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Hemodynamics I Flashcards

1
Q

Where does edema build up?

A

in the interstitial space

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2
Q

Protein-poor fluid is referred to as what?

A

Transudate

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3
Q

What is fluid in the pleural space?

A

Hydrothorax

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4
Q

What is fluid in the space between the heart and pericardium?

A

Hydropericardium

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5
Q

What is fluid in the peritoneal space?

A

Ascites or hydroperitoneum

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6
Q

What causes reduced sodium retention-edema?

A

Reduced renin/agiotensin system

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7
Q

What are the two factors from heart failure that leads to edema?

A
  1. increased capillary hydrostatic pressure

2. Decreased renal blood flow

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8
Q

What is the most important protein for maintaining the colloid osmotic pressure?

A

Albumin

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9
Q

What is anasarca, and what is it caused by?

A

general, severe edema, usually due to the lack of oncotic pressure

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10
Q

What is the earliest sign of anasarca?

A

Periorbital edema

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11
Q

What happens to fluid balance when there is an increase in salt in the circulation? Why does this lead to edema?

A

Intracellular fluid flows out, lower [albumin]

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12
Q

What is the system that balances Na?

A

Renin-angiotensin system

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13
Q

Is inflammation transudate or exudate?

A

Exudate

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14
Q

What causes the edema seen in inflammation?

A

Increased capillary leakiness

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15
Q

What are the two common causes of lymphedema?

A

Neoplasia

Inflammation

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16
Q

What is the parasite that is transmitted by mosquitoes and causes elephantitis?

A

Wuchereria bancrofti

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17
Q

Why did some patients who had radical mastectomy cause severe lymphedema?

A

Removal of axillary lymph nodes

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18
Q

Where does the fluid loss increase in hydrostatic causes of edema?

A

From the venules

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19
Q

What determines the microscopic appearance of edema?

A

Whether there is protein in the exudate

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20
Q

How does edema appear microscopically?

A

Clearing and separation of the ECM, with pink if protein present

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21
Q

Why can severe edema compromise healing?

A

Compromise venous return

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22
Q

What are the two sites of edema that are particularly clinically important?

A

Lung

Brain

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23
Q

What are the three common causes of cardiogenic pulmonary edema?

A
  1. Left ventricular failure
  2. MI
  3. Systemic HTN
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24
Q

What are some of the causes of noncardiogenic pulmonary edema?

A
  1. ARDS
  2. Pulmonary infx
  3. Renal failure
  4. Alveolar hypoxia
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25
Q

What are the clinical manifestations of pulmonary edema?

A
  1. Dypsnea
  2. Orthopnea
  3. Cyanosis
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26
Q

What are the three characteristics of the cough associated with pulmonary edema?

A
  1. Productive
  2. Frothy
  3. Hemoptysis
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27
Q

JVD = what?

A

Right heart failure

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28
Q

What are the two characteristics of the pulse associated with pulmonary edema?

A

Tachycardia

Bounding pulse

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29
Q

What are the breath sounds like in pulmonary edema?

A

Crackles

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30
Q

What are the gross findings of pulmonary edema on CXR?

A
  1. Poorly defined pulmonary vessels
  2. Visible lung fissures
  3. Septal lines
  4. Thick bronchial walls
31
Q

What are the microscopica characterisitics of pulmonary edema?

A

Pink fluid with thickened alveolar septum

32
Q

Hemosiderin laden macrophages =?

33
Q

What is tonsillar herniation?

A

Brain swelling that leads to herniation of the brain out of the foramen magnum, leading to compression of the medulla

34
Q

What are the three localized causes of cerebral edema?

A
  1. Abscess
  2. Neoplasm
  3. Trauma
35
Q

What are the four generalized causes of cerebral edema?

A
  1. Encephalitis
  2. HTN crisis
  3. Obstruction of vein flow
  4. Trauma
36
Q

What is transtentorial herniation?

A

Brain herniates into the tentorium cerebelli

37
Q

What is active hyperemia?

