Hemodynamic disorders

Question 1

Morphologic hallmark of edema

Answer 1

Clearing and separation of extracellular matrix and subtle cell swelling

Question 2

% Body water in the ECF

Answer 2

30%

Question 3

% Body water in the interstitium

Answer 3

15%

Question 4

Conditions that may lead to anasarca

Answer 4

Heart failure
Malnutrition
Dec hepatic synthesis
Nephrotic syndrome

Question 5

Type of edema fluid that is low in CHON and cell content; presents as pitting edema

Answer 5

Transudate

Question 6

Type of edema fluid that has high CHON and cell content; presents as non-pitting edema

Answer 6

Exudate

Question 7

ACTIVE process in w/c arteriolar dilation leads to inc BF

Answer 7

Hyperemia

Question 8

PASSIVE process resulting from reduced outflow of blood from tissue

Answer 8

Congestion

Question 9

What part of the liver undergoes steatosis when there is ischemia?

Answer 9

Periportal

Question 10

What part of the liver undergoes coagulation necrosis when there is ischemia?

Answer 10

Centrilobular

Question 11

Morphologic finding in chronic hepatic congestion where there is hemorrhagic centrilobular hepatocytes against uncongested tan liver; usually d/t R-sided HF

Answer 11

Nutmeg liver

Question 12

> 3mm hemorrhages; assoc w/ vasculitis

Answer 12

Purpura

Question 13

1-2cm subcutaneous hematomas

Answer 13

Ecchymoses

Question 14

Accumulation of blood w/in tissues; “bruise w/ bump”

Answer 14

Hematoma

Question 15

1-2mm hemorrhages into the skin, mucous membranes or serousal surfaces; usually d/t plt dysfx

Answer 15

Petechiae

Question 16

Triad of HSP

Answer 16

Arthritis
Abdominal pain
Renal glomerulonephritis

Question 17

Age of blue-green ecchymosis

Answer 17

5-7 days post-injury

Question 18

Age of ecchymosis with a gold-brown color

Answer 18

> 2 weeks

Question 19

% blood volume lost in hemorrhagic shock

Answer 19

> 20%

Question 20

4 processes in hemostasis

Answer 20

Arteriolar vasoconstriction: endothelin
Primary hemostasis: Plt adherence, activatin
Secondary hemostasis: F3,4, thrombin, fibrin
Thrombotic, anti-thrombotic mechanisms (tPA limit plug)

Question 21

Amplifies plt aggregation

Answer 21

Thromboxane A2 (TXA2)

Question 22

Complex deficient in Glanzmann thrombasthenia; for plt aggregation

Answer 22

GpIIb-IIIa complex

Question 23

Deficient in Bernard-Soulier syndrome; for plt adhesion

Answer 23

GpIb

Question 24

Factor found in subendothelium; reacts with GpIb

Answer 24

Von Willebrand factor

Question 25

Gp IIb-IIIa inhibitors

Answer 25

Abciximab Eptofibatide Tirofiban

Question 26

Virchow's triad of thrombosis

Answer 26

Endothelial injury Hypercoagulability AbN blood flow

Question 27

Most common primary hypercoagulable state

Answer 27

Factor V Leiden mutation | inc F8,9,11 or fibrinogen

Question 28

Type of heparin that may induce Abs that recognizes complexes of heparin and plt factor 4

Answer 28

Unfractionated heparin

Question 29

Antibodies involved in APAS

Answer 29

Anticardiolipin | Lupus anticoagulant

Question 30

What test will get a false-positive result in APAS?

Answer 30

RPR | test for FTA-ABS

Question 31

What activity is inihibited in APAS?

Answer 31

t-PA activity

Question 32

Morphologic sign in antemortem thrombosis; pale plt and fibrin deposits alt w/ darker red cell-rich layers

Answer 32

Lines of Zahn

Question 33

Post mortem lividity starts when after death?

Answer 33

20 mins- 3 hrs

Question 34

Thrombi occurring in heart chambers or in aortic lumen

Answer 34

mural thrombosis

Question 35

Thrombosis that occurs at sites of turbulence; freq in the coronaries

Answer 35

Arterial thrombosis

Question 36

Thrombosis that occurs on sites of stasis; freq on LE

Answer 36

Venous thrombosis

Question 37

Thrombi on the heart valves

Answer 37

Vegetations

Question 38

Consumptive cogaulopathy

Answer 38

DIC

Question 39

Most common cause of native valve endocarditis

Answer 39

Viridans strep

Question 40

Most common cause of prosthetic valve endocarditis

Answer 40

S. epidermidis

Question 41

Bacterium implicated in marantic endocarditis

Answer 41

Step. bovis

Question 42

Classic signs of pulmonary embolism

Answer 42

Accentuated pulmonic cmpt of S2 Neck vein engorgement Low-grade fever Tachycardia and tachypnea

Question 43

Embolism in the pulmonary artery bifurcation

Answer 43

Saddle embolus

Question 44

Complication of pulmonary embolism that occurs w/ R-sided HF

Answer 44

Cor pulmonale

Question 45

ECG manifestation of pulmonary embolism

Answer 45

Sinus tachy

Question 46

Gold standard in dx PE

Answer 46

Pulmonary angiography

Question 47

DVT that presents as a pale, painful leg w/ diminished arterial pulse d/t congestion

Answer 47

Phelgmasia alba dolens

Question 48

DVT that presents as cyanotic, painful leg d/t extensive thrombotic occlusion

Answer 48

Phlegmasia cerulea dolens

Question 49

80% of mural thrombi arises from what part of the heart?

Answer 49

Anterior wall

Question 50

Embolism that occurs with long bone fractures

Answer 50

Fat embolism

Question 51

Amount of air that causes air embolism

Answer 51

>100cc

Question 52

Inc amt of dissolved N in the pulmonary vasculature

Answer 52

chokes

Question 53

Ischemic necrosis of femoral heads, tibia and humerus

Answer 53

Caisson disease

Question 54

Embolism usually experienced postpartum; 80% mortality

Answer 54

Amniotic fluid embolism

Question 55

Valvular heart defect leading to septic embolism

Answer 55

Tricuspid valve embolism

Question 56

Organism usually involved in septic embolism

Answer 56

Staph. aureus

Question 57

Infarction occurring on tissues with dual circulation

Answer 57

Red infarction

Question 58

Infarction occurring on organs w/ end-arterial circulation (heart, spleen, kidneys)

Answer 58

White infarction

Question 59

Beck's triad of cardiac tamponade

Answer 59

Muffled heart sound Neck vein engorgement Hypotension

Question 60

ECG finding in cardiac tamponade

Answer 60

low-voltage complex

Question 61

What shock does burn patients suffer from?

Answer 61

Hypovolemic shock

Question 62

Most severe form of meningoccemia

Answer 62

Waterhouse-Friedrichsen syndrome

Question 63

What reflex should be tested in patients suspected w/ neurogenic shock?

Answer 63

Anal sphincter reflex

Question 64

Ig involved in anaphylactic shock

Answer 64

IgE

Question 65

Shock that presents with bradycardia and warm extremities, d/t peripheral pooling blood and loss of vascular tone

Answer 65

Neurogenic shock

Question 66

Best parameter for measuring blood volume in shock

Answer 66

PCWP