Fluid and Hemodynamics Flashcards

1
Q

What is Edema? What is Edema a pointer to?

A

Accumulation of interstitial fluid within tissues; Cardiac failure (Right) or Renal failure

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2
Q

Total Body Mass

A

40% Solid, 60% Water - 2/3 Intracellular Fluid, 1/3 - Extracellular Fluid - 80% Interstitial Fluid and 20% Plasma

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3
Q

Pulmonary Edema

A

Left Ventricular Heart Failure

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4
Q

Inflammatory VS Non-Inflammatory Edema

A

Inflammatory - Increased vascular permeability, Exudate; Non-Inflammatory - Hemodynamic cause, Transudate

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5
Q

Increased Hydrostatic Pressure Cause

A

Impaired Venous Return - CHF, Thrombosis (DVT); Arteriolar Dilation - Heat, Neurohumoral dysregulation

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6
Q

Reduced Plasma Osmotic Pressure

A

Decreased synthesis - Hypoproteinemia, Cirrhosis (Ascites), Protein malnutrition; Increase loss - Nephrotic syndrome, Protein losing glomerulopathy/gastroenteropathy

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7
Q

Lymphatic Obstruction

A

Inflammation, Neoplasm (Orange Peel), Axillary node resection, Node scarring, Microorganisms

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8
Q

Sodium Retention

A

Renal hypoperfusion, RAAS

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9
Q

Hyperemia VS Congestion

A

Hyperemia - Active, Excess blood supplying organ, Active, Erythema, Red tissue, O2; Congestion - Passive, Abnormal accumulation of fluid (blood), Passive, Cyanosis,

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10
Q

Lung Congestion

A

Acute - Engorged alveolar capillaries, Pulmonary edema; Chronic - Macrophages fill with Hemosiderin, Fibrotic and thick septa

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11
Q

Liver Congestion

A

Acute - Distended central vein and sinusoids, Peripheral cells better oxygenated; Chronic Passive - Central regions are red/brown and less cellular or necrotic (Right side failure, Shock)

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12
Q

Hemorrhage

A

Escape of blood from vessels into tissue
Inherit - Hemophilia, von Willebrand Disease
Acquired - Warfarin therapy, Liver failure, Vit K deficiency, DIC

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13
Q

Petechiae

A

1-2mm, Focal hemorrhage, Non-raised

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14
Q

Purpura

A

3-5mm, Focal hemorrhage, Flat or Raised

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15
Q

Ecchymosis

A

1-2cm, Widespread Petechiae

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16
Q

Hematoma

A

Localized collection of blood in tissue, organ or space

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17
Q

Hemopericardium

A

Blood in pericardium, Rupture of aorta, heart

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18
Q

Hemothorax

A

Blood in pleural cavity, Trauma or Aortic rupture

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19
Q

Hemoperitoneum

A

Blood in peritoneal cavity, Rupture of aorta, spleen, liver

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20
Q

Hemoarthrosis

A

Blood in joint space, Bleeding disorder, Trauma

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21
Q

Hemorrhage Color

A

Early = Hemoglobin (Black and Blue)
1st Day = Bilirubin (Blue and Red)
1-2 Days = Biliverdin (Blue and Green)
3-4 Days = Biliflavin/Hemosiderin (Yellow/Brown)

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22
Q

HHT VS Purpura

A

Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome)- Vascular hamartoma, Dilated veins, Endoglin mutation (HHT1), ALK-1 gene mutation (HHT2) VS does not disseminate w/pressure

23
Q

CREST Syndrome

A
Acrosclerosis
Calcinosis Cutis
Raynaud's Phenomenon (Diminished blood in digits)
Esophageal dysfunction
Sclerodactyly (Soft tissue atrophy)
Telangiectasia
24
Q

Spider Angioma

A

Nevus Araneus - Liver disease

25
Q

Thrombosis

A

Mass of blood in vascular system, Lower jelly layer and Upper clear “chicken fat” layer w/even platelets

26
Q

Virchow’s Triad

A

Endothelial Injury, Abnormal Blood flow, Hypercoagulability;

27
Q

Genetic Thrombosis Risk Factors

A

Factor V (Leiden) Mutation - Hypercoagulation, Prothrombin mutation, Increase Factor VIII, IX, XI or Fibrinogen, Antithrombin III deficiency, Protein C deficiency, Protein S deficiency

28
Q

High Risk Acquired Thrombosis Factors

A

Immobilization, Myocardial Infarction, Atrial Fibrillation, Tissue Injury, Cancer, Prosthetic Cardiac valves, DIC, Heparin Induced Thrombocytolpenia, Antiphospholipid Antibody syndrome

