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TOPNOTCHER PEDIA > HEMODYNAMIC DISORDERS > Flashcards

HEMODYNAMIC DISORDERS Flashcards

1
Q

Accumulation of fluid in tissues or body cavities

A

Edema (tissues)

Effusion (body cavities)

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2
Q

Increased blood volume within tissues

A

hyperemia and congestion

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3
Q

pathologic counterpart of hemostasis

A

thrombosis

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4
Q

A detached intravascular solid, liquid, or gaseous mass that is carried by the blood from its point of origin to a distant site, where it often causes tissue dysfunction or infarction

A

embolus

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5
Q

Area of ischemic necrosis caused by occlusion of either the arterial supply or the venous drainage

A

infarct

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6
Q

State in which diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia

A

shock

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7
Q

4 main mechanisms of edema formation

A
  1. Increased hydrostatic pressure
  2. Decreased oncotic pressure
  3. Increased vascular permeability
  4. Lymphatic obstruction
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8
Q

General morphologic appearance of edema

A
  1. Clearing and separation of ECM

2. Subtle cell swelling

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9
Q

58/M, with history of MI, presented with paroxysmal nocturnal dyspnea and orthopnea. CXR showed bilateral pleural effusion. What is the diagnosis, the mechanism of edema in this case, and the kind of effusion?

A

Congestive heart failure; Increased hydrostatic pressure; Transudate

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10
Q

32/M, with history of remittent fever and productive cough, developed dyspnea. CXR showed right pleural effusion with left parenchymal infiltrates. What is the mechanism of edema in this case, and what is the kind of effusion?

A

Parapneumonic effusion; CAP MR; Increased vascular permeability; Exudate

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11
Q

57/M, chronic alcoholic, presented with increase in abdominal girth. Chemistry showed low serum albumin and elevated ALT and AST. Abdominal UTZ showed moderate ascites. What is the mechanism of edema in this case?

A

Decreased oncotic pressure

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12
Q

Decreased oncotic pressure

34/F, known case of breast cancer stage 2 (T2N0M0), s/p MRM, left, developed left arm swelling. What is the mechanism of edema in this case?

A

lymphatic obstruction

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13
Q

It is an active process resulting from augmented blood flow due to arteriolar dilation or increased oxygen demand; affected tissue is redder than normal, because of engorgement with oxygenated blood

A

HYPEREMIA

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14
Q

It is a passive process resulting from impaired venous return out of a tissue; tissue has a blue-red color due to accumulation of deoxygenated blood in the affected tissue

A

CONGESTION

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15
Q

24/M, with a large left atrial myxoma that obstructed flow of blood into the left atrium, subsequently died. Autopsy of the lung showed engorged alveolar capillaries, alveolar septal edema, and focal intra-alveolar hemorrhage. What is the diagnosis?

A

Acute pulmonary congestion

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16
Q

34/F, died from acute right-sided heart failure secondary to saddle embolus. Autopsy of the liver showed distended central vein and sinusoids, centrilobular ischemic necrosis, and periportal fatty change. What is the diagnosis?

A

Acute hepatic congestion

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17
Q

55/M, died of complications from congestive heart failure. Autopsy of the lung showed thickened and fibrotic alveolar septa, and hemosiderin-laden macrophages. What is the diagnosis?

A

Chronic passive congestion, lung

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18
Q

60/M, died of complications from heart failure. On autopsy, liver is heavier than normal and has a nutmeg-like appearance. Sections show centrilobular hemorrhage, hemosiderin-laden macrophages, and hepatocyte loss of variable degrees. What is the diagnosis?

A

Chronic passive congestion, liver

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19
Q

Components of Virchow triad (abnormalities that lead to thrombus formation)

A

endothelial injury
stasis
hypercoagulability

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20
Q

It is a major contributor to the development of arterial thrombi

A

turbulence of endothelial injury

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21
Q

It is a major contributor to the development of arterial thrombi

A

turbulence or

endothelial injury

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22
Q

It is a major contributor to the development of venous thrombi

A

stasis

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23
Q

Any alteration of the coagulation pathway that predisposes to thrombosis; can be primary (e.g. Factor V Leiden, Protein C and S deficiency) or secondary (e.g. Cancer, atrial fibrillation, and prolonged immobilization)

A

hypercoagulability

24
Q

Factor V Leiden

hypercoagulability

a. primary
b. secondary

A

a.

25
Q

cancer

hypercoagulability

a. primary
b. secondary

A

b.

26
Q

protein c deficiency

hypercoagulability

a. primary
b. secondary

A

a.

27
Q

atrial fibrillation

hypercoagulability

a. primary
b. secondary

A

b.

