Haemodynamic disorders

Question 1

Definition of oedema

Answer 1

Abnormal increase in interstitial fluid

Question 2

aetiological classification of oedema

Answer 2

hypertension
inflammation
Reduced plasma oncotic pressure (reduced albumin) - generalised oedema
Lymphatic obstruction (tumour/lymph node dissection/chronic inflammation)
Sodium retention - reduced cardiac output - water retention - renin-angiotensin system

Question 3

generalised oedema, and causes

Answer 3

in serous cavities

Congestive heart failure, Hypoproteinaemia (low protein content), Nutritional oedema

Question 4

localised oedema, and causes

Answer 4

cerebral and pulmonary

Left heart failure, Inflammation, Venous hypertension, Lymphatic obstruction

Question 5

Pulmonary consequences of oedema

Answer 5

dyspnoea (breathlessness) - worse when flat (orthopnoea)

fluid in alveolar space - bacterial infection

Question 6

Define shock

Answer 6

systemic hypotension

System hypoxia

Question 7

causes of shock - general

Answer 7

Low cardiac output

reduced circulatory volume

Question 8

Cause of cardiogenic shock

Answer 8

acute MI
arrhythmia
cardiac tamponade (fluid in pericardium - compress heart)

Question 9

cause of septic shock

Answer 9

bacterial infection activate immune system (endotoxins - complement pathway, damage endothelial cells, tumour necrosis factor)
vasodilation
blood pooling
SIRS - systemic inflammatory response syndrome
severe sepsis and hypoperfusion

Question 10

cause of hypovolaemic shock

Answer 10

loss blood due to haemorrhage or fluid loss

kidney, brain skin

Question 11

cause of neurogenic shock

Answer 11

loss of vascular tone
cord injury
anaesthetic medication

Question 12

type of shock

Answer 12

septic
neurogenic
hypovolaemic
cardiogenic

Question 13

What is a haemorrhage

Answer 13

extravasion of blood due to a vessel rupture

Question 14

causes of haemorrhage

Answer 14

trauma

intrinsic disease of vessel - amyloid/collagen vascular disease.

Question 15

consequences of haemorrhage

Answer 15

risk hypovalaemia
shock
death

Question 16

Thrombosis definition

Answer 16

Abnormal blood clot in circulatory system

Question 17

embolism definition

Answer 17

Abnormal material in circulatory system that has travelled to site distant from origin

Question 18

infarction definition

Answer 18

Tissue necrosis due to ischemia

Question 19

cause of thrombosis

Answer 19

endothelial injury
stasis/turbulent blood flow
blood hypercoagulability

Question 20

How does endothelial injury cause a thrombosis

Answer 20

caused because high blood flow and high levels of stress

platelet aggregation

Question 21

How does stasis/turbulent blood flow cause thrombosis

Answer 21

lead to endothelial injury
stasis - disruption lamina blood flow - venous thrombi
turbulent blood flow - endothelial damage - localised stasis - arterial and cardiac thrombi

Question 22

cause of hyopercoagulability

Answer 22

blood disease
primary - factor V mutation, protein C deficiency
secondary - multifactorial, cancer, age, obesity, the pill

Question 23

fate of thrombi

Answer 23

propagation - occumulation more fibrin and platelets
embolization - dislodge
dissolution - fibrinolysis
organisation and recanalization - envelope fibroblasts, endothelial cells, smooth muscle cells, capillary channels develop

Question 24

consequence of thrombi

Answer 24

venous thrombosis - pulmonary embolism

arterial thrombosis - ischemia of tissue/infarction

Question 25

consequences of embolism

Answer 25

block vessels
venous thromboembolism - pulmonary thromboembolism - breathless, chest pain, dizziness, death
systemic emboli - TIA, stroke, bowel infarction, limb ischemia

Question 26

Cause of embolism

Answer 26

fragments dislodged thrombus

fat, air, amniotic fluid, tumour

Question 27

cause of infarction

Answer 27

thrombotic/embolic vascular occlusion
vasculitis
haematological abnormalities

Question 28

consequences of infarction

Answer 28

repair - permanent loss of structural tissue