Hemostasis Hemorrhagic Diathesis thrombosis (All the blood disorders etc) Flashcards
Which 2 intracellular adhesion junctions are most important between endothelial cells
Cadherin & Keratin
vWF are derived from what two cellular components
Weibel Palade bodies & A-granules in plasma cells
Dense bodies contain which components?
ADP, Aggregating agent, & Calcium
A-granules within platelets contain what components?
vWF, Fibrinogen, Platelet-derived growth (PDGF), & Platelet factor 4
Platelet factor 4 is a _______
Heparin-neutralizing factor (heparin = blood thinner)
Describe the general steps of hemostasis.
- Platelet adhesion via vWF to exposed subendothelial collagen
- Platelet morphs shape
- Platelet degranulates to release ADP & TXA2
Increase in blood flow
Hyperemia
Outflow is obstructed
Congestion
Formation of blood clots
Hemostasis
Clotting blood on vessel walls
Thrombosis
Starling forces:
Capillary hydrostatic pressure
pushes fluid out of the capillary usually die to venous obstruction because heart failure
Starling forces:
Capillary oncotic pressure
Pulls fluid into the capillaries, usually due to liver failure, nephrotic syndrome, or proteinemia
Starling forces:
Interstitial hydrostatic pressure
Pushes fluid into capillaries, usually via lymph obstruction
Starling forces:
Interstitial oncotic forces
Fluid gets pulled into the interstitial space
Increased PWCP is a sign of what condition
Left ventricular failure
Increase in hydrostatic pressure may indicate which conditions?
Heart failure, Hypertension, and embolism
Decrease in osmotic pressure may indicate which conditions?
Hypoproteinemia, Liver/kidney failure, or cirrhosis
An increase in vascular permeability may indicate which conditions?
RA, SLE, TB infections, or Hep B/C
Describe the patient’s condition
Myxedema (pretibial) patient will have elevated ECM components such as glycosaminoglycans and hyaluronic acid)
Usually in Graves, Hypothyroidism, or Hashimotos
What do elevated BNP/BNF indicate?
Left ventricular hypertrophy
Describe some of the key signs of heart failure
Dyspnea
Orthopnea (hard to breath lying down)
Paroxysmal nocturnal dyspnea (not breathing wake you up)
Fatigue
Cough (pink & frothy)
Nocturia
What is featured in this CT? What condition is a patient likely to have if they present with this?
Kerley B lines, these indicate left-sided heart failure with elevated PCWP (above 18-20mmHg) causing pulmonary edema
Constrictive pericarditis generally presents with what?
Decreased cardiac output, diastolic volume, ejection fraction, & a thickened pericardium
An ejection fraction of less than 50% indicates what condition?
Left ventricular failure
Viral pericarditis can be cause by which of the following organisms?
Coxsackie A+B
Echoviruses
Adenoviruses
Bacterial pericarditis can be caused by which of the following infectious organisms?
Staphylococci
Streptococci A+B
Gram negative rods (Pseudomonas & E.coli)
Acute pleuritic chest pain (retrosternal)
Elevated ST segment
PR depression
Pericardial effusion
Pain eases when sitting/leaning forward
What’s the condition?
Acute pericarditis
What are some of the features of acute pericarditis?
- Sharp/acute retrosternal chest pain
- Pericardial friction rub
- pain eases when sitting/leaning forward
- New or worsening pericardial effusion
- Elevated troponin, CRP, ESR, & CK
What are some of the features of a chronic constrictive pericarditis?
- Thickened pericardium
- Calcifications
- Flat or interval T waves
- Decreased QRS
- JVD (prominent X & Y descent)
- Peripheral edema
- Ascites
- Decreased CO
- Hepatic vein congestion
- Kussmaul sign
- Thickened & rigid pericardium
What are some of the features of chronic effusive constrictive pericarditis?
- Pericardial effusion
- Thickened pericardium
- Increased right atrial pressure despite pericardiocentesis (a strong indicator)
Acute pericarditis can lead to what condition?
Acute pericarditis can lead to Dressler’s syndrome after 2-10 weeks post MI signs include:
- Acute pericarditis
- Friction rub
- Pleuritic chest pain
- Diffuse ST elevations, troponin, and leukocytosis
