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PATHOLOGY > HEMODYNAMICS and THROMBOEMBOLIC DISEASES > Flashcards

HEMODYNAMICS and THROMBOEMBOLIC DISEASES Flashcards

1
Q

also termed as phlebothrombosis

A

Venous thrombosis

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1
Q

Factor III is known as what?

A

Tissue Factor/ Thromboplastin

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1
Q

A chronic form of decompression sickness

A

Caisson Disease

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2
Q

when do the counter-regulatory mechanisms of hemostasis take place?

A

Thrombus and antithrombotic events

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2
Q

Coumarin is an anticoagulant. How does it mediate its actions?

A

by inhibiting vitamin K

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3
Q

finger pressure over substantially edematous subcutaneous tissue displaces the interstitial fluid and leaves a depression

A

Pitting edema

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3
Q

most physiologically relevant pathway for coagulation occuring when vascular damage has occurred

A

Extrinsic Pathway

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4
Q

severe generalized edema with widespread subcutaneous tissue spreading

A

Anasarca

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4
Q

What is obstructed in Parasitic filariasis which causes elephantiasis?

A

Lymphatics/ Lymph nodes

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4
Q

sudden or insidious onset of widespread fibrin thrombi in the microcirculation

A

(DIC) Disseminated Intravascular Coagulation

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4
Q

What are the 3 main etiologies of decreased plasma protein (albumin) concentrations that ultimately lead to Edema?

A

Nephrotic Syndrome Chronic Liver Disease Malnutrition

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5
Q

a membrane bound procoagulant glycoprotein that is synthesized by endothelium

A

Tissue factor/Factor 3/Thromboplastin

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5
Q

What is a secondary hemostatic plug?

A

irreversibly fused mass of platelets

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6
Q

sequence of hemostasis where thrombin cleaves fibrinogen to insolube fibrin

A

Secondary Hemostasis

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7
Q

Hyperemia typically results to Erythema while Congestion results to?

A

Cyanosis

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8
Q

Hydrostatic pressure in the arteriolar segment of the capillary

A

32 mmHg

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8
Q

Patterns of Tissue Hemorrhage

A

Hematoma Petechiae Purpura Ecchymoses

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9
Q

A form of cerebral edema that preferentially affects gray matter

A

Cytotoxic Cerebral Edema

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9
Q

what can be found inside the alpha granules of platelets?

A

Fibrinogen Fibronectin Factors 5 and 8 platelet factor 4 platelet-derived growth factor transforming growth factor-Beta

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10
Q

Subcutaneous Edema is Important. TRUE or FALSE.

A

TRUE

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11
Q

What are the Calcium-dependent factors?

A

1 2 10 13

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12
Q

Abnormal increase in interstitial fluid within tissues

A

Edema

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12
Q

Discharge of blood out of the vascular space

A

Hemmorhage

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13
Q

Differentiate Prostacyclin and Thromboxane as to: 1. Where is it derived 2. VC or VD 3. platelet Activator or Inhibitor

A

Prostacylin: VD, platelet inhibitor and endothelial derived Thromboxne VC, platelet activator and platelet derived

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14
Q

2 types of platelet cytoplasmic granules

A

Alpha and Sigma

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14
Q

most common primary genetic disorder of coagulability

A

Leiden Mutation

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14
Q

True or False. Salt & Water retention corrects the primary volume deficit caused by low serum protein

A

False.

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15
Q

accumulation of fluid in peritoneal space

A

Ascites

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16
Q

TRUE or FALSE. After exposure of Subendothelial surface from injury, Platelets adhere to a single factor in the ECM which is called the Von Willebrand Factor.

A

FALSE. it can also adhere to other factors such as Fibronectin

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17
Q

Microscopic morphology of Edema

A

Clearing Separation of ECM Subtle cell swelling

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18
Q

the Vitamin K dependent factors

A

9 10 7 2

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20
Q

An edema caused by increased hydrostatic pressure or decreased plasma preotein; protein poor fluid

A

Transudate

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21
Q

Gamna-Gandy bodies are seen in what organ as a result of congestion

A

Spleen

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21
Q

The initial wave of platelet aggregation is? (reversible or irreversible)

A

Reversible

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22
Q

accumulation of blood in the joint spaces

A

Hemarthrosis

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23
Q

a protease that cleaves plasminogen to form plasmin

A

t-PA (Tissue Plasminogen Activator)

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23
Q

Prothrombic properties

A

Platelet Procoagulant Antifibrinolytic

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24
Q

What are the color changes in Ecchymoses and their significance?

A

Red=RBC rupture Blue-green=bilirubin oxidation Gold/yellow-brown=Hemosiderin

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24
Q

components of Virchow’s triad

A

Endothelial injury Hypercoagulability Abnormal blood flow

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24
Q

Subcutaneous Hemorrhage is Important. TRUE or FALSE

A

FALSE

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25
Q

what are the fates of thrombus?

A

Propagation Embolization Dissolution Organization

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26
Q

Chronic passive pulmonary congestion is caused by?

A

impeded outflow of blood from the lungs

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27
Q

TRUE/FALSE. RBC and Leukocytes can be found in a normal platelet plug.

