Hemodynamics Flashcards
What is anasarca?
exteremely severe generalized edema
Wha tis normal body fluid balance?
2/3 intracellular
1/3 extracellular
5% as blood plasma
What does edema result from?
increased hydrostatic pressure
or decreased osmotic pressure
What can cause a reduceed plasma osmotic pressure?
albumin loss due to nephrotic syndrome protein losing eeneteropathy malnutrition liver disease -
Excessive loss of albumin leads to what?
decreased intravascular volume
and secondary hyperaldosteronism
What are the normal coses of lymphatic obstruction leading to edema?
post-surgical/radiation
neoplastic
inflammatory
What is a nutmeg liver?
edema in liver with increased RBCs due to back up from heart around central vein;
What are the steps of primary hemostasis?
- injury
- transient vessel constriction
- platelet adhesion by vWF and gp1b
- shape change of platelets
- granule release
- platelet recruitment
What is secondary hemostasis?q
clotting cascade; stabilizes platelet clot
- Tissue factor released
- phospholipid copmlex exxpression
- thrombin activation
- fibrin polymerization
What are the labs for determining primary hemostasis?
platelet count platelet function -PFA 100 -Platlet aggregation studies vWF studies -antigen -activity
What are the labs for measuring secondary hemostasis
Prothrombin Time (PT)( Extrinsic+common) activated partial thromboplastin Time (PTT) (intrinsic+common) fibrinogen activity
What factors are dependent of vitamin K?
2,7,9,10 as well as factor C and S but less important
What is disseminated intravascular coagulation?
DIC, factor and platelet consumption
What are common causes of hemorrhage?
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
What is petichial hemorrhage?
hemorrhage into skin, mucuos membrane or serosal
associated with low platelt count or dyfunciton platelt
What is purpura?
large petichial hemorrhages
What are the lab screening for anticoags?
protein C and S activity and antigen
ATIII activity and antigen
molecular abnormalities in Factor 5 or prothrombin gene
Lupus anticoagulant
What facotrs promote thrombosis?
abnormal blood flow
endothelial injury
hypercoaguability
What are some inherited hypercoaguablility?
factor 5 Leiden Prothrombin 20210 hyperhmocysteinemia protein C deficiency protein S deficiency AT 3 deficiency dysfibrinogenemia
What are acquired hyperocaguability?
malignancy estrogen antiphospholipid antibody heparin-induced thrombocytopenia DIC thrombotic thrombocytopenic pupura
What is factor 5 leidn?
single point mutation in cleavage site for protein C
so has activated protein C resistance
heterozygotes (5x) thrombosis
homo (50x) thrombosis risk
What is the role of antiphsphobilipid antibodies in clotting?
act as inhibitorsof clotting in vitro but promote clotting in vivo
2 types
lupus anticoagulant
anti-cardiolipin antibodies
What are causes of turbulent flow?
ulcerated atherosclerotic plaques
aneurysm
ascute MI
processes that cause left atrial dilation
What is DIC chaaracterized by?
initial clotting resulting in organ ischemia and consumption of platelets
