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Pathology > Haemodynamic Disorders > Flashcards

Haemodynamic Disorders Flashcards

1
Q

Thrombosis and Embolism both causes

A

Infarction

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2
Q

Normal Hemostasis depends on

A

Vascular wall
Platelets
Blood clotting system

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3
Q

What is hemorrhage

A

Injury without blood clotting which results with blood escape from the vessels

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4
Q

4 steps of Blood clotting

A

1- Vasoconstriction
2-Primary Hemostasis
3-Secondary Hemostasis
4-Thrombus and Antithrombotic events

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5
Q

What happens first step of blood clotting

A

Vasoconstriction
Endothelin release causes vasoconstriction
Maintained by endothelial cells
Inhibit the escaping from BV
Injury to vessel wall
Shrinkage of BV

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6
Q

What happens and which molecules take place in the second step of Blood clotting

A

Primary Hemostasis
Normal functioning epi cells and platelets take role
1-Platelet adhesion
2-Shape of platelets change
3-Granule release (ADP,TXA2)
4-Increase in the number of platelets bc of TXA2
5- Hemostatic plug formation

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7
Q

What happens and which molecules take place in the third stage of blood clotting?

A

Platelets, clotting factors,epi cells,fibrin
1- Tissue factor secretion and stimulates clotting cascades
2-Phospholipd complex expression
3-Thrombin activation
4-Fibrin polymerization
At the end solid plaque

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8
Q

Function of Fibrin

A

Adhere platelets to each other while forming the solid plaque

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9
Q

What happens and which molecules take place at the last stage of blood clotting

A

Clotting factors,platelets
Release of t-PA (fibrinolysis)
Release of Thrombomodulin — blocks coagulation cascade —secreted from platelets
Degradation of the solid plaque

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10
Q

2 mechanisms of Endothelium and Subendothelium

A

1-Passive mechanism
2-Active mechanism

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11
Q

Passive Mechanism

A

Covers the subendo which is thrombogenic — plug formation
Fibriller collagen
Fibronectin

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12
Q

Role of Fibriller collagen in Passive mechanism

A

Platelet adhesion
Platelet activation
Contact activation of clotting factor

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13
Q

Role of Fibronectin in Passive mechanism

A

Stabilize cell to cell, cell to substrate attachments in the endothelial lining
*Cross-linked to fibrin

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14
Q

Active mechanism of Endothelium and Subendothelium

A

Antithrombotic factors
Prothrombotic factors

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15
Q

What happens at the Thrombotic stage of Blood clotting

A

Platelet stimulation—vWF and collagen binding
Platelet adhesion— held together by fibrinogen
Procoagulant—Coagulation stimulation—membrane bound tissue factor, coagulation sequence
Antifibrinolytic

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16
Q

What happens at the Antithrombotic stage of Blood clotting

A

Anticoagulant— Thrombin inactivation—Thrombomodulin and thrombin direct binding, Heparin-like molecule and Antithrombin 3 binding.

Antiplatelet— PGI2,NO,Adenosine Diphosphate releasing from endo cells— inhibits platelet aggregation.

Fibrinolytic— t-PA

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17
Q

Control of PGI2,NO and Adenosine Diphosphate is belong to

A

Thrombin— anti-coagulant

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18
Q

Types of platelets receptors

A

Gp1b
Gp2b-3a

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19
Q

Role of Gp1b receptor

A

Binding of platelets to vWF
**Adherence

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20
Q

Role of Gp2b-3a

A

Binding 2 platelets together by binding the same fibrinogen
Fibrinogen binds first after than the second platelet comes and binds
**Platelet aggregation

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21
Q

Role of vWF

A

Binds to platelets by Gp1b receptor

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22
Q

Secretion of vWF by

A

Endothelial cells

23
Q

Deficiency of Gp2b-3a causes

A

Glanzmann thrombasthenia

24
Q

Deficiency of Gp1b causes

A

Bernard-Soulier syndrome

25
Q

Deficiency of vWF causes

A

Von Willebrand disease— rapid hemorrhage

26
Q

Platelet activation maintained by (*)

A

Collagen

27
Q

In order to activate platelets which events should occur

A

Adhesion and shape change
Secretion
Aggregation

28
Q

Platelets synthesize_?

