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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
what does pulmonary edema sound like? due to?
snap, crackle, and pop; little bubbles air makes with water and surfactant
26
why is cerebral edema problematic?
can push the brainstem out of the bottom of the skull
27
what is hyperemia? characteristics?
increased blood flow to the organ, red and throbbing
28
what is congestion?
decreased blood flow from organ, (also increases blood in organ)
29
what happens if your last heartbeat isn't as strong as your healthy heartbeats (provided you don't bleed out)? looks like?
blood pools in liver and veins draining it; looks like nutmeg in cross-section
30
what can congestion result in?
vascular problems that produce transudate
31
what is hemorrhage?
blood cells that have escape from a blood vessel
32
what is a hematoma?
enough blood in the tissues for you to be able to palpate it
33
what is a hemothorax?
blood in a pleural cavity
34
what is a hemopericardium?
blood in the pericardial sack
35
what is a hemoperitoneum?
blood in peritoneal cavity
36
what is hemoarthorosis? what is it associated with?
bleed into joint space; hemophilia
37
what defines ecchymosis?
over 10mm
38
what is the difference in petechiae and pupura?
little vs big (bruises)
39
what do petechiae on the lower eyelid warn of?
endocaritis
40
name of a complex viral infection involving microvasculature that recently returned to the US due to climate change?
Dengue; damages vessels, hemorrhage and systemic edema
41
what does the petechiae on the epicardium indicate?
severe thrombocytopenia
42
what is hemoptysis?
coughing up blood
43
what is hematemesis?
throwing up blood
44
what is hematochezia?
bright red blood from the rectum
45
what is melena?
blood digested during passage through the gut
46
what is a thrombus?
blood that has solidified within a vascular lumen or cardiac chamber
47
what is a clot?
blood that has solidified anywhere else
48
process of hemostasis?
vasoconstriction, primary hemostasis, platelet adhesion, secondary hemostasis
49
what happens a few hours after a clot/thrombus forms?
factor 12 cross-links and polymerize the fibrin; makes clot firm and crumbly
50
what is Virchow's triad?
1. injured endothelium 2. altered blood flow (turbulence and stasis) 3. hypercoaguable blood
51
how do we recognize a thrombus is formed before death?
lines of zahn
52
what direction does a thromboembolus propagate?
always toward the heart
53
what does a thrombus usually turn into? what happens after? called?
granulation tissue, contracts and opens up many channels, recanalization
54
what do post-mortem clots look like? feel like?
chicken fat and currant jelly; feel rubbery no lines of Zahn, don't propagate
55
most common place for a DVT?
legs
56
name for a thrombus on the wall of the left ventricle?
mural thrombus
57
what are thrombi on heart valves?
vegetations
58
what are the most common genetic mutation that causes hypercoaguable blood?
factor V-Leiden and prothrombin G0923uoi2u4ih23k whatever hell the numbers are after
59
what are the less common genetic mutations that cause hypercoaguable blood?
deficiencies of AT-III, Protein S, protein C
60
what is white clot syndrome/"heparin induced thrombocytopenia"?
illness caused by antibodies against a complex of heparin and platelet factor 4
61
what process breakdowns clots as soon as they are formed?
fibrinolysis
62
what does disseminated intravascular coagulation results when?
blood clotting is activated throughout the circulating bloodstream
63
whats the nemonic that DIC can stand for?
Death is Coming; both "too much bleeding" and "too much clotting" problem
64
what are the causes of DIC?
thromboplastin gets into the blood, damaged endothelium, or both
65
what are the different kind of emboli?
thrombus, paradoxical embolus (venous to arterial circulation), amniotic fluid, air embolus, gas (decompression sickness), fat, bone marrow, cholesterol, silicone, bullet, any fucking thing....
66
what can heroin users get?
talc granulomas
67
what are infarcts?
areas of ischemic necrosis caused by loss of blood supply
68
what are white infarcts?
arterial insufficiency, not reperfused, and single blood supply
69
what are red infarcts?
venous insufficiency, reperfused, and dual blood supply
70
what two important organs have dual blood supplies?
lung and liver
71
what happens after an infarct?
scar formation, contraction
72
what kind of infarct will testicular torsion lead to?
venous infaract
73
what are watershed infarcts?
necrosis at the places farthest from the arterial supply
74
what is shock?
whenever there is widespread undwrperfusion of the body
75
what are 3 overarching causes of shock?
1. cardiac 2. hypovolemia 3. loss of vascular tone
76
what metabolic condition can be expected in shock?
lactic acidosis (due to poor perfusion, too little oxygen to tissue)
77
what happens in compensated shock?
you shunt blood, first to the vital organs: heart and brain
78
what happens in progressive shock/decompensated shock?
you are going into anaerobic, kidney and liver are mostly dead, acidic
79
what is happening in irreversible shock?
you will be dead soon
80
what is sepsis?
bacteria is actually flourishing in the bloodstream, rapidly fatal if not Rx'd quickly and successfully
81
what is the most common organism associated with sepsis?
gram positive cocci
82
how do pts feel when in shock? sepsis?
shock- cold; sepsis- warm
83
what kind of infarct is part of downward spiral of shock?
watershed infarct of subendocardium
84
what are responsible for late lung changes that follow shock?
cytokines and neutrophil products
85
what causes cyanosis?
>5g of unoxygenated hemoglobin in the blood
86
why is Dianne crying right now?
because of Grey's. Obviously not this section.. WE GOT THIS SHIT!

Mechanisms of Disease (8 decks)

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