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PBD I Exam 2 > Hemodynamic Disorders I > Flashcards

Hemodynamic Disorders I Flashcards

1
Q

edema

A

increased interstitial fluid

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2
Q

anasacara

A

edema with subQ tissue swelling

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3
Q

fluid in body cavity

A

hydro-

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4
Q

transudate

A

protein poor

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5
Q

exudate

A

protein rich

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6
Q

ascites

A

liver cirrhosis

-reduced albumin - reduced plasma osmotic pressure

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7
Q

nephrotic syndrome

A

glomeruli leaky - albumin loss

-lead to edema

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8
Q

sodium and water retention

A

can cause edema

-kidney disorders

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9
Q

CHF

A

renal hypoperfusion
-leads to edema

early - RAAS activated with increased ADH - restore renal perfusion

over time - retained fluid causes edema

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10
Q

subQ edema

A

influenced by gravity - dependent edema
-displaced - pitting edema

can signify underlying cardiac or renal pathology

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11
Q

pulmonary edema

A

left ventricular failure

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12
Q

hyperemia

A

active process

-artery dilation - increased blood flow

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13
Q

erythema

A

tissue turns red

response to hyperemia

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14
Q

congestion

A

passive process

-reduced outflow of blood from tissue

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15
Q

cyanotic

A

tissue is reddish blue

response to congestion
-deoxygenated Hg

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16
Q

acute pulmonary congestion

A

engorged capillaries with edema

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17
Q

chronic pulmonary congestion

A

septa thickened and fibrotic

-hemosiderin macrophages

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18
Q

heart failure cells

A

hemosiderin M0s - in chronic pulmonary congestion

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19
Q

acute hepatic congestion

A

central vein and sinusoids are distended

  • centrilobular cells ischemic
  • periorbial better oxygenated
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20
Q

