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general path > Edema/Congestion/Hemostasis > Flashcards

Edema/Congestion/Hemostasis Flashcards

1
Q

what is Edema

A

increase fluid within interstitial tissue

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2
Q

generally, what causes an edema

A

Increased Hydrostatic pressure

Decreased venous return

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3
Q

in the body what causes an edema

A

Reduced plasma osmotic pressure
Lymphatic obstructure
Sodium and water retention
Inflammation

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4
Q

what is a generalized edema

A

Anasarca

Hydrops

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5
Q

how does Inflammatio lead to an edema

A

Vasodilation and increased permiability due to more blood being present

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6
Q

what causes vasodilation

A

NO
Protoglycans
Histamine

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7
Q

what would causes an increase in hydrostatic pressure to cause an edema

A

Impaired venous return for mechanical obstruction or congestive heart pressure

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8
Q

what would cause reduced plasma osmotic pressure to lead to an edema

A 
reduced protein (albumin) synth
Increased loss of protein (nephrotic syndrome, gastroenteropathy)
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9
Q

what would cause lymphatic obstrucutre to lead to a edema

A

Fibrosis
Parasites
cancer
Compression

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10
Q

what would cause a Na and Water retension to lead to an edema

A

Acute impairment of renal function

decreased renal perfusion with release of renin

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11
Q

what would lead to inflammation to cause an edema

A

Increased vascular permeability
necrosis
angiogensis

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12
Q

Pulmonary edema does what to gas exchage

A

Impairs gas exchange

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13
Q

what causes pulpmonary edema

A

Acute congestive heart failure

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14
Q

what does a cerebral edema leads to

A

Causes compression and herniation of critical areas

decreases blood flow

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15
Q

what is plasma osmotic pressure

A

The pulling of water into the blood vessels due to solutes being present

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16
Q

where is balance normally found to stop edema

A

Between hydrostatic and osmotic presssure

- prefers to leave capillary slowly and taken up by lymph

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17
Q

what is effusion

A

Collection of fluid in body cavity or other space

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18
Q

where might effusion occure

A

Pleural
Pericardial
Peritoneal (ascites)
Joint space (synovial)

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19
Q

a buldge in the abdominal cavity due to effusion

A

Ascites

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20
Q

what does effusion in the joint space lead to

A

Limited movement

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21
Q

what is transudate effusion

A

Transudate is fluid pushed through the capillary due to high pressure within the capillary

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22
Q

what is exudate effusion

A

Exudate is fluid that leaks around the cells of the capillaries caused by inflammation.

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23
Q

what is Hyperemia

A

increased tissue blood volume secondary to neurogenic mechanisms or inflammation

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24
Q

is hyperemia active or passive

A

active

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25
Q

what is congestion

A

Increased tissue blood volume secondary to impaired venous return

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26
Q

is Congestion active or passive

A

Passive

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27
Q

is Hyperemia and congestion both associated with increase in blood flow

A

No, only hyperemia is an increase blood flow

Congestion is due to increased volume from a blockage(less outflow)

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28
Q

color of congestion and hyperemia

A

Hyperemia: red
Congestion: blue (low O2)

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29
Q

what often accompanies congestion

A

Edema

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30
Q

examples of congestion

A

Acute pulmonary congestion
Chronic pulmonary congestion with hemosiderin
Chronic hepatic congestion
Acute hepatic congestion

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31
Q

what causes chronic pulmonary congesion with meosiderin

A

Laden Macrophages

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32
Q

what does chronic hepatic congestion lead to

A

Gross appearance of nutmeg pattern due to blood in the centrizonal sinusoids

33
Q

what does Acute peatic congestion lead to

A

Ischemic necrosis of centrizonal hepatocytes (centrizonal necrosis)

34
Q

what is a hemorrhage

A

Loss of blood secondary to vessel injury or physical disruption
- blood no longer in the vessel