A

Active process in which arteriolar dilation results in increased flow of blood to a tissue

38
Q

What are the clinical symptoms/signs of active hyperemia? Passive hyperemia?

A 
active = Erythema
Passive = bluish discoloration
39
Q

What is passive hyperemia?

A

Congestion–Impaired outflow of blood from a tissue

40
Q

What is the cause of systemic congestion?

41
Q

What are the clinical signs of congestion?

A

Cyanosis
Edema
Congestion

42
Q

What are the three major characteristics of acute pulmonary congestion?

A
  1. Alveolar capillaries engorged with blood
  2. Alveolar septal edema
  3. Focal intra alveolar hemorrhage
43
Q

What are microscopic characteristics of chronic pulmonary congestion?

A

Thickened and fibrotic septa

Heart failure cells

44
Q

What are the gross characteristics of nutmeg liver?

A

Central regions of hepatic lobules are grossly red/brown and depressed

45
Q

What are the microscopic characteristics of chronic hepatic congestion?

A

Centrilobular necrosis

46
Q

Long standing hepatic congestion maya result in what?

A

Hepatic fibrosis

47
Q

What are the two classifications of hemorrhage?

A

External or internal

48
Q

Blanching petechiae = ?

Non-palpable = ?

A

Blanching petechiae = vasculitis

Non-palpable= Angiomas

49
Q

How does platelet dysfunction present?

50
Q

What is ecchymoses?

A

hematoma >1-2cm

51
Q

What are purpura?

A

Hematoma greater than 3 mm, but less than 1 cm

52
Q

What percent of blood volume loss can patients be okay with (if healthy)?

53
Q

What determines if Fe can be reused in hemorrhage?

A

only if it is internal bleeding

54
Q

What is the etiology of edema in CHF?

A

Elevated hydrostatic pressure

55
Q

What is the etiology of edema in Constrictive pericarditis?

A

Elevated hydrostatic pressure

56
Q

What is the etiology of edema in ascites from liver cirrhosis?

A

Elevated hydrostatic pressure

57
Q

What is the etiology of edema in venous obstruction/compression?

A

Elevated hydrostatic pressure

58
Q

What is the etiology of edema in nephrotic syndrome?

A

Decreased plasma oncotic pressure

59
Q

What is the etiology of edema in end stage liver disease?

A

Decreased plasma oncotic pressure

60
Q

What is the etiology of edema in malnutrition?

A

Decreased plasma oncotic pressure

61
Q

What is the etiology of edema in inflammation/ neoplasia?

A

Lymphatic obstruction

62
Q

What causes edema with increased Renin/aldosterone?

A

Increased Na reuptake

63
Q

How does interstitial edema appear on CXR?

A

Increased vascular pattern, with few densities

Haziness to the overall CXR

64
Q

What does alveolar pulmonary edema appear on CXR?

A

Patchiness

65
Q

Left heart failure results in what?

A

pulmonary edema and trouble breathing

66
Q

Right heart failure results in what?

A

Blood will back up into the veins resulting in signs such as jugular venous distension

67
Q

What are the three systems that control plasma [Na]?

A
  1. Renin/angiotensin
  2. ANP
  3. Symp nervous activity
68
Q

What happens with increased Na uptake to the balance of fluid?

A

Shifts from intracellular to intravascular space

69
Q

What happens with increased Na uptake to the capillary hydrostatic pressure?

70
Q

What happens with increased Na uptake to the oncotic pressure?

A

Decreases d/t dilution of albumin

71
Q

What are the two types of pulmonary edema?

A

Interstitial or alveolar

72
Q

Left heart failure results in what? RIght heart?

A 
Left = Pulmonary edema
Right = JVD
73
Q

Which comes first: pulmonary interstitial edema or alveolar?

A

Interstitial, then alveolar

74
Q

Fragility of blood vessels is usually the result of what?

A

Vit C deficiency

Pathology (32 decks)

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