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Pathology > Exam 1: DIsorders of blood flow > Flashcards

Exam 1: DIsorders of blood flow Flashcards

1
Q

edema

A

accumulation of fluid in the interstitial tissue spaces of thebody or body cavities

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2
Q

why does edema occur

A

because there is a loss of homeostatic mechanisms that control the normal fluid volumes of the body

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3
Q

what are the 4 causes of edema

A

increased microvascular permeability
increased intravascular hydrostatic pressure
decreased intravascular osmotic pressure
decreased lymphatic drainage

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4
Q

what is an example of increased microvascular permeability

A

generalized or local inflammation due o infectious agents

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5
Q

this is mediated by

A

release of histamine, bradykinins, leukotrienes, IL-1, TNF, y-interferon

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6
Q

what is an example of increased intravascular hydrostatic pressure

A

cardiovascular disease or failure; congestion or hyperemia in tissue

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7
Q

what are examples of intravascular osmotic pressure

A

hepatic failure with acquired or congenital porto-systemic shunt with decreased albumin production; loss of albumin in kidney or GI tract (PLN, PLE)

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8
Q

What is an example of decreased lymphatic drainage

A

neoplasia, fibrosis or inflmmation that is compressing/obstructing lymphatic vessels; lymphangiectasia in GI tract

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9
Q

what does edema look like morphologically

A

clear to slightly yellow fluid (mostly water)
“doughy” consistency
leaves a delayed impression (pitting edema)
tissues will be wet or shiny and thickened on necropsy

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10
Q

does edema contain small or large amounts of protein

A

small; but can be more protein rich in some conditions

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11
Q

where does edema tend to collect

A

on more ventral regions of body

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12
Q

when edema is present is there any loss of function of the tissue

A

when severe it can cause partial or complete loss of function and can be life threatening

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13
Q

where can edema be life threatening

A

CNS edema, pulmonary edema, hydropericardium

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14
Q

edema is recognized how microscopically in H&E?

A

amorphous, pale eosinophlic material within tissue spaces (dont confuse with fibrin deposition

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15
Q

hydropericardium

A

watery fluid accumulation within pericardial sac (can be secondary to edema)

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16
Q

hydrothorax

A

watery fluid accumulation within the thoracic cavity (can be secondary to edema)

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17
Q

hydroperitoneum

A

one form of ascites that consists of watery fluid accumulation within the abdominal cavity (can be secondary to edema)

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18
Q

hyepremia

A

active engorgement of small arterioles and capillaries with blood

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19
Q

physiologic hyperemia

A

hyperthermia, post-prandial to intestines

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20
Q

pathologic hyperemia

A

increased blood flow secondary to inflammation

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21
Q

what is the morphologic appearance of hyperemia

A

tissues are reddened and warm to touch

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22
Q

what does hyperemia look like histologically

A

arterioles and capillaries engorged with blood; RBC in the lumen of the vessels

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23
Q

what types of hyperemia can a pt have

A

acute/chronic
focal/regionally localized
IMPOSSIBLE TO BE GENERALIZED

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24
Q

congestion

A

engorgement of small venules and capillaries when venous blood flow is diminished or obstructed (secondary to many pathologic processes)

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25
Q

acute passive congestion

A

occurs after processes such as acute heart failure, post euthanasia, post barbiturate administration

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26
Q

chronic passive congestion

A 
often secondary to neoplasia (obstructive venous flow)
marked inflammation
organ displacement (volvulus, torsion)
marked fibrosis
chronic R side heart failure
chronic left side heart failure
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27
Q

what is the morphologic appearance of congestion

A

tissues are enlarged, heavier, and darker red due to increased blood volume
liver has a nutmeg appearance (mottled red and light yellow appearance diffuse)

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28
Q

what is the microscopic appearance of congestion

A

increased amount of eryhtrocytes within the lumen of small capillaries and venules (only small amounts of RBC in interstitium due to diapedesis effect or tissue processing artifact)

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29
Q

shock is also known as

A

cardiovascular collapse

30
Q

what is shock

A

a circulatory dysregulation that is associated with loss of circulating blood volume, reduced cardiac output and/or alteration of peripheral vascular resistance

31
Q

causes of shock are numerous but often secondary to

A

severe hemorrhage, massive burns, massive tissue trauma, endotoxemia, or severe water loss secondary to diarrhea/vomiting

32
Q

what is the primary consequence to shock

A

hypotension and subsequent impaired tissue perfusion and cellular hypoxia leading to anaerobic metabolism, cellular degeneration and death

33
Q

what are the types of shock

A

cardiogenic shock
hypovolemic shock
blood maldistribution shock

34
Q

cardiogenic shock

A

when heart fails and cant pump blood to tissues

35
Q

hypovolemic shock

A

when there is reduced circulating volume of blood/water in the vascular that occurs due to loss of fluids secondary to seere diarrhea, vomiting, burns, hemorrahage

36
Q

up to ____ of blood/water volume can be lost and compensatory measures will result to keep blood pressure and cardiac output sufficient