A

TRUE

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27
Q

A thrombus formed in one location that detaches from a vessel wall t its point of origin and travels to a distant site

A

thromboembolism

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28
Q

thrombi on heart valves

A

Vegetations

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29
Q

Sequence of hemostasis where Hemostatic plug is formed

A

Primary Hemostasis

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30
Q

AGGREGATION is accomplished by binding of fibrinogen to what platelet receptor?

A

Glycoprotein IIb-IIIa

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31
Q

the most common cause of systemic thromboembolism

A

Intracardiac mural thrombi

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32
Q

Standard Assay fro coagulation pathway which specifically asess functions of factors in extrinsic pathway

A

Prothrombin time

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34
Q

Passive Hyperemia; reduced blood outflow from a tissue

A

Congestion

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34
Q

A type of Clot without the prsence of Lines of Zahn

A

Postmortem Clot

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35
Q

a detached intravascular solid, liquid or gaseous mass that is carried by blood to a site distant from its origin

A

embolism

36
Q

What are the type of infarcts seen in the folowing: Venous occlusion Arterial Occlusion

A

Venous Occlusion: Red infarct Arterial Occlusion: White Infarct

38
Q

type of edema that reflects a global disorder of fluid and Electrolyte metabolism often times associated with Heart Failure

A

Generalized Edema

39
Q

general sequences of hemostasis

A

Vasoconstriction Primary Hemostasis Secondary hemostasis thrombus and antithrombic events

39
Q

most important coagulation factor

A

Thrombin

40
Q

cerebral edema that is a consequence of hydrocephalus

A

Interstitial

40
Q

Plasminogen Activators

A

t-PA Urokinase-like PA (u-PA) Streptokinase

41
Q

laminations that represent pale fibrin and platelet deposits alternating with darker red cell-rich layer

A

Lines of Zahn

43
Q

Subcutaneous hematoma; RBC’s in this lesion are degraded by Macrophages

A

Ecchymoses

43
Q

What type of Edema is typically seen in the setting of Left Ventricular Failure?

A

Pulmonary Edema

45
Q

Most common form of Cerebral edema; mainly in the white matter; BBB is disrupted

A

Vasogenic Cerebral Edema

45
Q

more redblood cells are deposited in? (Arterial or Venous thrombosis)

A

Venous (more RBC’s. less platelet)

47
Q

other ways by which lymphatic channels may be blocked

A

Malignant neoplasms Fibrosis Surgical ablation

49
Q

Protein-rich fluid; a.k.a inflammatory edema

A

Exudate

50
Q

a pentasaccharide inhibitor of factor 10

A

Fondaparinux

51
Q

What are “Gamna-Gandy bodies”?

A

iron-containing fibrotic and calcified foci of old hemorrhage

52
Q

Px exhibits only the manifestations of a hypercoagulable state and lack evidence of other immune disorders

A

Primary antiphospholipid Syndrome

53
Q

an active process that increases blood flow at a local site

A

Hyperemia

53
Q

binds calcium and serve as a critical nucleation site for the assembly of complexes containing the various coagulation factors

A

Phosphatidylserine

55
Q

“nutmeg” Liver is a condition of

A

Passive Chronic congestion of the liver

57
Q

What glycoprotein is deficient in Bernard Soulier Syndrome

A

Glycoprotein Ib

59
Q

amount of Plasma oncotic Pressure

A

26 mmHg

60
Q

A condition where glomeruli become leaky due to decreased plasma protein synthesis (albumin)

A

Nephrotic Syndrome

62
Q

Engorgement of alveolar capillaries, Alveolar septa edema and focal intra-alveolar hemorrhage are charactersitic of what disease?

A

Acute pulmonary congestion

63
Q

amount of Air in air embolism that can elicit clinical effect

A

>100ml

64
Q

platelet derived stimulus that amplifies platelet aggregation which leads to the formation of primary hemostatic plug

A

Thromboxane A2

66
Q

a.k.a. Heart-Failure cells

A

Hemosiderin-laden macrophages

68
Q

consolidation of platelet plug

A

Secondary Hemostasis

70
Q

Three forms of Cerebral edema

A

Vasogenic Cytotoxic Interstitial

71
Q

What is more severe, Venous thrombi or Arterial Thrombi?

A

Arterial Thrombi (obstruction at critical sites (Cerebral and Coronary Vessels)

73
Q

What disease characterizes a deficiency in Glycoprotein IIb-IIIa complex

A

Gianzmann Thrombasthenia

74
Q

the major activator of the extrinsic clotting cascade

A

Tissue Factor

75
Q

what are the classical findings in Amniotic Fluid Embolism

A

Fetal Squamous cells Lanugo Hair Fat from vernix caseosa Mucin in the maternal pulmonary vasculature (derived from Fetal Respiratory tract and GIT)

77
Q

Major determinant of extracellular fluid volume (electrolyte)

A

Sodium or Total Body Sodium

78
Q

the most common site of arterial thrombus are (3)

A

Coronary, Cerebral and Femoral Arteries

79
Q

How does protein C mediate its action?

