Hemodynamics/ Thrombosis & Embolus/ Shock

Question 1

Define: Edema

Answer 1

Increased hydrostatic pressure and/or decreased plasma oncotic pressure that leads to fluid movement out of the capillaries and into the adjacent tissue.

Question 2

Define: Effusion

Answer 2

INcreased hydrostatic pressure and/or decreased plasma oncotic pressure that leads to fluid movement out of the capillaries and into the body cavity

Question 3

True or False: Inadequate drainage of fluid from the tissues via the lymphatic system can also lead to fluid accumulation.

Answer 3

True.

Question 4

Define: Hyperemia

Answer 4

An active increase in blood flow due to arteriolar dilation. It serves normal physiologic purposes such as bringing inflammatory and repair mediators into areas of tissue damage or infection, and it provides increased oxygen to contraction skeletal muscle

Question 5

Define: Congestion

Answer 5

Pathologic accumulation of blood due to impaired outflow of venous blood.

Question 6

Define: Transudate

Answer 6

Transudates typically occur when the vessel wall is intact due to elevated hydrostatic pressure or owered plasma oncotic pressure.

Question 7

Define: Exudate

Answer 7

Exudates are associated with damage to the vessel wall resulting in abnormal permeability to proteins

Question 8

If a fluid has a lot of white cells in it, how would it be classified?

Answer 8

Exudate

Question 9

What causes hemorrhagic disorders?

Answer 9

Tissue and vessel damage exceeds the body’s normal hemostatic mechanisms or because diminished hemostatic mechanisms cannot manage and repair normal levels of damage

Question 10

What are three basic factors that promote thrombosis?

Answer 10

1. Endothelial injury
2. Abnormal clood flow
3. Hypercoagulability

Question 11

Where is the most common site for thrombi?

Answer 11

Venous system

Question 12

What is the most common cause of thrombi in the arterial system?

Answer 12

Endothelial injury

Question 13

Where do arterial thrombi most commonly occur?

Answer 13

Coronary, cerebral and femoral arteries

Question 14

A free floating, iintravascular mass of a solid, liquid or gas is a(n) __________

Answer 14

embolus `

Question 15

Emboli in the venous/right sided system is most commonly lodged in what organ?

Answer 15

Lungs

Question 16

Emboli in the arterial/left sided system can affect any organ, but most commonly what two areas?

Answer 16

Brain and legs

Question 17

Describe what happens in disseminated intravascular coagulation (DIC).

Answer 17

Generalized activation of clotting leads to widespread thrombosis with subsequent consumption of platelets and clotting factors&raquo_space;» Deficiency of platelets and clotting factors that then results in bleeding

Question 18

How does DIC present clinically?

Answer 18

Anemia
Respiratory insufficiency
Convulsions
Acute renal failure
Shock

Question 19

What symptom usually dominates when DIC presents acutely?

Answer 19

Bleeding

Question 20

What symptom usually dominates when DIC presents chronically?

Answer 20

Thrombosis

Question 21

Thrombosis and emboli commonly lead to severe _________& ___________

Answer 21

Ischemia and infarction

Question 22

What are two types of infarcts?

Answer 22

Red (hemorrhagic)

White (anemia)

Question 23

Describe the location(s) of red infarcts.

Answer 23

Red infarcts can occur in two ways:

1. Venous occlusion
2. Can form after an arterial occlusion if clood flow is subsequently reestablished and damaged vessels allow movement of blood into the necrotic area

Question 24

Describe the location of white infarcts.

Answer 24

White infarcts are an arterial blookage, a single blood supply, and a dense tissue that limits accumulation of blood in necrotic areas

Question 25

What is the rough shape of an infarct?

Answer 25

Wedge

Question 26

Define Shock

Answer 26

Shock occurs when the circulating blood volume or blood pressure is not adequate to perfuse body tissues&raquo_space;»> widespread cellular hypoxia&raquo_space;»> global cell death

Question 27

What is cardiogenic shock?

Answer 27

Results from failure of the heart to pump an adequate amount of blood and/or to generate an adequate blood pressure to perfuse distal tissues

Question 28

What is hypovolemic shock?

Answer 28

Occurs when there is not enough blood volume to widely perfuse all tissues, and the cardiac output decreases because there is low blood return to the heart

Question 29

What are some symptoms of hypovolemic shock?

Answer 29

Low blood pressure
low cardiac output 
vasoconstriction
increased heart rate
renal conservation of fluid

Question 30

You are a third year medical student in the emergency room. A patient presents with coolness and pallor of skin, tachycardia, and decreased urine output. What do you suspect is the problem?

Answer 30

You’re smart so you’re totally like, “Yo this dude has hypovolemic and cardiogenic shock”

Question 31

What is septic shock?

Answer 31

A subtype of shock due to systemic inflammation (SIRS) It occurs when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage and venous blood pooling,

Question 32

How does septic shock usually present?

Answer 32

Typically initially presents with warm, flushed skin and fever.