A

10%

37
Q

once blood/water loss exceeds _____ cardiac output and blood pressure drop dramatically and shock occurs

A

25%

38
Q

blood maldistribution shock

A

when there is reduced peripheral vascular resistance, which results in pooling of blood in tissues and hypoperfusion of tissues

39
Q

typically, blood maldistribution is associated with

A

significant peripheral vasodilation, which vastly increases the microvascular spaces and pools blood away from vital tissues

40
Q

what are the categories of blood maldistribution shock

A

anaphylactic shock
neurogenic shock
septic shock

41
Q

anaphylactic shock occurs secondary to ______ reaction where some type of allergen triggers interations with IgE and subsequently mast cells

A

Type I hypersensitivity

42
Q

mast cells release _____ causing _____

A

histamine and serotonin causing vasodilation

43
Q

neurogeinc shock

A

induced by trauma, particularly to CNS that causes a systemic autonomic discharge leading to peripheral vasodilation, venous pooling, and hypoperfusion of tissues

44
Q

septic shock occurs secondary to

A

large amounts of substances released from microorganisms (often bacteria) that are infecting an animal, either locally or systemically

45
Q

endotoxemia occurs most with

A

LPS with gram-negative bacteria

46
Q

_______ from gram-positive bacteria

A

peptidoglycans and lipoteichoic acids

47
Q

these substances produced by the bacteria do what exactly

A

bind to receptors (toll like receptors, CD14) which in turn release a milieu of inflammatory cytokines, active compliment, coagulation factors, and platelets that lead to vascular permeability changes, vasodilation, hypovolemia, and pooling go fblood

48
Q

what do you expect in tissues of anaphylactic shock?

A

edema and hyperemia

49
Q

what do you expect in neurogenic shock

A

congestion (hard to ID)

50
Q

what do you expect in septic shock?

A

vasculitis, thrombosis, hyperemia/congestion, generalized r localized inflammation may be present

51
Q

What is a hemorrhage

A

physical loss either internally or externally, of blood and blood consituents from the vascular compartments

52
Q

what does hemorrhage occur from

A

loss of vascular integrity or from abnormal function of any of the major components of normal hemostasis including endothelium and blood vessels, platelets, and coagulation factors

53
Q

hemorrhage by vessel rupture (rhexis) occurs following many types ofinjury to vessels to include

A

trauma, vascular insult by bacteria, bacterial toxins or viral replication in endothelium and many mescellaneous causes

54
Q

hemorrhage by diapedesis

A

passage of RBC across blood vessel walls that occurs secondary to inflammation, congestion, or hyperemia; (minimal blood loss)

55
Q

hemorrhage by loss of platelet numbers or function

A

severe thrombocytopenia, DIC, IMT, bone marrow diesease leads to inability to control blood loss following vascular damage; congenital platelet defect or acquired platelet function defect

56
Q

hemorrhage by loss of normal coaglation factor amount or function

A

secondary to many disorders includingcongenital coagulation factor deficiency, goagulation factor loss of function; coagulation factor consumption, coagulation factor lack of production, liver insufficiency from a variety of causes

57
Q

petechia

A

pinpoint (1-2) cutaneous hemorrhage often caused by diapedesis or small vascular injury

58
Q

purpura

A

pinpoint (0.3 to 1 cm) to small cutaneous hemorrhage that is often specifically associated with infectious causes

59
Q

ecchymosis

A

small cutaneous hemorrhage (2-3 cm) due to larger vascular injury

60
Q

hemopericardium

A

hemorrhage into pericardial sac, which can lead to cadiac tamponade

61
Q

hemothorax

A

hemorrhage into thoracic cavity

62
Q

hemoadbomen (hemoperitoneum)

A

hemorrhage into abdominal cavity

63
Q

hemoptysis

A

expectoration of blood filled secretions or sputum secondary to hemorrhage into the airways

64
Q

hematemesis

A

blood filled vomit secondary to hemorrhage into stomach or upper GIT

65
Q

hematochezia

A

passage of bright red blood from the anus secondary to hemorrhage into the lower gastrointestinal tract

66
Q

melena

A

dark red to black blood filled stool secondary to hemorrhage into the upper GIT

67
Q

hematuria

A

blood in urine secondary to hemorrhage into the urinary tract

68
Q

hematoma

A

hemorrhage confined to a local space, often in subcutaneous tissues which leads to a pocket of fluid (blood) accumulation due to continuous blood flow into space or lack of drainage away from space

69
Q

epistaxis

A

blood exuding from nares secondary to hemorrhage into the nasal cavity

70
Q

hyphema

A

hemorrhage into anterior/posterior chamber or vitreous of eye

71
Q

what will hemorrhage appear like grossly

A

blood filled body cavities, free blood within the GIT lumen, blood filled airways, petechiation, purpura, ecchymosis, and hemarthrosis would indicate hemorrhage

72
Q

what will hemorrhage appear like microscopically

A

erythrocytes pooling outside of blood vessels, macrophages ingesting erythrocytes (erythrophagocytosis), hemosiderin or hematoidin within macrophages (chronic hemorrhage or free within tissues

Pathology (17 decks)

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