A

TXA2 for aggregation/vasoconstriction

29
Q

2 groups of platelet secretions

A

1-Alpha granules = Fibrinogen,TGF-beta,Platelet factor 3,vWF
2-Dense bodies= ADP,ATP,Ca,histamine,serotonin, epinephrine

30
Q

Role of ADP in blood clotting

A

Formation of primary and secondary hemostotic plague

31
Q

Fibrinogen converted to fibrin how

A

By activated thrombin(active coagulant factor 2) and Ca

32
Q

Which of the platelet factor limites the excess blood clotting in the are of injury

A

Unmasking platelet factor 3

33
Q

Gp2b-3a activated by?

A

Thromboxane

34
Q

Gp1b inhibited by

A

Heparin

35
Q

What are the secretions of endothelium when stimulated by Thrombin

A

T-PA
NO
PGI2
All of them inhibit aggregation of platelets

36
Q

Two coagulant effects of Thrombin

A

Pro-coagulant
Anti-coagulant

37
Q

Anticoagulant mechanisms

A

Depletion of clotting factors
Clearance of activated clotting factors
Inhibition of activated proteases
Fibrinolysis—main anti-coagulant mechanism

38
Q

How is Fibrinolysis occur?

A

Fibrin+Fibrinogen—> Split products
Enzyme= Plasmin protease
Plasmin is formed from Plasminogen(Zymogen)

39
Q

Plasminogen activators

A

Urokinase-like PA—>fluid phase, plasma
Tissue type PA —>fibrin,endo cells

40
Q

Thrombosis

A

Clotted mass of blood in a specific area
Limits the blood flow
Attached to the vessel wall
Endothelial injury,Hypercoagulability, Abnormal blood flow causes Thrombosis

41
Q

Alterations in normal blood flow

A

Turbulence= Countercurrents,local pockets of stasis
Stasis= sluggish venous thrombosis, varicose veins

42
Q

Hypercoagulability seen in

A

Deficiency of antithrombin 3/protein C
Kidney diseases
Severe trauma or burns
Disseminated cancer
Late pregnancy

43
Q

Hazards of thrombosis

A

Race
Age
Smoking
Obesity

44
Q

Types of thrombi

A

Venous Thrombi= occlusive. Occurs in superficial varicose veins, deep leg veins. Attached to the underlying vessel wall.emboli in lung. Venous infarction

Arterial Thrombi=occlusive, coronary,cerebra,femoral. Due to atherosclerosis,vasculitis,traumatic injury. Infraction in myocardial,cerebral. Emboli in cardiac chambers and aorta

45
Q

Mural thrombi

A

Non-occlusive
At heart chambers of aorta

46
Q

Vegetations thrombi

A

Thrombotic masses on the heart valves

47
Q

What is Lines of Zahn

A

Alternating layers of platelets+ fibrin(pale) and RBC (darker)
Characteristic for thrombus
In autopsy *

48
Q

Types of Embolism

A

Pulmonary= thrombi of large veins of the lower leg
Systemic = thrombi from the heart

49
Q

Critical determinants for Embolism

A

Site of lodgement
Size of the emboli

50
Q

Amniotic fluid embolism

A

Result of tear in placental membranes+rupture of uterine veins—>Amniotic fluid enters in circulation HUMORAL FACTOR (PGF2)—> Pulmonary vasoconstriction +impaired cardiac contractility—> cardiac shock+ pulmonary edema

51
Q

Fat embolism

A

Fractures of large bones
Affects lung,brain,kidney
Embolism of fat globules
Emulsion instability
Chemical injury to microvessels
Activation of the coagulant system

52
Q

Air or Gas Embolism Barotrauma

A

Caused by delivery or abortion

53
Q

Decompression sickness

A

Sudden change in atmospheric pressure
Acute= effects small blood vessels
Chronic= causes Caisson disease —> Platelet activation and Intravascular coagulation

54
Q

Infarction

A

Localized areas of ischemic necrosis
Red infarct
White infarct
Septic infarct
Bland infarct

Pathology (12 decks)

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