A

inhibits clotting by inactivating factors 5a and 8a

80
Q

A detached intravascular solid, liquid or gaseous mass that is carried by the blood to a site distant from its point of origin

A

Embolism

81
Q

An event when an embolus passes through an interatrial or interventricular defect and gain access to the systemic circulation

A

Paradoxical Embolism

82
Q

an event that is dependent on platelet cytoskeleton that creates an irreversibly fused mass of platelets

A

Platelet contraction

83
Q

an irreversible cyclooxygenase inhibitor

A

aspirin

84
Q

An amplifying process of enzymatic conversions culminating in thrombin formation

A

Coagulation Cascade

85
Q

Anti-coagulant effects of endothelium

A

Thrombomodulin Heparin-like molecule Protein S Tissue factor pathway Inhibitor

86
Q

a form of respiratory distress in the lungs where gas bubble in the vasculature causes edema, hemorrhage, focal atelectasis or emphysema

A

Chokes

87
Q

Edema of the lower extremities and thrombosis of hepatic veins

A

Budd-Chiari Syndrome

89
Q

What do you call a polymerized fibrin and platelet aggregate and which sequence of hemostasis does it emerge?

A

Permanent Plug;Thrombus and antithrombotic events

90
Q

infusion of amniotic fluid/ fetal tissue in the maternal circulation via a tear in the placetal membranes or rupture of uterine veins

A

Amniotic Fluid Embolism

92
Q

Patients with burns are suffering from what type of edema?

A

Local Edema

93
Q

Pathologic result of hemostasis; clot formation in intact vessels

A

Thrombosis

94
Q

What is the function of Calcium in the Coagulation cascade?

A

holds components together and ensures that clotting is localized to the surface of activated platelet or endothelium

95
Q

An area of ischemic necrosis caused by occlusion of either arterial supply or venous drainage

A

Infarction

96
Q

What are the Symptoms in the Fat Embolism Syndrome?

A

(P-A-N-T) Pulmonary Insufficiency Anemia Neurologic Symptoms Thrombocytopenia

97
Q

occurs when individuals experience sudden decrease in atmospheric pressure

A

Decompression sickness

99
Q

Characterized by platelet adhesion, activation and aggregation

A

Primary Hemostasis (2nd step)

100
Q

Accumulation of blood that may be external or contained within a tissue

A

Hematoma

101
Q

sudden or insidious onset of widespread fibrin thrombi in the microcirculation

A

Disseminated Intravascular Coagulation (DIC)

103
Q

pinpoint hemorrhages (1-2mm); reflects rupture of a capillary

A

Petechiae

105
Q

functions as an adhesion bridge between subendothelial collagen and glycoprotein Ib platelet receptor

A

Von Willebrand Factor

106
Q

painful condition from the rapid formation of gas bubbles within skeletal muscles and supporting tissues in and about the joints

A

Bends

108
Q

Facilitates drainage of the interstitium

A

Lymphatics

109
Q

Activates plasmin in the fluid phase

A

Urokinase-like PA

110
Q

thrombus that occur in the heart chambers or in the aortic lumen

A

Mural thrombus

111
Q

what can be found inside the delta granules of platelets?

A

ADP and ATP Ionized calcium Histamine Serotonin Epinephrine

112
Q

the most common site of venous thrombosis (90%)

A

Veins of lower extremities

113
Q

Screens for factor 12, 11, 9, 8, 10, 5 and 2

A

Partial Thromboplastin Time

114
Q

Thrombus that originates at sites of turbulence or endothelial injury

A

Arterial/Cardiac thrombi

115
Q

3 anti-thrombotic properties of endothelium

A

Antiplatelet Anticoagulant Fibrinolytic

116
Q

Px with a well defined autoimmune dse such as SLE

A

Secondary antiphospholipid Syndrome

118
Q

what 2 opposing movements control movement of water and LMW solutes between intravascular and interstitial spaces

A

Vascular Hydrostatic Pressure and Plasma Colloid Oncotic Pressure

119
Q

induces a hypercoagulable state by causing endothelial injury via activation of platelets and complement directly

A

Antiphospholipid Antibody Syndrome

120
Q

the most common cause of pulmonary embolism

A

Deep Vein Thrombosis

122
Q

what are the characteristic features of Chronic pulmonary congestion?

A

thickened and fibrotic septae, hemosiderin-laden cells

123
Q

Hydrostatic pressure in the middle segment of the capillary

A

20 mmHg

124
Q

hemorrhages associated with trauma (>3mm)

A

Purpura

125
Q

Thrombus that originates at sites of stasis

A

Venous thrombi

126
Q

inactivates free plasmin thus preventing excessive lysing of thrombi elsewhere in the body

A

Alpha-2 Plasmin inhibitor

127
Q

Antiplatlet effects of Endothelium

A

Prostacyclin, NO, ADP

128
Q

polymerizes an insoluble gel that encases platelets and other circulating cells in the secondary hemostatic plug

A

Fibrin

129
Q

an edema that is caused by injury to the endothelium where vascular bed become leaky

A

Traumatic/Inflammatory Edema

PATHOLOGY (9 decks)

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