Hemodynamic disorders

Question 1

edema

Answer 1

increased fluid in tissue interstitial spaces

Question 2

categories of edema

Answer 2

increased hydrostatic pressure/ impaired venous return; reduced plasma oncotic pressure, lymphatic obstruction, sodium retention, inflammation

Question 3

hyperemia

Answer 3

increase in amount of intravascular blood in tissue due to active arteriolar dilation so more blood is allowed into the capillary bed. Occurs in inflammation and exercise

Question 4

congestion

Answer 4

passive process of impaired venous outflow; capillary bed becomes more full due to obstruction of venous outflow. Appears more blue/ cyanotic due to accumulation of deoxygenated blood. usually goes together with edema

Question 5

heart failure cells

Answer 5

hemosiderin-laiden macrophages, esp in lung with chronic passive congestion

Question 6

hemorrhage

Answer 6

extravasation of blood due to vessel rupture

Question 7

hematoma

Answer 7

blood accumulation in a space or tissue

Question 8

petechiae

Answer 8

small (1-2 mm) punctate hemorrhages

seen on skin or mucosal/serosal surfaces, associated with low platelets (thrombocytopenia)

Question 9

purpura

Answer 9

slightly larger punctate hemorrhages (≥ 3 mm), associated with small vessel vasculitis

Question 10

hemostasis

Answer 10

rapid formation of a localized plug at site of vascular disruption. requires vascular wall endothelium, platelets, coagulation proteins

Question 11

primary hemostasis

Answer 11

Platelet adherence, activation and aggregation

Question 12

secondary hemostasis

Answer 12

Generation of active thrombin and fibrin with polymerization of fibrin and platelet aggregates

Question 13

thrombosis

Answer 13

pathologic activation of hemostatic mechanism in which clot occurs inside vessel

Question 14

virchow triad of thrombosis

Answer 14

endothelial injury, abnormal blood flow, hypercoagulability

Question 15

genetic factors in hypercoagulability

Answer 15

Factor V Leiden or prothrombin mutation

Question 16

acquired factors in hypercoagulability

Answer 16

visceral malignancy, hyperestrogenic states, etc

Question 17

embolus

Answer 17

intravascular solid, liquid, gaseous material that detaches from vascular wall and is carried to a distant site

Question 18

paradoxical embolism

Answer 18

a venous thromboembolus passing through an atrial or ventricular heart defect to lodge in the systemic arterial system

Question 19

infarct

Answer 19

an area of ischemic necrosis caused by occlusion of arterial supply or venous drainage
nearly all result from arterial thrombosis or thromboembolism

Question 20

factors affecting infarction

Answer 20

nature of vascular supply (dual vs end arterial), rate of occlusion, oxygen content of blood, susceptibility of tissue

Question 21

shock

Answer 21

CV collapse resulting in systemic hypoperfusion

Question 22

cardiogenic shock

Answer 22

failure of heart as a pump, due to MI, cardiac tamponade, saddle embolus/ outflow obstruction

Question 23

hypovolemic shock

Answer 23

substantial loss of intravascular volume due to hemorrhage, plasma loss

Question 24

septic shock

Answer 24

systemic inflammatory response to presence of pathogenic organisms or their toxins in the blood or tissues. inflammatory response-> systemic vasodilation-> profound hypotension

Question 25

acute respiratory distress

Answer 25

clinical syndrome of pulmonary dysfunction caused by diffuse alveolar capillary damage

Question 26

diffuse alveolar disease

Answer 26

histologic picture of the lung from ARDS

Question 27

disseminated intravascular coagulation

Answer 27

widespread activation of coagulation within vessels AND widespread activation of fibrinolytic system leading to excessive bleeding