Hemostasis Hemorrhagic Diathesis thrombosis (All the blood disorders etc)

Question 1

Which 2 intracellular adhesion junctions are most important between endothelial cells

Answer 1

Cadherin & Keratin

Question 2

vWF are derived from what two cellular components

Answer 2

Weibel Palade bodies & A-granules in plasma cells

Question 3

Dense bodies contain which components?

Answer 3

ADP, Aggregating agent, & Calcium

Question 4

A-granules within platelets contain what components?

Answer 4

vWF, Fibrinogen, Platelet-derived growth (PDGF), & Platelet factor 4

Question 5

Platelet factor 4 is a _______

Answer 5

Heparin-neutralizing factor (heparin = blood thinner)

Question 6

Describe the general steps of hemostasis.

Answer 6

1. Platelet adhesion via vWF to exposed subendothelial collagen
2. Platelet morphs shape
3. Platelet degranulates to release ADP & TXA2

Question 7

Increase in blood flow

Answer 7

Hyperemia

Question 8

Outflow is obstructed

Answer 8

Congestion

Question 9

Formation of blood clots

Answer 9

Hemostasis

Question 10

Clotting blood on vessel walls

Answer 10

Thrombosis

Question 11

Starling forces:

Capillary hydrostatic pressure

Answer 11

pushes fluid out of the capillary usually die to venous obstruction because heart failure

Question 12

Starling forces:

Capillary oncotic pressure

Answer 12

Pulls fluid into the capillaries, usually due to liver failure, nephrotic syndrome, or proteinemia

Question 13

Starling forces:

Interstitial hydrostatic pressure

Answer 13

Pushes fluid into capillaries, usually via lymph obstruction

Question 14

Starling forces:

Interstitial oncotic forces

Answer 14

Fluid gets pulled into the interstitial space

Question 15

Increased PWCP is a sign of what condition

Answer 15

Left ventricular failure

Question 16

Increase in hydrostatic pressure may indicate which conditions?

Answer 16

Heart failure, Hypertension, and embolism

Question 17

Decrease in osmotic pressure may indicate which conditions?

Answer 17

Hypoproteinemia, Liver/kidney failure, or cirrhosis

Question 18

An increase in vascular permeability may indicate which conditions?

Answer 18

RA, SLE, TB infections, or Hep B/C

Question 19

Describe the patient’s condition

Answer 19

Myxedema (pretibial) patient will have elevated ECM components such as glycosaminoglycans and hyaluronic acid)

Usually in Graves, Hypothyroidism, or Hashimotos

Question 20

What do elevated BNP/BNF indicate?

Answer 20

Left ventricular hypertrophy

Question 21

Describe some of the key signs of heart failure

Answer 21

Dyspnea
Orthopnea (hard to breath lying down)
Paroxysmal nocturnal dyspnea (not breathing wake you up)
Fatigue
Cough (pink & frothy)
Nocturia

Question 22

What is featured in this CT? What condition is a patient likely to have if they present with this?

Answer 22

Kerley B lines, these indicate left-sided heart failure with elevated PCWP (above 18-20mmHg) causing pulmonary edema

Question 23

Constrictive pericarditis generally presents with what?

Answer 23

Decreased cardiac output, diastolic volume, ejection fraction, & a thickened pericardium

Question 24

An ejection fraction of less than 50% indicates what condition?

Answer 24

Left ventricular failure

Question 25

Viral pericarditis can be cause by which of the following organisms?

Answer 25

Coxsackie A+B
Echoviruses
Adenoviruses

Question 26

Bacterial pericarditis can be caused by which of the following infectious organisms?

Answer 26

Staphylococci
Streptococci A+B
Gram negative rods (Pseudomonas & E.coli)

Question 27

Acute pleuritic chest pain (retrosternal)
Elevated ST segment
PR depression
Pericardial effusion
Pain eases when sitting/leaning forward

What’s the condition?

Answer 27

Acute pericarditis

Question 28

What are some of the features of acute pericarditis?

Answer 28

• Sharp/acute retrosternal chest pain
• Pericardial friction rub
• pain eases when sitting/leaning forward
• New or worsening pericardial effusion
• Elevated troponin, CRP, ESR, & CK

Question 29

What are some of the features of a chronic constrictive pericarditis?

Answer 29

• 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

Question 30

What are some of the features of chronic effusive constrictive pericarditis?

Answer 30

• Pericardial effusion
• Thickened pericardium
• Increased right atrial pressure despite pericardiocentesis (a strong indicator)

Question 31

Acute pericarditis can lead to what condition?

Answer 31

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