hemodynamic disorders

Question 1

hyperemia

Answer 1

1) arteriolar dilation and increase blood inflow

Question 2

conjestion

Answer 2

1) impaired blood flow from a tissue
- cyanotic1

Question 3

edema

Answer 3

1) movement of fluid from vessels to interstitial space
- protein poor or rich

Question 4

extravascular fluid can also

Answer 4

1) collect in body cavities
- pleural cavity (hydrothorax)
- pericardial cavity (hydropericardium)
- peritoneal cavity (hydroperitoneum)

Question 5

anasarca

Answer 5

severe, generalized edema

Question 6

vascular hydrostatic pressure

Answer 6

1) balanced by colloid osmotic pressure (from proteins)
2) imbalance will cause edema

Question 7

edema can cause

Answer 7

1) impaired venous return
2) arteriolar dilation
3) lymphatic obstruction
4) sodium retention
5) inflammation

Question 8

decrease in plasma albumin

Answer 8

1) decrease in plasma osmotic pressure
2) edema results
3) important clinical marker in malnutrition

Question 9

deep venous thrombosis

Answer 9

• distal portion of lower extremity (legs)
• can cause edema!!
• can lead to heart failure

Question 10

nephrotic syndrome

Answer 10

1) damaged glomerular capullaries become leaky
2) loss of albumin in urine
3) generalized edema

Question 11

types of edema

Answer 11

1) subcutaneous
2) dependent
3) pitting
- finger pressure over subcutaneous area

Question 12

pulmonary edema

Answer 12

1) lungs are three to four times its own weight2) frothy and blood tinged fluid
- edema fluid, RBC, and air

Question 13

brain edema

Answer 13

1) needs immediate surgical intervention
- craniotomy
- let brain expand for a few months
2 ) caused by trauma

Question 14

hemorrhage

Answer 14

1) extravasation of blood from vessels
2) petechiae
1-2 mm
3) purpura
- 0.3-5mm
4) ecchymosis
- 1-2 cm

Question 15

significance of blood loss

Answer 15

1) clinical signficance depends on blood volume lost

Question 16

hemostasis and thrombosis

Answer 16

1) vascular wall, platelets, and coagulation
2) normal hemostasis
- vascular injury
- endothelial injury
- fibrinolysis

Question 17

platelets

Answer 17

1) hemostatic plug that seals vascular defect
2) surface recruits cells and activates clotting factors
- the antifibrinolytic effects
3) anucleate cells
4) alpha granules and dense bodies are produced

Question 18

antithrombotic properties of nromal endothelium

Answer 18

1) inhibitory effects on platelets
2) inhibitory effect on coagulation factors
2) fibrinolysis

Question 19

prothrombotic properties of

Answer 19

1) activation of platelets
2) actication of clotting factors
3) antifibrinolytic effects
- von Willebrand factor

Question 20

deficiency

Answer 20

1) von willebrand
2) glanzmann
3) bernard-soulier

Question 21

external damage

Answer 21

1) extrinsic pathway
- thromboplastin

Question 22

internal damage

Answer 22

1) intrinsic pathway
- hagemann factor

Question 23

when people are on anti-coagulants

Answer 23

1) INR
- internal normalized ratio
2) PT
- extrinsic
- prothrombin time
- vitamin K antagonists and factor 7
3) PTT
- any intrinsic factor
- sensitive to heparin

Question 24

role of thrombin in hemostasis

Answer 24

1) generate fibrin by cleaving fibrinogen (factor 13)
2) insoluble clot
3) activate other coagulation factors to amplify the cascade

Question 25

virchow's triad

Answer 25

1) endothelial integrity is the most important factory 2) endothelial injury, abnormal flood flow, hypercoagubility to form the clot

Question 26

how to damage blood flow

Answer 26

1) sepsis 2) bacterial products 3) radiation injury 4) endothelial dysfunction 5) turbulent blood flow

Question 27

abnormal blood flow

Answer 27

1) endothelial injury 2) stasis: stagnant blood flow - major development of venous thrombosis - platelets and leukocytes start cascade

Question 28

acute myocardial infarction

Answer 28

1) heart attack 2) MI is serious - cells are DEAD 3) angina is reversible

Question 29

hypercoagubility

Answer 29

1) risk factor for venous thrombosis 2) primary - mutation neofactor 5 - prothrombin genes 2) secondary - prolonged bedrest - important to be on heparin - PTT test (do not want it super low or high)

Question 30

heparin induced thrombocytopenia

Answer 30

1) heparin makes autoantibodies and cause them to bleed 2) autoimmune disorder 3) severe consumption of platelets

Question 31

antiphospholipid antibody syndrome

Answer 31

1) autoantibody against phospholipids and plasma proteins

Question 32

thrombosis developed

Answer 32

1) virchow's triad going wrong 2) when all three come together, you get thrombus formation 3) what can happen?? - PROPAGATE - ORGANIZE - EMBOLIZE (free floating clot)

Question 33

disseminated intravascular coagulation

Answer 33

1) body is trying to stop a clot and throw a clot simultaneously - stop the bleeding and prevent them from getting a stroke 2) life threatening - massive bleeding and clotting 3) lack of platelets 4) diagnoses by blood count - fibrinogen, PT, PTT, D-dimer, blood smear 5) low-dose heparin

Question 34

embolism

Answer 34

1) carried from distant origin 2) thrombus that is detached - solid, liquid, or gas carried by blood 3) bone marrow can embolize 4) gas bubbles can be risk to divers 5) can lodge in vessels and result in partial or complete occlusion - extremities and lungs - cell death (necrosis)

Question 35

pulmonary thromboembolism

Answer 35

1) uncommon but pretty fatal 2) embolism goes into lungs 3) risk factors - pregnancy, obesity, stroke, trauma, stroke, anything that makes you bedbound 4) fever, tachycardia, systemic decompensation 5) diagnosis - D-dimer test and modified walls criteria, *CT angiography*, EKG, respiratory alkalosis, 6) treatment - warfarin and keep INR at 2-3 - surgical intervention (inferior vena cava filter) - thrombectomy (lung resection)

Question 36

modified wells criteria

Answer 36

1) to determine likelihood of PE 2) <= 4 is unlikely 3) > 4 is likely

Question 37

chest xray

Answer 37

know it is gold standard