Edema/Congestion/Hemostasis

Question 1

What is edema?

Answer 1

increased fluid within interstitial tissues

Question 2

True or False: Increased fluid (edema) can results from decreased hydrostatic pressure and increased venous return.

Answer 2

False: Edema = increased hydrostatic pressure with decreased venous return

Question 3

Edema can result from ______ plasma osmotic pressure.

Answer 3

Reduced (decreased proteins allows fluid to penetrate more easily)

Question 4

Edema can result from ______ obstruction.

Answer 4

lymphatic

Question 5

Edema can result from ______ and water retention.

Answer 5

sodium

Question 6

True or False: Edema can result from inflammation.

Answer 6

true

Question 7

Decrease in protein = _______ in osmotic pressure

Answer 7

decrease

Question 8

In the case of “transudate,” which is higher: Osmotic Pressure or Hydrostatic Pressure?

Answer 8

Hydrostatic pressure (transudate = low protein = leakiness)

Question 9

What is “effusion?”

Answer 9

collection of fluid in the body cavity or space

Question 10

What are four typical types of effusion?

Answer 10

Pleural (lung)
Pericardial (heart)
Peritoneal (abdomen)
Joint Space

Question 11

________ is the increase in tissue blood volume secondary to neurogenic mechanisms or inflammation

Answer 11

Hyperemia

Question 12

________ is the increase in tissue blood volume secondary to impaired venous return

Answer 12

Congestion

Question 13

True or False: Hyperemia is an active process.

Answer 13

True (things are moving quickly)

Question 14

True or False: Congestion is an active process.

Answer 14

False. It is PASSIVE (outflow is restricted)

Question 15

Hyperemia is characterized by _________ inflow such as in exercise or inflammatory processes.

Answer 15

increased

Question 16

Congestion is characterized by ________ outflow such as in congestive heart failure.

Answer 16

decreased

Question 17

What is a hemorrhage?

Answer 17

Loss of blood secondary to vessel injury or physical disruption (total or partial)

Question 18

Hemorrhage can be of what two varieties?

Answer 18

Internal (not to a surface)

External (bleeding out)

Question 19

What are four signs of “internal hemorrhage” that appear on the skin?

Answer 19

Hematoma
Ecchymosis
Purpura
Petecchia

Question 20

A _______ is a large mass (tumor) of blood.

Answer 20

hematoma

Question 21

_________ is a sign of internal hemorrhage that is 1 cm or larger.

Answer 21

Ecchymosis

Question 22

A ______ is between 0.3 and 0.9 cm (3-9 mm).

Answer 22

Purpura

Question 23

How large are petechia?

Answer 23

1 to 2 mm (pinpoints)

Question 24

“Shock” is the loss of more than ____ % blood volume and is also called _____ hemorrhage.

Answer 24

20

acute

Question 25

Anemia is an example of ______ hemorrhage.

Answer 25

chronic

Question 26

True or False: Hemorrhage can flow into body spaces.

Answer 26

True | ex. hemothorax, hemopericardium, hemarthrosis, hemoperitoneum

Question 27

With which disease is petechial hemorrhage commonly seen?

Answer 27

mononucleosis

Question 28

What is hemostasis?

Answer 28

Rapid arrest of blood loss at site of injury

Question 29

What are the three major components of hemostasis?

Answer 29

1. Endothelium 2. Platelets 3. Coagulation Cascade

Question 30

Endothelial cells line the vascular surfaces and control the clotting system by regulating the expression of binding sites for ________ and ______ factors on the cell

Answer 30

anticoagulant | procoagulant

Question 31

Platelets function mostly as a ______.

Answer 31

procoagulant

Question 32

The _______ cascade is a series of proteolytic events.

Answer 32

coagulation

Question 33

vWF and the extrinsic pathway (tissue factor) are involved in ________.

Answer 33

thrombosis

Question 34

Exposure of membrane-bound _______ will initiate the extrinsic coagulation sequence.

Answer 34

tissue factor

Question 35

Von Willebrand Factor binds to _______ when it is exposed in endothelial cells due to damage occurring to the blood vessel.

Answer 35

collagen

Question 36

Factor _____ is bound to vWF (preventing its destruction) while it is inactive in circulation and is released from vWF by the action of thrombin.

Answer 36

VIII

Question 37

What are some of the molecules involved in INHIBITION of thrombosis?

Answer 37

Antithrombin III = inactivates thrombin Thrombomodulin = binds thrombin to activate Protein C Prostacyclin/NO = inhibit platelet aggregation t-Pa = activates fibrinolysis

Question 38

von Wildebrand Factor binds to ______ on platelets.

Answer 38

GP I b

Question 39

The extrinsic system of the coagulation cascade is dependent on ________.

Answer 39

tissue factor

Question 40

The intrinsic system of the coagulation cascade involves factor ______.

Answer 40

twelve (XII)

Question 41

``` The coagulation cascade involves what four basic elements? 1. active enzyme 2. substrate 3. 4. ```

Answer 41

3. Cofactor | 4. Calcium

Question 42

What would a calcium-chelator due to the coagulation cascade?

Answer 42

it would prevent clotting because you need calcium to form the clot

Question 43

What are the two final products of coagulation?

Answer 43

thrombin | fibrin

Question 44

In coagulation, what occurs prior to Primary and Secondary Hemostasis?

Answer 44

Vasoconstriction

Question 45

Why is vasoconstriction important in coagulation?

Answer 45

minimizes the surface area that must be filled in by platelets

Question 46

What occurs during Primary Hemostasis?

Answer 46

``` Platelets adhere Platelets flatten out on top of the vWF and collagen Granules (ADP, TXA2) are released Recruitment of more platelets Hemostatic Plug ```

Question 47

What occurs during Secondary Hemostasis?

Answer 47

``` Tissue Factor is released Complex expression of phospholipid Thrombin is activated Fibrin polymerization (meshwork) = more stable clot than "hemostatic plug" of primary hemostasis ```

Question 48

Why is fibrinolysis important in the coagulation cascade?

Answer 48

you do NOT want to completely close off blood supply...the clot is trimmed to fit the area of injury

Question 49

______ trims the clot after it is activated by ______

Answer 49

Plasmin | tPA (tissue plasminogen activator)

Question 50

What does thrombomodulin do?

Answer 50

blocks the coagulation cascade by acting as a cofactor in the activation of Protein C (antigoagulation path)

Question 51

True or False: Fibrin degradation products are able to activate monocytes and cause inflammation.

Answer 51

True (this causes issues in areas away from the injury)

Question 52

_______ is involved in neutrophil adhesion, monocyte activation, and platelet activation.

Answer 52

Thrombin