29
Q

Low Risk Acquired Thrombosis Factors

A

Cardiomyopathy, Nephrotic Syndrome, Hyperestrogenic states, Oral contraceptive, Sickle cell anemia, Smoking

30
Q

Predispositon to Thrombosis - Artery

A

Atheroma, Aneurysm

31
Q

Predispositon to Thrombosis - Vein

A

Slow flow, Stagnation; Hypercoagulation

32
Q

Predispositon to Thrombosis - Atrium

A

Atrial Fibrillation (Stasis), Mitral Valve Stenosis

33
Q

Predispositon to Thrombosis - Heart Valve

A

Inflammation by Infection

34
Q

Predispositon to Thrombosis - Ventricle

A

Inflammation by Infarction, Ventricular aneurysm

35
Q

Predispositon to Thrombosis - Cerebral venous sinus

A

Inflammation by Infection, Hypercoagulability

36
Q

Arterial VS Venous Thrombi

A

Arterial Thrombi - Atherosclerotic plaque, Injury site or vessel bifurcation, Retrograde, Prominent Lines of Zahn, Non-occlusive aortic and cardiac, Rapid flow, Distal infarction;
Venous Thrombi - Stasis to Valvular damage by trauma or occlusion, With flow, Red, Occlusive from edema, thrombrophlebitis, Embolism

37
Q

Vegetations on Heart Valves

A

Non-Bacterial Thrombotic Endocarditis, Infective Endocarditis (Strept), Verrucous (Libman-Sacks) Endocarditis - Systemic Lupus Erythematosus

38
Q

Deep Vein VS Varicose Vein Thrombosis

A

DVT - Pain and Edema, Embolize, Stasis and Hypercoagulation; Varicose Vein Thrombosis - Congestion, Ulcer, Rare embolize

39
Q

DIC

A

Disseminated Intravascular Coagulation - Widespread clotting cascade, Fibrinolytic mechanism

40
Q

Thrombophelbitis Migrans

A

Trousseau Syndrome - Thrombosus appear and reappear, Pancreatic cancer, Consumptive coagulopathy

41
Q

Embolus

A

Detached mass that may lodge - Atherosclerotic debris, Heart valve vegetation, Tumor fragment, Amniotic fluid, Gas, Fat, Foreign particles

42
Q

Pulmonary Embolism

A

Most common, DVT, Pass right side of heart to vessels

43
Q

Systemic (Arterial) Embolism

A

Left side of heart, Major arteries

44
Q

Non-Thrombotic Embolism

A

Fat Emboli - Trauma with bone fracture, Burn, Soft tissue injury; Air Emboli - Gas bubbles and Nitrogen bubbles; Amniotic Embolism - Respiratory distress to DIC

45
Q

Infarction

A

Ischemic death of tissue in body - Causes: Arterial thrombosis or embolism, Atheromatous plaque, Dissecting aortic aneurysm, External compression, Testicular or ovarian torsion, Venous obstruction or Congestion

46
Q

Alternative and Non blood supply organs

A

Dual: Lungs, Liver, Hands, Forearms
End: Kidney, Spleen, Retina

47
Q

Infarction in most tissues

A

Inflammation - Ischemic coagulative necrosis (Heal by fibrosis); Liquefactive necrosis in brain

48
Q

Shape of Infarcts

A

Lungs: Wedge
Kidney: Triangle
Spleen: Irregular
Brain: Fluid cyst

49
Q

Shock

A

Vascular collapse, Multi organ failure (Liver, Kidney, CNS)

50
Q

Types of Shock

A
Cardiogenic
Hypovolemic (Blood loss)
Septicemic/Septic/Endotoxic (Infection) - Arterial vasodilation, Venous pooling, Endothelial activation, DIC, Cytokines
Neurogenic (Dilated veins)
Anaphylactic (Dilated veins)
Obstructive (Artery)
Traumatic
Hypoadrenal
51
Q

Early Non-Progressive Shock

A

Reversible, Reflex compensatory mechanism and vital organ perfusion, Neurohumoral, Tachycardia, Vasoconstriction, Cool, clammy skin

52
Q

Progressive Shock

A

Damage but Reversible, Hypoperfusion, Anaerobic glycolysis - Decrease pH - Dilated arteries and Blood pool, Tachypnea, Fail organs, Confusion, Decline urine

53
Q

Irreversible Stage

A

NO survival, Lysosomal enzyme leak, Decrease myocardial contractility, Ischemic Bowel disease, Acute tubular necrosis, Ischemic encephalopathy, Shock lung, Central hemorrhagic necrosis