Hemodynamic Disorders Flashcards
Thromboembolism can cause
Myocardial infarction
Pulmonary embolism
Stroke
Heart failure cells
Macrophage laden with hemosiderin
Seen in chronic pulmonary congestion
Anasarca
Severe, generalized edema marked by profound swelling of subcutaneous tissues and accumulation of fluid in body cavities
In acute hepatic congestion l, peripoetal hepatocytes
Better oxygenated -> less severe hypoxia and may develop only reversible fatty change
Chronic passive congestion of liver
Macro : red brown tan sometimes fatty liver (nutmeg liver)
Micro: centrilobular hepatocyte necrosis, hemorrhage, hemosiderin laden macrophages
What lead to extravascular fluid accumulation
Increase hydrostatic pressure and decreased osmotic pressure
Filiariosis
Lymphatic obstruction by parasite -> massive edema of the lower extrem and external genitalia (elephantiasis) by lymph fibrosis
Lymph edema
Breast cancer -> peau dorange
Complication of therapy -> breast cancer who undergo axillary lymph node resection/ irradiation -> lymphedema of the arm
Excessive salt and water retention are seen in
Post streptococcal glomerulonephritis
Acute renal failure
Petechiae
Def
Causes
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
Purpura
Def
Causes
3-5 mm
Cause : same causes as petechiae + trauma, vascular inflammation (vasculitis) and increased vascular fragility
Ecchymoses
Def
Cause
1-2 cm subcutaneous (commonly called bruises)
Internal bleeding impact on iron ?
Does not lead to iron def (bc iron is recycled)
Hemostasis and thrombosis involve 3 elements
Vascular wall
Platelets
Coagulation cascade
Virchow’s triad in thrombosis
Endothelial injury
Abnormal blood flow (stasis or turbulence)
Hyper coagulability
Primary (inherited) hypercoagulability most often is caused
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
High risk for thrombosis (secondary/acquired)
9
Prolonged bed rest MI AFIB Tissue injury Cancer Prosthetic cardiac valves Disseminated intravascular coag Heparin induced thrombocytopenia Antiphospholipid antibody syndrome
Most frequent site of cerebral hemorrhage
Internal capsule and adjacent basal ganglia
The vessels most commonly ruptured are : arteriae lenticulostriatae, small branches of middle cerebral artery
Fatty streak
First grossly visible lesion in dev of atherosclerosis
Consists of foam cells which are lipoprotein-loaded macrophages located in the intima
Fate of thrombus
Propagation
Embolism
Dissolvation
Organization( replacement of thrombus by connective tissue) and recanalization
Thrombosis may results in
Ischemia by occlusion of arterial lumen
Passive congestion : due to impairment of venous blood outflow
Thromboembolism : after detachment of entire thrombus
Most frequent fat embolism
Pulmonary bone marrow embolism
Fat embolism syndrome
Pulmonary insufficiency
Neurologic symptoms
Anemia
Thrombocytopenia
Symptoms begin 1-3 days after injury with sudden onset of tachypnea, dyspnea, tachycardia
Ischaemic (white) infarcts occurs in
And causes
Macroscopic
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