35
Q

is a hemorrhage internal or external

A

Can be both

36
Q

what is an external hemorrhgae

A

Bleeding

37
Q

what is an internal hemorrhage

A

Bleeding inside of connective tissue

38
Q

types of Internal hemorrhages based on size

A

Hematoma
Petechiae
Purpura
Ecchymoses

39
Q

what is a hematoma

A

large

blood in tissue as a tumor of blood

40
Q

what is petechiae

A

Skin or muscous membrane hemorrhage that are 1-2mm in size

41
Q

size of petechiae

A

1-2mm in size

42
Q

what is purpura

A

Skin or muccous membrane hemorrhages larger than 3-9mm

43
Q

what is Ecchymoses

A

Focal skin and subcutaneous hemorrhages larger than 1 cm

44
Q

what are the types of hemmorhages into body spaces

A

Hemothorax
Hemopericardium
Hemarthrosis
hemoperitoneum

45
Q

When does a hemorrhage cause shock

A

A loss of blood graeter than 20%

46
Q

what type of hemorrhage causes shock

A

Acute hemorrhages

47
Q

what does Chronic hemorrhages cause

A

Anemia

48
Q

what is hemostasis

A

The rapid arrest of blood loss at the site of an injury

49
Q

is the problem with hemmorhages into body spaces the loss of blood alone

A

No, can compress other organs

50
Q

what are the 3 componenets of Hemostasis

A

Endothelium
Platelets
Coagulation cascade

51
Q

what aspects of the endothelium is used for hemostasis

A

Antithrombotic properties
Anticoagulent properties
Prothrombotic properties

52
Q

what are the antithrombotic properties of Endothelium to cause Hemostasis

A
  • Barrier from the extracellular matrix ECM

- prostacyclin (PGI2) inhibiting platelet aggregation

53
Q

action of heparin-like molecules from the endothelium to serve as an anticoagulant

A

Heparin-like molecules allow antithrombin III (AT III) to inactivate thrombin, Xa and other factors

54
Q

action of thrombomodulin in endothelium

A

serves as an anticoagulant to bind to thrombin and activate protein C

55
Q

roll of PRotein S in ANticoagulant in endothelium

A

Protein S is synth by Endothelium

- serves as a cofactor needed for full protein C function, inactivation of Va and VIIIa)

56
Q

what synthesizes Tissue Plasminogen activator

A

Endothelium

57
Q

What does the endothelium do to encourange anticoagulation in hemostasis

A

creates Heparin-like molecules
Thrombomodulin
Synth Protein S
Synth tissue plasminogen activator

58
Q

what are the parts of the prothrombotic properties of endothelium

A

Von Wellebrand factor
Tissue Factor
inhibitors of plasminogen activity

59
Q

what is the Von Wilebrand factor from endothelium roll

A

A cofactor for binding platelets to collagen

60
Q

when is tissue factor secreted by endothelium

A

After exposure to cytokines(aka endothelial activation)

61
Q

what does tissue factor initiate

A

The extrinsic clotting pathway

62
Q

what are the phases to forming a platelet plug

A

Adhesion
Secretion
Aggregation

63
Q

how does adhesion of platelets occur

A

Von Willebrand factor bridges between collagen and a surface platelet receptor (glycoprotein Ib)

64
Q

What is secretion in platelet plug formation

A

Release of contents from both types of granules
- ADP and Ca
surface expression of a phospholipid complex

65
Q

What mediates platelet aggregation

A

ADP

66
Q

what is the roll of Ca in platelet plug formation

A

coagulation cascade

67
Q

why do phospholipid complexes express themeslves during platelet plug formation

A

serves as a binding site for Ca and Coagulation factors

68
Q

what is the Coagulation cascade biochemically

A

a series of enzymait conversions of inactive proenzymes to activated enzymes

69
Q

what occures at the phospholipid complex on platlet membrane during the coagulation cascade

A

Binding of Ca

Active enzyme cofactor and substrate (proenzyme)

70
Q

what is the roll of tissue factor (Thromboplastin) in the coagulation cascade

A

activates the extrinsic system

71
Q

what is the roll of Factor XII (hageman factor) in the coagulation cascade

A

Activates the intrinsic system

72
Q

what are the final products of the extrinsic and intrinsic systems

A

Thrombin (extrinsic)

Fibrin (Intrinsic)

73
Q

what controlls excesss coagulation

A

Antithrombins (Including AT III)

and protein C and S

74
Q

what is the action of antithrombins

A

Inhibit activity of thrombin and other coagulation factor

75
Q

what is the action of protein C and S

A

inactivate Factors Va and VIIIa

76
Q

why does Fibrinolysis occures

A

By the activation of plasmin from plasminogen by tissue plasminogen activator (t-PA)

77
Q

what does plasmin do when activated

A

breaks down fibrin, resulting in fibrin split/degradation products

78
Q

what is responsible for inhibiting clots

A

Antithrombin

Thrombomodulin

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