Haemodynamic Disorders

Question 1

define oedema

Answer 1

abnormal increase in interstitial fluid

Question 2

name causes of oedema

Answer 2

increased hydrostatic pressure due to impaired venous return or increased venous pressure
salt and water retention
reduced plasma oncotic pressure
inflammation
lymphatic obstruction

Question 3

name and describe the types of oedema

Answer 3

generalised
-fluid in serous cavities, subcutaneous tissue
-due to heart failure, inflammation, venous hypertension, lymphatic obstruction
localised
-pulmonary, cerebral
-due to congestive heart failure, hypoproteinaemia, low albumin

Question 4

define thrombosis

Answer 4

abnormal clot formation

Question 5

what is virchows triad?

Answer 5

endothelial injury
stasis/turbulent flow
hyper-coagulation

Question 6

what are the causes of venous thrombosis?

Answer 6

due to stasis and hyper-coagulation

Question 7

what is the most common type of vein thrombosis? what is a complication

Answer 7

DVT

pulmonary embolism

Question 8

what is the cause of arterial thrombosis?

Answer 8

vessel wall injury by atherosclerotic plaque

Question 9

what does an arterial thrombosis cause?

Answer 9

ischaemia of supplied tissue

Question 10

what can thrombi do?

Answer 10

propagate - get bigger
embolise - dislodge
dissolute - break down
organise and recanalise - formation of lumen through thrombi

Question 11

define embolus

Answer 11

abnormal material within circulation, carried by blood to distant site from origin

Question 12

name some types of embolus

Answer 12

dislodged thrombi, air, fat, tumour

Question 13

define infarct

Answer 13

area of ischaemic necrosis caused by occlusion

Question 14

name the types of infarct

Answer 14

red infarct - venous occlusion

white infarct - arterial

Question 15

what causes a venous thromboembolism?

Answer 15

DVT

Question 16

how do the symptoms of a pulmonary embolism vary depending on the artery?

Answer 16

major = death
medium = breathless 
minor = breathless, chest pain, dizzy

Question 17

define haemorrhage

Answer 17

extravasation of blood due to rupture

Question 18

name the causes of a haemorrhage

Answer 18

trauma (triple A) or intrinsic ( marfan’s disease)

Question 19

name the types of shock

Answer 19

hypovolaemic - blood loss
cariogenic - heart attack
anaphylactic - allergy
septic - sepsis
neurogenic - brain

Question 20

give characteristics of hybovolaemic shock

Answer 20

loss of greater then 1 litre of blood

most perfused organs e.g. kidneys, brain

Question 21

give characteristics of cardiogenic shock

Answer 21

heart can’t pump to meet demands
acute MI
death

Question 22

give characteristics of systemic inflammatory response syndrome

Answer 22

temp above 38 or below 36
tachycardia
resp rate greater than 20
WBC greater then 12x10^9

Question 23

what is sepsis?

Answer 23

SIRS + infection

Question 24

what is severe sepsis?

Answer 24

sepsis + organ hypoperfusion

Question 25

what is septic shock?

Answer 25

severe sepsis + hypoperfusion despite fluid resuscitation

Question 26

what causes septic shock?

Answer 26

gram positive bacteria

Question 27

what are complications of septic shock?

Answer 27

organ dysfunction and failure
ischaemic tissue
acute tubular necrosis in kidney

Question 28

summarise the mechanism of pulmonary oedema

Answer 28

plasma oncotic pressure should be higher than hydrostatic pressure in pulmonary capillaries
left heart failure leads to increased hydrostatic pressure so fluid accumulates in IS space then alveolar spaces

Question 29

summarise the mechanism of cerebral oedema

Answer 29

increased permeability of capillaries and venules

derangement of Na/K pump