Hemodynamic Disorders IV Flashcards
what is virchow’s triad
hypercoagulatble state
endothelial injury
circulatory stasis
endothelial injury
dominant influence on thrombosis
what are risk factors for endothelial dysfunction
diabetes mellitus
hypercholesterolemia
hypertension
smoking
what is hypercoagulable state often caused by
factor V mutation
what does factor V leiden casue
resistance to degradation by activated protein C
increased probability of thrombosis
antiphospholipid antibody syndrome
serum antibodies directed against anionic phospholipids
antiphospholipid antibody syndrome in vitro
inhibit clotting tests due to interference with assembly of phospholipid complexes
antiphospholipid antibody syndrome in vivo
hypercoagulable state
clinical signs of antiphospholipid antibody syndrome
recurrent venous or arterial thrombi
repeated miscarriages
cardiac valve vegetaations
thrombocytopenia
causes of turbulent
ulcerated atheroscloertic plaque
MI
atrical fib
where do arterial thrombi occur
sites of endothelial injury
what does venous thrombi usually occur as a consequence of
statis
risk factors for arterial thrombossi
MI
rhematic heart disease
Afib
atheroscelorsis
arterial thrombosis
may cause local obstruction or distant embolization
what arteries tend to have arterial thrombi
coronary > cerebral > femoral
what are arterial thrombi composed of
platelets
fibrin
erythrocyte
leukocyte
risk factors for venous thrombosis
CHF trauma surgery pregnacy cancer
trouseeaue syndrome/migratory thrombophlebitis
serine protease released by maligant tumor cells activates factor 10
tumor cells release plasma membrane vesicles exhibiting procoagulant activity
What are common sources for arterial emboli
a fib mitral stenosis endocarditis mural thrombi paradoxical emboli
systemic thromboembolism
emboli that migrate within the arterial ciruclation
most common systemic thromboembolism
intracardiac mural thrombi
What is the most common destination of arterial embolization
lower extremities
mural thrombi
arterial thrombosis in cardiac chamber due to myocardial infarction, ulcerated atherosclerotic plaque or aneurysmal dilation
paradoxical embolism
rare condition where an embolus originating from venous circulation passes through an inter-atrial or inter-ventricular defect to gain access to systemic circulation
What do pulmonary thromboembolism usually arise from
DVT
most common pulomary emboli
small
large pulmonary emboli
saddle emboli
sudden death or acute right heart failure
small to medium sized pulmonary emboli
more likely to cause infarcation
seen mainly in pts with heart or lung disease
small pulmonary emboli
mostly silent
infarctions only if compromised pulmonary circulation
hemorrhages mainly
recurrent pulmonary emboli
worsening dyspnea
chronic
How do you get fat embolism
fractures of long bones
soft tissue trauma
burns
symptoms of fat embolism syndrome
tachypnea, dyspnea
tachycardia
diffuse petechial rash
What is air embolism due to
obstetric procedures
chest wall injury
decompression sickness
sudden changes in atm pressure
the bends
painful formation of gas bubbles in skeletal muscles and supporting tissues in and around joints
the chocks
gas emboli in lungs cause edema, hemorrhage, atelectasis and emphysema causing respiration
amniotic fluid embolism
amniotic fluid within circulation
symptoms of amniontic fluid embolism
dyspnea, cyanosis, shock, coma, DIC
what does an amniotic fluid embolism consist of
epithlial cells
lanugo hair
fat from venix caseosa
mucin
