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SS- CMOD Block 2 > Hemodynamics > Flashcards

Hemodynamics Flashcards

1
Q

Most common cause of generalized edema

A

heart failure

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2
Q

effusion

A

excess fluid in serosal body cavity

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3
Q

hydrothorax

A

fluid in a pleural cavity

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4
Q

anasarca

A

generalized edema

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5
Q

pathophysiologic categories of edema

A
  1. increased hydrostatic pressure
  2. decreased oncotic pressure (decreased plasma osmotic pressure)
  3. lymphatic obstruction (least common)
  4. sodium retention
  5. inflammation
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6
Q

Causes of increased hydrostatic pressure leading to edema in:

  1. leg
  2. lungs
  3. lower body
A
  1. DVT
  2. left heart failure
  3. right heart failure
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7
Q

How does hydrostatic edema cause sodium retention?

A
  1. heart failure decreases blood flow to the kidney
  2. activation of the renin-angiotensin-aldosterone system
  3. aldosterone causes retention of sodium (and water)
  4. leads to edema (along with hydrostatic edema)
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8
Q

How does nephrotic syndrome cause edema?

A

protein loss through kidneys and therefore decreased oncotic pressure leading to edema

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9
Q

Hepatic cirrhosis edema is due to:

A
  1. increased hydrostatic pressure in the portal venous system
  2. decreased oncotic pressure do to loss of protein into ascites and decreased production of protein by liver
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10
Q

Hypoalbuminemia

A
  1. decreased oncotic pressure

2. leads to hyperaldoteronism if it is enough to cause generalized edema which then leads to edema due to Na retention

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11
Q

Causes of edema due to sodium retention

A
  1. heart failure

2. kidney failure

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12
Q

Types of edema due to inflammation

A
  1. localized at site of infection

2. general with SIRS/sepsis

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13
Q

Edema in SIRS

A
  1. site of insult: maximal edema- EXUDATE (cytokines cause vascular permeability; chemokine cause leukocyte transmigration)
  2. generalized- TRANSUDATE (cytokines, but few chemokine)
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14
Q

peau d’orange

A

lymphedema due to breast cancer

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15
Q

Causes of lymphedema

A 
lymphatic obstruction due to
1. tumor
2. inflammation
3. surgery
4. radiation
5. scar
usually localized
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16
Q

cause of elephantiasis

A

parasitic filariasis

lymphedema due to fibrotic obstruction

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17
Q

Causes of pulmonary edema

A
  1. left heart failure (most common)
  2. ARDS
  3. hypersensitivity
  4. pneumonia
  5. renal failure
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18
Q

major symptom of pulmonary edema

A

dyspnea

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19
Q

major sign of pulmonary edema

A

pulmonary crackles

20
Q

hyperemia

A

active increase in arterial blood flow

red color

21
Q

congestion

A

decrease in venous outflow; cyanosis

22
Q

What causes passive congestion of the liver? Where does it occur first? What is this called?

A
  1. right heart failure
  2. centrilobar area
  3. nutmeg liver (hemorrhagic alternates with steatotic areas)
23
Q

hematoma

A

hemorrhage in enclosed tissue

24
Q

petechiae

A

1-2 mm hemorrhages due to platelet deficiency

25
Q

purpura

A

3-10 mm hemorrhages due to vasculitis, vessel fragility, et.

26
Q

ecchymoses

A

over 1 cm subcutaneous hemorrhages

red-blue -> blue-green -> gold-brown

27
Q

hemothroax

A

hemorrhage in pleural cavity

28
Q

hemostasis

A

formation of a blood clot at site of vascular injury

29
Q

regulation of hemostasis

A
  1. endothelium
  2. platelets
  3. coagulation cascade
30
Q

Platelet factors important for hemostasis

A
  1. ADP
  2. fibrinogen
  3. factors V and VIII
  4. Ca2+
  5. Epinephrine
31
Q

Platelet factors that are important for healing

A
  1. TGF-beta
  2. PDGF
  3. platelet factor-4
  4. fibronectin
32
Q

eptifibatide (Integrilin)

A

IV to patients who are clotting off coronary arteries

33
Q

clopidogrel (Plavix)

A

blocks platelet ADP receptors

34
Q

Antiphospholipid antibody syndrome

A

causes arterial thrombosis; most common in young females; autoimmune (Ab against phospholipids)

35
Q

Presentation of antiphospholipid antibody syndrome

A

miscarriages, DVT, cerebral infarctions, migraines, cardiac vegetations, ischemic hands or feet, thrombocytopenia, etc.

36
Q

Disseminated intravascular coagulation (DIC)

A

thrombus formation in small blood vessels all over body

complication of: sepsis, metstatic cancer, multi organ trauma, etc.

37
Q

Manifestation of DIC

A

1st: brain malfunction
2nd: lung malfunction
Also: heart and kidney
Use up all the platelets: now have a bleeding problem

38
Q

mycotic aneurysm

A

localized outpouching of an artery, especially the aorta, containing infected thrombus (piece of infected vegetation)

39
Q

Coagulopathy

A

an abnormal tendency to bleed

40
Q

How would you treat:

  1. hemorrhagic shock
  2. cardiogenic shock
  3. septic shock
A
  1. blood transfusion
  2. assist heart
  3. antibiotics
41
Q

cardiac tamponade triad

A
  1. shock
  2. distant heart sounds
  3. jugular venous distension
42
Q

CARS

A

compensatory anti-inflammatory response syndrome

sepsis can be fatal due to counter-regulation (overshooting)

43
Q

MARS

A

mixed antagonistic response syndrome

swing back and forth between pro and anti inflammatory response

44
Q

superantigen

A

promote T cell mitosis in a nonspecific way, bypassing antigen receptor specificity
release massive amounts of cytokines like IL-1 and TNF

45
Q

MOF

A

multiple organ failure: can be caused by shock

SS- CMOD Block 2 (16 decks)

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