

82
Q

Circulatory collapse=

A

Shock

83
Q

Describe shock

A

-A state of systemically low blood flow when cardiac output is reduced or effective blood volume is decreased

84
Q

What are the 4 types of shock?

A
  • Hypovolumic shock
  • Cardiogenic shock
  • Obstructive Shock
  • Septic Shock
85
Q

Describe hypovolemic shock

A
  • Decrease blood volume (some trauma event)
  • Pressure drops
  • Shock like status because you cant keep up cardiac output
  • Fluid loss (diarrhea, burns, lose hydration through the skin)
86
Q

This causes swelling and fluid movement from intracellular to extracellular

  • Cant maintain normal blood flow
  • Loss of fluid from the vascular compartment
A

Anaphases

87
Q

Describe cardiogenic shock

A

• Lose pumping power and cant maintain cardiac output

88
Q

What is a cause of cardiogenic shock?

A
  • MI

- Heart and muscle disease

89
Q

Describe septic shock

A
  • Seen a lot
  • Caused or induced by infections- causes inflammatory response
  • Can cause cardiogenic or hypovolemic shock
  • DIC (deseminated intracellular coagulation)
  • Decreases bp and results in hypoperfusion
90
Q

What does your body do to compensate in septic shock?

A 
o	Increase HR
o	Vasoconstriction (by angiotensin) to increase PVR
o	Body is going to try to retain fluids (via ADH and aldosterone)
91
Q

Describe obstructive shock

A
  • Seen in paracardial tamponade- trauma patients
  • Obstructive force causes mechanical interference
  • Leads into cardiogenic- heart loses the ability to pump
92
Q

What are the 3 stages of shock

A
  • Non-progressive
  • Progressive
  • Irreversible Shock
93
Q

Describe non-progressive shock

A
  • Re-establish profusion
  • But your low BP continues
  • Hypoxia occurs (bc RBC cant deliver blood)
  • Anaerobic metabolism starts- lactic acid is produced as a byproduct
  • Lactic acid is a fixed acid (causes pH to go down)
  • Body wants to increase pH via bicarb from the kidney, and increase ventilation (get rid of CO2 which is a volatile acid)
94
Q

Describe non-progressive shock

A
  • More severe hyperperfsion
  • More acidtic
  • More hypoperfused
  • More septic- in your gut
  • Not all progressive shock leads into DIC
  • You can get to a point where nothing is reversible
95
Q

Describe irreversible shock

A
  • Heart- starving for o2 and decreases contractility
  • Decrease filtration/dehydration
  • Once your kidneys fail you cant maintain and allow for reabsorption and cant secrete bicarb
  • Kidney and heart

Pathophysiology (18 decks)

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