Hemodynamic Disorder Flashcards
What is the first step in hemostasis?
Arteriolar vasoconstriction
A deficiency in Gplb leads to what disease?
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
What pathologic liver finding is characterized by centrilobular regions that are grossly red-brown and slightly depressed contrasted with the normal tan surface?
Nutmeg liver
What disease is characterized by ischemia of the femoral head, tibia, and humerus due to formation of gas bubbles in the blood?
Caisson disease
Which two characteristics differentiate antemortem from post mortem thrombosis?
- Attachment to vessel wall ( ante : yes, post: no)
- 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.
Accumulation of fluid in tissues or body cavities?
Edema - tissues , Effusion - body cavities
Increased blood volume within tissues.
Hyperemia and Congestion
Pathologic counterpart of hemostasis?
Thrombosis
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.
Embolus
Area of ischemic necrosis caused by occlusion of either the arterial supply or the venous drainage.
Infarct
State in which diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia.
Shock
Four mechanism of edema?
- Increased hydrostatic pressure
- Decreased oncotic pressure
- Increased vascular permeability
- Lymphatic obstruction
General morphologic appearance of edema? (2)
- Clearing and separation of ECM
- Subtle cell swelling
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.
Hyperemia
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.
Congestion
Components of Virchow triad ( abnormalities that lead to thrombus formation).
Endothelial injury, Stasis , Hypercoagulability
It is a major contributor development of arterial thrombi.
Turbulence or Endothelial Injury ( arterial)
It is a major contributor development of venous thrombi?
Stasis ( venous)
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.
Hypercoagulability
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.
Lines of Zahn
Most common site of arterial thrombosis?
Coronary > Cerebral > Femoral
Most common site of venous thrombosis?
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.
Most common and most dreaded sequela of deep venous thrombosis.
Pulmonary embolism
Embolus occluding the bifurcation of the pulmonary trunk, associated with sudden death due to acute right sided heart failure.
Saddle embolus
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?
Pulmonary embolism