28
Q

S deficiency

hypercoagulability

a. primary
b. secondary

A

a

29
Q

prolonged immobilization

hypercoagulability

a. primary
b. secondary

A

b

30
Q

Laminations composed of pale platelet and fibrin deposits alternating with darker red cell-rich layers; signify formation of thrombus in flowing blood; present in antemortem thrombosis

A

lines of zahn

31
Q

Most common site of arterial thrombosis

A

coronary > cerebral

32
Q

Most common site of venous thrombosis

A

Superficial or deep veins of the leg

33
Q

the most common sources of venous emboli

A

thrombi in deep leg veins are the most common sources of venous emboli
(Thrombi in superficial leg veins rarely embolize)

34
Q

Thrombi accumulate additional platelets and fibrin

A

Propagation

35
Q

Thrombi dislodge and travel to other sites in the vasculature

A

Embolization

36
Q

Rapid shrinkage and total disappearance of recent thrombi

A

Dissolution

37
Q

Thrombi becomes incorporated in the vessel wall with formation of new capillary channels that restore blood flow

A

Organization and recanalization

38
Q

Most common and most dreaded sequela of deep venous thrombosis

A

Pulmonary embolism

39
Q

Embolus occluding the bifurcation of the pulmonary trunk; associated with sudden death due to acute right-sided heart failure

A

Saddle embolus

40
Q

65/F, known case of DVT, came from a 17-hour flight, developed respiratory distress with right ventricular wall dysfunction on 2D-Echo. What is the diagnosis?

A

Pulmonary embolism

41
Q

45/F, known case of thyrotoxic heart disease and chronic atrial fibrillation, developed sudden left-sided weakness and loss of sensation. What is the type of embolism observed in the patient?

A

Systemic thromboembolism (from mural thrombus)

42
Q

38/M, known case of Non-Hodgkin lymphoma, developed sudden right-sided weakness. Patient has had a recent admission for a month, and has a history of a cardiac pathology that the cardiologist deemed benign. What is the phenomenon observed in the patient?

A

Paradoxical embolism (Cardiac pathology is PFO patent foramen ovale)

43
Q

refers to an embolus which is carried from the venous side of circulation to the arterial side, or vice versa. It is a kind of stroke or other form of arterial thrombosis caused by embolism of a thrombus (blood clot), air, tumor, fat, or amniotic fluid of venous origin, which travels to the arterial side through a lateral opening in the heart, such as a patent foramen ovale,[1] or arteriovenous shunts in the lungs.

A

paradoxical embolism

44
Q

32/M, involved in a motorcycle accident, and sustained a mid-shaft right femoral fracture, without any blunt or penetrating head and chest trauma. Patient developed progressive respiratory distress, and died. Autopsy shows fat globules in pulmonary vasculature. What is the diagnosis?

A

fat embolism

45
Q

25 G1P1(1001) developed respiratory distress, seizures, and refractory bleeding post-partum, and died. Autopsy shows fetal skin and lanugo in pulmonary vasculature. What is the diagnosis?

A

Amniotic fluid embolism

46
Q

30/M, diver, developed respiratory distress and joint pain after rapid ascent. Work-up showed gas bubbles in pulmonary vasculature and joints. What is the diagnosis?

A

Air embolism (Decompression sickness)

47
Q

also called generalized barotrauma or the bends, refers to injuries caused by a rapid decrease in the pressure that surrounds you, of either air or water. It occurs most commonly in scuba or deep-sea divers, although it also can occur during high-altitude or unpressurized air travel.

A

decompression sickness

48
Q

Infarcts that tend to occur in loose tissues and in those with dual circulations, previously congested tissues, or when flow is reestablished after an infarction (i.e. after angioplasty of obstructed artery);

A

Red (hemorrhagic) infarct

49
Q

examples: Pulmonary and Bowel infarcts

A

Red (hemorrhagic) infarct

50
Q

Infarcts that tend to occur in solid organs with end-arterial circulations

A

White (anemic) infarct

51
Q

examples: Myocardial and Splenic infarcts

A

White (anemic) infarct

52
Q

55/M, known case of massive MI, developed ventricular fibrillation, and died. What kind of shock did the patient suffer from?

A

Cardiogenic shock

53
Q

65/M, with ruptured abdominal aortic aneurysm, died. What kind of shock did the patient suffer from?

A

Hypovolemic shock

54
Q

23/M, college student and dormer, developed cough and colds for 2 days, followed by remittent high-grade fever, with dusky ecchymoses on the lower extremities. At ER, patient was stuporous with BP = 50 palpatory. What is the diagnosis, and the kind of shock did the patient suffer from?

A

Meningococcemia; Septic shock

55
Q

25/F, suffered from a bee sting, developed generalized wheals, periorbital edema, and respiratory distress. At ER, BP = 70/50. What kind of shock did the patient suffer from?

A

Anaphylactic shock

56
Q

28/F, suffered from a blunt trauma of the back after a vehicular accident, was hypotensive for several days, and was started on vasopressors for management. What kind of shock did the patient suffer from?

A

Neurogenic shock

TOPNOTCHER PEDIA (30 decks)

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