chronic passive hepatic congestion

A

centrilobular red-brown and depressed - nutmeg liver

-hemosiderin M0s

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21
Q

centrilobular area of liver

A

likely to undergo necrosis

-at edge of blood supply

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22
Q

hemorrhage

A

extravasation of blood into extravasculature

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23
Q

hematoma

A

hemorrhage maintained in a tissue

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24
Q

petechiae

A

1-2mm hemorrhage in skin, mucous membrane, or serosa

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25
purpura
>3mm hemorrhages in skin, mucous membrane, or serosa
26
ecchymoses
>1-2mm subQ hematoma typical bruise Hg (red-blue) > bilirubin (blue green) > hemosiderin (gold brown)
27
thrombosis
clot in intact vessels
28
site of vascular injury
vasoconstriction - due to endothelin ECM promotes platelet adherence and activation platelets aggregate to form plug
29
primary hemostasis
platelet aggregation forming hemostatic plug
30
tissue factor
factor III, or thromboplastin -activates factor VII in extrinsic pathway of coagulation
31
thrombin
cleaves fibrinogen to fibrin
32
secondary hemostasis
fibrin and platelets
33
permanent plug
polymerized fibrin and platelet aggregates
34
t-PA
limit hemostatic plug at site of injury
35
antithrombosis of endothelium
adenosin diphosphatase, prostacyclin and NO - antiplatelet heparin-like mlcs > antithrombin III, thrombomodulin - anticoagulant t-Pa - fibrinolytic
36
thrombomodulin
binds thrombin and converts it to anticoagulant - its ability to activate protein C - inactivates factors Va and VIIIa
37
prothrombosis of endothelium
vWF - platelet binding tissue factor - in response to TNF and IL-1 - extrinsic clotting PAIs - antifibrinolytic
38
platelets
shed from megakaryocytes
39
alpha granules of platelets
``` P-selectin fibrinogen fibronectin factor V and VIII PF4 PDGF TGF-beta ```
40
delta granules of platelets
``` ADP ATP calcium histamine serotonin epinephrine ``` **important for coagulation and platelet aggregation
41
platelet adhesion
vWF > GpIb
42
bernard soulier syndrome
deficient GpIb no platelet adhesion to vWF bleeding disorder
43
TxA2
vasoconstrictor | also stimulates platelet aggregation
44
thrombin activity
1 - binds to PAR - activates platelet aggregation 2 - converts fibrinogen to fibrin
45
fibrinogen
binds to platelet GpIIb-IIIa receptor | -bridging interactions
46
glanzmann thrombasthenia
deficiency in GpIIb-IIIa receptor | -no fibrinogen bridging of platelets
47
clopidogrel
block ADP binding block platelet aggregation
48
prostacyclin
PGI2 | -vasodilator and inhibits platelet aggreagation
49
aspirin
irreversible COX inhibitor -blocks synthesis TxA2 used to decreased chance of thrombosis
50
reactions of coagulation
surface of phospholipid | -held together by Ca2+
51
coumadin
anti-thrombotic agent - inhibits binding of coagulation factors - rxn that requires Vit K normally
52
blood coagulation converge on
factor V
53
intrinsic clotting pathway
factor XII
54
extrinsic clotting pathway
requires exogenous trigger
55
PT time
assays extrinsic pathway factors VII, X, II, V, fibrinogen add TF to citrated plasma -add calcium - measure time to clot
56
PTT time
assays intrinsic pathway factors XII, XI, IX, VIII, X, V, II, fibrinogen negative charged particle (glass) -time to clot measured
57
thrombin proinflammatory
through binding PARs
58
endogenous anticoagulants
antithrombins protein C and S TFPI
59
plasmin
breaks down fibrin -releases fibrin split products fibrinolytic cascade
60
t-PA
activates plasminogen to plasmin
61
virchows triad
lead to thrombus 1 - endothelial injury 2 - stasis or turbulent blood flow 3 - hypercoagubility of blood
62
thrombi in cardiac chambers
often due to endothelial injury
63
thrombophilia
hypercoagulability
64
leiden mutation
point mutation in factor V gene -lead to hypercoagulabiltiy resistant to cleavage by protein C
65
prothrombin gene mutation
hypercoagulability
66
homocystein
prothrombic effects
67
rare inherited causes of primary hypercoagulability
deficiency in antithrombin III, protein C, protein S
68
patients under age 50 with thrombosis
need to consider genetic causes
69
smoking and obesity
hypercoagulability
70
oral contraceptive
hypercoagulability
71
heparin induced thrombocytopenia syndrome
administration of unfractionated heparin -antibodies for heparin and platelet complexes results in thrombocytopenia -also - prothrombotic state
72
antiphospholipid antibody syndrome
recurrent thrombosis repeated miscarriage valve vegetations thrombocytopenia antibodies to plasma proteins -induce hypercoagulable state false positive for syphilis** secondary - to some other disorder primary - no evidence of autoimmune disorder
73
growth of thrombi
toward heart arterial - retrograde venous - anterograde
74
lines of zahn
laminations in thrombi -platelet/fibrin layers and red cell layers show it was in flowing blood -not postmortem
75
mural thrombi
in heart chambers or in aortic lumen
76
arterial thrombi
often occlusive | -coronary, cerebral, femoral arteries
77
phlebothrombosis
venous thrombi -almost always occlusive lots of red cells - red (stasis) thrombi
78
postmortem clots
gelatinous with dark red portion where red cells settled and yellow chicken fat upper portion usually not attached to underlying wall
79
vegetations
thrombi on heart valves
80
libman sacks endocarditis
SLE vegetations
81
fate of thrombi
propagation embolization dissolution organization and recanalization
82
venous thrombi
can embolize to lung
83
superficial venous thrombi
saphenous vein | -rarely embolize
84
deep venous thrombi
DVT - popliteal, femoral, iliac veins - can embolize to lung
85
trousseau syndrome
migratory thrombophlebitis
86
arterial thrombosis
often with atherosclerosis
87
DIC
disseminated intravascular coagulation widespread fibrin thrombin in microcirculation platelet and coagulation consumption -can result in excessive bleeding catastrophe

PBD I Exam 2 (18 decks)

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