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Year 2 > Haemodynamic Disorders > Flashcards

Haemodynamic Disorders Flashcards

1
Q

What is involved in fluid homeostasis?

A

Vessel integrity
Osmolality
Maintenance of intravasccular pressure.

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2
Q

How is fluid balance maintained?

A

Hydrostatic pressure and colloid oncotic pressure

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3
Q

What is colloid concotic pressure

A

Negative pressure generated by oncotic proteins which promote reabsorption.

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4
Q

What is oedema?

A

Build up of fluid in the extracellular space due to:
Na+ retention with excessive RAAS activation
Inflammation
Lymphatic obstruction
Loss of plasma proteins via liver cirrhosis, burns, urine in nephrotic syndrome or faeces.

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5
Q

What is hydrothorax?

A

Oedema in the thoracic cavity.

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6
Q

What is hyperaemia?

A

Increase blood volume to tissues via vasodilation. The two types of hyperaemia are reactive and active hyperaemia.

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7
Q

What is reactive hyperaemia?

A

Increased vasodilation in response to low oxygen or accumulation of metabolic waste.

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8
Q

What is active hyperaemia?

A

Vasodilation in response to activity like exercise.

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9
Q

What is congestion?

A

Passive process where there is excessive accumulation of blood due to obstruction of the veins or heart failure.
Local congestion is an isolated venous obstruction such as thrombosis or tumour
Systemic congestion is due to heart failure which creates widespread oedema.

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10
Q

What are the stages of haemostasis?

A

Haemostasis is a process to reduce blood flow which involves:
Haemorrhage
Thrombosis to form a clot
Fibrinolysis to dissolve the clot

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11
Q

What is haemorrhage?

A

Loss of blood due to rupture of a blood vessel. Types include petechia, purpura and ecchymosis.

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12
Q

What is petechia?

A

Minute haemorrhage of the skin and the mucosa, due to thrombocytopenia, clotting factor deficiency or increased capillary pressure.

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13
Q

What is purpura?

A

Small haemorrhage due to trauma of the skin.

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14
Q

What is ecchymosis?

A

Subcutaneous haematoma, with colour change due to metabolism of haemoglobin.

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15
Q

What are the features of centrilobular hepatic congestion?

A

Mottled nutmeg appearance, representing dilated and congested hepatic venules.

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16
Q

What are the features of chronic pulmonary congestion?

A

Blood backup increases pressure on the alveolar capillaries, causing erythrocytes to leak out. Alveolar macrophages engulf the erythrocytes and cause brownish haemosiderin, indicating heart failure.

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17
Q

What is a thrombus?

A

Blood clot formed in the vessel which remains attached to the vessel wall, which is caused by:
Endothelial injury
Abnormal blood flow
Hypercoaguability

18
Q

What are the features of arterial thrombi?

A

Platelet rich thrombi formed under high shear flow at damaged atherosclerotic plaques or endothelium. The two types of arterial thrombus are mural and occlusive.

19
Q

What are the features of venous thrombi?

A

Fibrin and erythrocyte rich clot formed following activation of the coagulation cascade under low shear flow, due to changes in blood composition or blood flow or vessel wall damage. It forms by hypercoagubility or fibrin driven response.

20
Q

What is a mural thrombus?

A

A type of arterial thrombi which does not occlude a vessel and causes a minor or transient clinical event.

21
Q

What is an occlusive thrombus?

A

A type of arterial thrombi which occludes a vessel and causes a major clinical event.

22
Q

What is atherosclerosis?

A

Disease of any of the arteries which begins in early life and is a major cause of death, which develops progressively through accumulation of cholesterol.

23
Q

What is atherogenesis?

A

Initiating of fatty streak formation after endothelial dysfunction causes lipid entry in the tunica intima layer which leads to leukocyte recruitment and macrophage consumption of fat, causing foamy macrophages. It causes the formation necrotic core with dead foam cells and encapsulated by a fibrous cap. The plaque will rupture due to its thrombogenic potential and leads to atherothrombosis.

24
Q

What are the clinical complications of atherosclerosis?

A

Coronary artery disease
Carotid artery disease
Peripheral artery disease
Chronic kidney disease
Aneurysm

25
Q

What is an embolism?

A

Solid, liquid or gaseous mass which is carried away to a site distant from the origin, such as a fat globule or foreign material. When it is a blood clot, it is a thrombus.

26
Q

What is a pulmonary embolus?

A

Originates from a deep vein thrombosis (DVT) which creates a blockage of blood flow in the lungs

27
Q

What is ischaemia?

A

An inadequate blood supply to an organ or tissue, which creates an insufficient blood supply to oxygen or nutrients, and inadequate removal of metabolic waste.

28
Q

What is hypoxia?

A

A region of the body is deprived of oxygen at the tissue level.

29
Q

What is infarction?

A

Complete cessation of blood flow typically caused by embolus which results in tissue death and ischaemic necrosis.

30
Q

What is an aneurysm?

A

Abnormal bulge in the vessel wall, which is more common in arterial vessels. The two types of aneurysm are true and pseudoaneurysms.

31
Q

What is a true aneurysm?

A

Affects all layers of the tunica intima, media and externa and is divided into:
Fusiform aneurysm
Saccular aneurysm

32
Q

What is a fusiform aneurysm?

A

Symmetrical true aneurysm.

33
Q

What is a saccular aneurysm?

A

Assymetrical true aneurysm.

34
Q

What is pseudo aneurysm?

A

It is a locally contained haematoma which involves no layers of the vessel wall.

35
Q

What is a shock?

A

Systemic hypoperfusion which reduces the delivery of oxygen and nutrients, that leads to the cellular injury and inadequate tissue function.

36
Q

What is cardiogenic shock?

A

Failure of the heart to pump sufficient blood caused by myocardial damage with pulmonary embolism.

37
Q

What is obstructive shock?

A

Obstruction to blood flow in the heart or pulmonary artery, due to an embolism.

38
Q

What is the cause of neurogenic shock?

A

Severe damage to the CNS which leads to systemic vasodilation

39
Q

What is the cause of septic shock?

A
40
Q

What is the cause of haemorrhagic shock?

A

Loss of blood plasma through severe burns.

41
Q

What is the Pathophysiology of sepsis?

A

Bacterial components from the lipopolysaccharide wall of Gram negative bacteria triggers the systemic release of cytokines Il-1 and TNF-alpha, where nitric oxide release causes vasodilation and increased permeability of vessels. There is activation of the complement system and abnormal blood gases.

42
Q

What is MODS?

A

Multi-Organ Dysfunction Syndrome, where 2 or more organs are irreversibly damaged, due to conditions like sepsis.

Year 2 (247 decks)

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