Hemodynamics

Question 1

What is anasarca?

Answer 1

exteremely severe generalized edema

Question 2

Wha tis normal body fluid balance?

Answer 2

2/3 intracellular
1/3 extracellular
5% as blood plasma

Question 3

What does edema result from?

Answer 3

increased hydrostatic pressure

or decreased osmotic pressure

Question 4

What can cause a reduceed plasma osmotic pressure?

Answer 4

albumin loss due to
nephrotic syndrome
protein losing eeneteropathy
malnutrition
liver disease
-

Question 5

Excessive loss of albumin leads to what?

Answer 5

decreased intravascular volume

and secondary hyperaldosteronism

Question 6

What are the normal coses of lymphatic obstruction leading to edema?

Answer 6

post-surgical/radiation
neoplastic
inflammatory

Question 7

What is a nutmeg liver?

Answer 7

edema in liver with increased RBCs due to back up from heart around central vein;

Question 8

What are the steps of primary hemostasis?

Answer 8

1. injury
2. transient vessel constriction
3. platelet adhesion by vWF and gp1b
4. shape change of platelets
5. granule release
6. platelet recruitment

Question 9

What is secondary hemostasis?q

Answer 9

clotting cascade; stabilizes platelet clot

1. Tissue factor released
2. phospholipid copmlex exxpression
3. thrombin activation
4. fibrin polymerization

Question 10

What are the labs for determining primary hemostasis?

Answer 10

platelet count
platelet function
-PFA 100
-Platlet aggregation studies
vWF studies
-antigen
-activity

Question 11

What are the labs for measuring secondary hemostasis

Answer 11

Prothrombin Time (PT)( Extrinsic+common)
activated partial thromboplastin Time (PTT) (intrinsic+common)
fibrinogen activity

Question 12

What factors are dependent of vitamin K?

Answer 12

2,7,9,10 as well as factor C and S but less important

Question 13

What is disseminated intravascular coagulation?

Answer 13

DIC, factor and platelet consumption

Question 14

What are common causes of hemorrhage?

Answer 14

ruptured vessel: trauma, weakening of vessel wall
peptic ulcer
chronic congestion: liver,lungs
predisposition to hemorrhage with minimal trauma: seenw ith decreased ability to clot

Question 15

What is petichial hemorrhage?

Answer 15

hemorrhage into skin, mucuos membrane or serosal

associated with low platelt count or dyfunciton platelt

Question 16

What is purpura?

Answer 16

large petichial hemorrhages

Question 17

What are the lab screening for anticoags?

Answer 17

protein C and S activity and antigen
ATIII activity and antigen
molecular abnormalities in Factor 5 or prothrombin gene
Lupus anticoagulant

Question 18

What facotrs promote thrombosis?

Answer 18

abnormal blood flow
endothelial injury
hypercoaguability

Question 19

What are some inherited hypercoaguablility?

Answer 19

factor 5 Leiden
Prothrombin 20210
hyperhmocysteinemia
protein C deficiency
protein S deficiency
AT 3 deficiency
dysfibrinogenemia

Question 20

What are acquired hyperocaguability?

Answer 20

malignancy
estrogen
antiphospholipid antibody
heparin-induced thrombocytopenia
DIC
thrombotic thrombocytopenic pupura

Question 21

What is factor 5 leidn?

Answer 21

single point mutation in cleavage site for protein C
so has activated protein C resistance
heterozygotes (5x) thrombosis
homo (50x) thrombosis risk

Question 22

What is the role of antiphsphobilipid antibodies in clotting?

Answer 22

act as inhibitorsof clotting in vitro but promote clotting in vivo
2 types
lupus anticoagulant
anti-cardiolipin antibodies

Question 23

What are causes of turbulent flow?

Answer 23

ulcerated atherosclerotic plaques
aneurysm
ascute MI
processes that cause left atrial dilation

Question 24

What is DIC chaaracterized by?

Answer 24

initial clotting resulting in organ ischemia and consumption of platelets