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Mechanisms of Disease > Fluid & Hemodynamic - Friedlander > Flashcards

Fluid & Hemodynamic - Friedlander Flashcards

1
Q

What is one of the greatest life-saving interventions we possess?

A

Fluid therapy

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2
Q

Edema in the living

A

Too much interstitial fluid in the tissue and outside the individual cells

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3
Q

Intracellular edema

A

The cloudy swelling we see in injured (but not necessarily killed) cells

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4
Q

Anasarca

A

Generalized, severe edema

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5
Q

Effusion

A

Liquid in the pericardial, pleural, peritoneal or joint cavities

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6
Q

Ascites

A

Effusion in the peritoneal cavity

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7
Q

Hydrothorax

A

Watery fluid in the pleural space

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8
Q

Empyema

A

Pus/purulent effusion in the pleural cavity

Less often, pyothorax

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9
Q

Hydropericardium

A

Watery fluid in the pericardial cavity

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10
Q

Hydrocephalus

A

Too much CSF for whatever reason

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11
Q

Hydrocele

A

Extra fluid within the membrane around the testis

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12
Q

Hydrosalpinx

A

Too much fluid in the fallopian tube (oviduct)

Often follow gonorrheal or other salpingitis

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13
Q

Ileus

A

Too much fluid in the small bowel for whatever reason

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14
Q

Seroma

A

Non-infected fluid in the surgical incision

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15
Q

Loculated effusion

A

More than one compartment, due to scarring

Harder to drain

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16
Q

Blister

A

Fluid in the epidermis or between epidermis and dermis

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17
Q

Bulla

A

Big blisters

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18
Q

Vesicles

A

Little blisters

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19
Q

Edema spreads what?

A

Collagen and smooth muscle

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20
Q

5 mechanisms by which edema can form

A
  1. excess total body fluid
  2. increased pressure in the small veins of the body
  3. decreased total plasma protein/albumin con ten
  4. Lymphatic vessel obstruction

These 4 will give you a transudate

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21
Q

Transudate

A

Salt water without very much protein in it

Can be caused by a shitload of things

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22
Q

What can contribute to dependent edema seen in patients with failing heart pumps

A

Excess total body water and increased venous hydrostatic pressure

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23
Q

When does edema pit?

A

IF the cause is something other than inflammation or obstructed lymph vessels

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24
Q

If there’s edema around the feet what should you think? around the eyes? abdomen?

A

cardiac edema; renal edema; liver disease

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25
Q

what does pulmonary edema sound like? due to?

A

snap, crackle, and pop; little bubbles air makes with water and surfactant

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26
Q

why is cerebral edema problematic?

A

can push the brainstem out of the bottom of the skull

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27
Q

what is hyperemia? characteristics?

A

increased blood flow to the organ, red and throbbing

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28
Q

what is congestion?

A

decreased blood flow from organ, (also increases blood in organ)

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29
Q

what happens if your last heartbeat isn’t as strong as your healthy heartbeats (provided you don’t bleed out)? looks like?

A

blood pools in liver and veins draining it; looks like nutmeg in cross-section

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30
Q

what can congestion result in?

A

vascular problems that produce transudate

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31
Q

what is hemorrhage?

A

blood cells that have escape from a blood vessel

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32
Q

what is a hematoma?

A

enough blood in the tissues for you to be able to palpate it

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33
Q

what is a hemothorax?

A

blood in a pleural cavity

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34
Q

what is a hemopericardium?

A

blood in the pericardial sack

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35
Q

what is a hemoperitoneum?

A

blood in peritoneal cavity

36
Q

what is hemoarthorosis? what is it associated with?

A

bleed into joint space; hemophilia

37
Q

what defines ecchymosis?

A

over 10mm

38
Q

what is the difference in petechiae and pupura?

A

little vs big (bruises)

39
Q

what do petechiae on the lower eyelid warn of?

A

endocaritis

40
Q

name of a complex viral infection involving microvasculature that recently returned to the US due to climate change?

A

Dengue; damages vessels, hemorrhage and systemic edema

41
Q

what does the petechiae on the epicardium indicate?

A

severe thrombocytopenia

42
Q

what is hemoptysis?

A

coughing up blood

43
Q

what is hematemesis?

A

throwing up blood

44
Q

what is hematochezia?

A

bright red blood from the rectum

45
Q

what is melena?

A

blood digested during passage through the gut

46
Q

what is a thrombus?

