Hemodynamic Disorder

Question 1

What is the first step in hemostasis?

Answer 1

Arteriolar vasoconstriction

Question 2

A deficiency in Gplb leads to what disease?

Answer 2

Bernard-Soulier Syndrome

Note:
Autosomal recessive
Giant platelets , Thrombocytopenia, Prolonged bleeding time.
Absent ristocetin-induced platelet aggregation.
Deficiency: GPIb , IX, V Complex
Homozygous mutations: GP1BA, GP1BB, GP9

Question 3

What pathologic liver finding is characterized by centrilobular regions that are grossly red-brown and slightly depressed contrasted with the normal tan surface?

Answer 3

Nutmeg liver

Question 4

What disease is characterized by ischemia of the femoral head, tibia, and humerus due to formation of gas bubbles in the blood?

Answer 4

Caisson disease

Question 5

Which two characteristics differentiate antemortem from post mortem thrombosis?

Answer 5

1. Attachment to vessel wall ( ante : yes, post: no)
2. Presence of lines of Zahn ( ante: yes, post: no)

Lines of Zahn: characteristic of thrombi , with lighter layers of platelets and fibrin , and darker layers of RBCs.

Question 6

Accumulation of fluid in tissues or body cavities?

Answer 6

Edema - tissues , Effusion - body cavities

Question 7

Increased blood volume within tissues.

Answer 7

Hyperemia and Congestion

Question 8

Pathologic counterpart of hemostasis?

Answer 8

Thrombosis

Question 9

A detached intravascular solid, liquid, or gaseous mass that is carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or infarction.

Answer 9

Embolus

Question 10

Area of ischemic necrosis caused by occlusion of either the arterial supply or the venous drainage.

Answer 10

Infarct

Question 11

State in which diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia.

Answer 11

Shock

Question 12

Four mechanism of edema?

Answer 12

1. Increased hydrostatic pressure
2. Decreased oncotic pressure
3. Increased vascular permeability
4. Lymphatic obstruction

Question 13

General morphologic appearance of edema? (2)

Answer 13

1. Clearing and separation of ECM
2. Subtle cell swelling

Question 14

It is an active process resulting from augmented blood flow due to arteriolar dilation or increased oxygen demand ; affected tissue is redder than normal because of engorgement with oxygenated blood.

Answer 14

Hyperemia

Question 15

It is a passive process resulting from impaired venous return out of a tissue, tissue has a blue red color due to accumulation of deoxygenated blood in the affected tissue.

Answer 15

Congestion

Question 16

Components of Virchow triad ( abnormalities that lead to thrombus formation).

Answer 16

Endothelial injury, Stasis , Hypercoagulability

Question 17

It is a major contributor development of arterial thrombi.

Answer 17

Turbulence or Endothelial Injury ( arterial)

Question 18

It is a major contributor development of venous thrombi?

Answer 18

Stasis ( venous)

Question 19

Any alteration of the coagulation pathway that predisposes to thrombosis; can be
Primary eg. Factor V Leiden , Protein C & S deficiency or
Secondary eg. Cancer, Atrial fibrillation, and prolonged immobilization.

Answer 19

Hypercoagulability

Question 20

Laminations composed of pale platelet and fibrin deposits alternating with darker red cell-riched layers; signify formation of thrombus in flowing blood ; present in antemortem thrombosis.

Answer 20

Lines of Zahn

Question 21

Most common site of arterial thrombosis?

Answer 21

Coronary > Cerebral > Femoral

Question 22

Most common site of venous thrombosis?

Answer 22

Superficial or Deep Veins of the leg

Note: thrombi in superficial leg veins rarely embolize , while thrombi in deep veins are the most common sources of venous emboli.

Question 23

Most common and most dreaded sequela of deep venous thrombosis.

Answer 23

Pulmonary embolism

Question 24

Embolus occluding the bifurcation of the pulmonary trunk, associated with sudden death due to acute right sided heart failure.

Answer 24

Saddle embolus

Question 25

65/F known case of DVT , came from a 17 hour flight developed respiratory distress with right ventricular wall dysfunction on 2D echo. What is the diagnosis?

Answer 25

Pulmonary embolism