Hemodynamic Disorders

Question 1

Thromboembolism can cause

Answer 1

Myocardial infarction
Pulmonary embolism
Stroke

Question 2

Heart failure cells

Answer 2

Macrophage laden with hemosiderin

Seen in chronic pulmonary congestion

Question 3

Anasarca

Answer 3

Severe, generalized edema marked by profound swelling of subcutaneous tissues and accumulation of fluid in body cavities

Question 4

In acute hepatic congestion l, peripoetal hepatocytes

Answer 4

Better oxygenated -> less severe hypoxia and may develop only reversible fatty change

Question 5

Chronic passive congestion of liver

Answer 5

Macro : red brown tan sometimes fatty liver (nutmeg liver)

Micro: centrilobular hepatocyte necrosis, hemorrhage, hemosiderin laden macrophages

Question 6

What lead to extravascular fluid accumulation

Answer 6

Increase hydrostatic pressure and decreased osmotic pressure

Question 7

Filiariosis

Answer 7

Lymphatic obstruction by parasite -> massive edema of the lower extrem and external genitalia (elephantiasis) by lymph fibrosis

Question 8

Lymph edema

Answer 8

Breast cancer -> peau dorange

Complication of therapy -> breast cancer who undergo axillary lymph node resection/ irradiation -> lymphedema of the arm

Question 9

Excessive salt and water retention are seen in

Answer 9

Post streptococcal glomerulonephritis

Acute renal failure

Question 10

Petechiae
Def
Causes

Answer 10

1-2 mm in diam into skin mucous membranes or serosal surfaces

Cause: low platelet counts (thrombocytopenia)
Loss of vascular wall support as in Vitamin C deficiency

Question 11

Purpura
Def
Causes

Answer 11

3-5 mm

Cause : same causes as petechiae + trauma, vascular inflammation (vasculitis) and increased vascular fragility

Question 12

Ecchymoses
Def
Cause

Answer 12

1-2 cm subcutaneous (commonly called bruises)

Question 13

Internal bleeding impact on iron ?

Answer 13

Does not lead to iron def (bc iron is recycled)

Question 14

Hemostasis and thrombosis involve 3 elements

Answer 14

Vascular wall
Platelets
Coagulation cascade

Question 15

Virchow’s triad in thrombosis

Answer 15

Endothelial injury
Abnormal blood flow (stasis or turbulence)
Hyper coagulability

Question 16

Primary (inherited) hypercoagulability most often is caused

Answer 16

Mutations in factor V (Leiden mutation, resistant to protein C)
Heterozygotes-> 5-fold increase risk for venous thrombosis
Homozygotes-> 50-fold

and prothrombin genes (1-2% in general pop) ,
Increased prothrombin transcription
3-fold increased risk

Question 17

High risk for thrombosis (secondary/acquired)

9

Answer 17

Prolonged bed rest 
MI 
AFIB 
Tissue injury 
Cancer 
Prosthetic cardiac valves 
Disseminated intravascular coag 
Heparin induced thrombocytopenia 
Antiphospholipid antibody syndrome

Question 18

Most frequent site of cerebral hemorrhage

Answer 18

Internal capsule and adjacent basal ganglia

The vessels most commonly ruptured are : arteriae lenticulostriatae, small branches of middle cerebral artery

Question 19

Fatty streak

Answer 19

First grossly visible lesion in dev of atherosclerosis

Consists of foam cells which are lipoprotein-loaded macrophages located in the intima

Question 20

Fate of thrombus

Answer 20

Propagation
Embolism
Dissolvation
Organization( replacement of thrombus by connective tissue) and recanalization

Question 21

Thrombosis may results in

Answer 21

Ischemia by occlusion of arterial lumen

Passive congestion : due to impairment of venous blood outflow

Thromboembolism : after detachment of entire thrombus

Question 22

Most frequent fat embolism

Answer 22

Pulmonary bone marrow embolism

Question 23

Fat embolism syndrome

Answer 23

Pulmonary insufficiency
Neurologic symptoms
Anemia
Thrombocytopenia

Symptoms begin 1-3 days after injury with sudden onset of tachypnea, dyspnea, tachycardia

Question 24

Ischaemic (white) infarcts occurs in

And causes

Macroscopic

Answer 24

Organs with anatomically of functionally terminal arteries such as heart, spleen, kidney.

Caused by arterial oclusion from thrombosis or embolism

Macroscopically, white shaped cone with the base at the periphery and apex towards occluded artery

Question 25

Pyknosis

Answer 25

Nuclei are shrunken and more intensively stained with hematoxylin

Question 26

Karyorhexis

Answer 26

Nuclei undergo fragmentation

Question 27

Karyolysis

Answer 27

Nuclei lose ability to stain with hematoxylin and disappear

Question 28

Saddle embolism occurs in

Answer 28

Pulmonary artery

Question 29

Precursor protein in senile systemic amyloidosis

Answer 29

Tranthyretin