A

blood that has solidified within a vascular lumen or cardiac chamber

47
Q

what is a clot?

A

blood that has solidified anywhere else

48
Q

process of hemostasis?

A

vasoconstriction, primary hemostasis, platelet adhesion, secondary hemostasis

49
Q

what happens a few hours after a clot/thrombus forms?

A

factor 12 cross-links and polymerize the fibrin; makes clot firm and crumbly

50
Q

what is Virchow’s triad?

A
  1. injured endothelium
  2. altered blood flow (turbulence and stasis)
  3. hypercoaguable blood
51
Q

how do we recognize a thrombus is formed before death?

A

lines of zahn

52
Q

what direction does a thromboembolus propagate?

A

always toward the heart

53
Q

what does a thrombus usually turn into? what happens after? called?

A

granulation tissue, contracts and opens up many channels, recanalization

54
Q

what do post-mortem clots look like? feel like?

A

chicken fat and currant jelly; feel rubbery no lines of Zahn, don’t propagate

55
Q

most common place for a DVT?

A

legs

56
Q

name for a thrombus on the wall of the left ventricle?

A

mural thrombus

57
Q

what are thrombi on heart valves?

A

vegetations

58
Q

what are the most common genetic mutation that causes hypercoaguable blood?

A

factor V-Leiden and prothrombin G0923uoi2u4ih23k whatever hell the numbers are after

59
Q

what are the less common genetic mutations that cause hypercoaguable blood?

A

deficiencies of AT-III, Protein S, protein C

60
Q

what is white clot syndrome/”heparin induced thrombocytopenia”?

A

illness caused by antibodies against a complex of heparin and platelet factor 4

61
Q

what process breakdowns clots as soon as they are formed?

A

fibrinolysis

62
Q

what does disseminated intravascular coagulation results when?

A

blood clotting is activated throughout the circulating bloodstream

63
Q

whats the nemonic that DIC can stand for?

A

Death is Coming; both “too much bleeding” and “too much clotting” problem

64
Q

what are the causes of DIC?

A

thromboplastin gets into the blood, damaged endothelium, or both

65
Q

what are the different kind of emboli?

A

thrombus, paradoxical embolus (venous to arterial circulation), amniotic fluid, air embolus, gas (decompression sickness), fat, bone marrow, cholesterol, silicone, bullet, any fucking thing….

66
Q

what can heroin users get?

A

talc granulomas

67
Q

what are infarcts?

A

areas of ischemic necrosis caused by loss of blood supply

68
Q

what are white infarcts?

A

arterial insufficiency, not reperfused, and single blood supply

69
Q

what are red infarcts?

A

venous insufficiency, reperfused, and dual blood supply

70
Q

what two important organs have dual blood supplies?

A

lung and liver

71
Q

what happens after an infarct?

A

scar formation, contraction

72
Q

what kind of infarct will testicular torsion lead to?

A

venous infaract

73
Q

what are watershed infarcts?

A

necrosis at the places farthest from the arterial supply

74
Q

what is shock?

A

whenever there is widespread undwrperfusion of the body

75
Q

what are 3 overarching causes of shock?

A
  1. cardiac
  2. hypovolemia
  3. loss of vascular tone
76
Q

what metabolic condition can be expected in shock?

A

lactic acidosis (due to poor perfusion, too little oxygen to tissue)

77
Q

what happens in compensated shock?

A

you shunt blood, first to the vital organs: heart and brain

78
Q

what happens in progressive shock/decompensated shock?

A

you are going into anaerobic, kidney and liver are mostly dead, acidic

79
Q

what is happening in irreversible shock?

A

you will be dead soon

80
Q

what is sepsis?

A

bacteria is actually flourishing in the bloodstream, rapidly fatal if not Rx’d quickly and successfully

81
Q

what is the most common organism associated with sepsis?

A

gram positive cocci

82
Q

how do pts feel when in shock? sepsis?

A

shock- cold; sepsis- warm

83
Q

what kind of infarct is part of downward spiral of shock?

A

watershed infarct of subendocardium

84
Q

what are responsible for late lung changes that follow shock?

A

cytokines and neutrophil products

85
Q

what causes cyanosis?

A

> 5g of unoxygenated hemoglobin in the blood

86
Q

why is Dianne crying right now?

A

because of Grey’s. Obviously not this section.. WE GOT THIS SHIT!

Mechanisms of Disease (8 decks)

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