Infarction and Ischaemia Flashcards

1
Q

What is infarction

A

Death of tissue within living body due to ISCHAEMIA

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2
Q

What are three characteristics of an infarct in the first 6 hours

A
  1. ECG changes
  2. No visible change histologically
  3. EM shows swollen mitochondria
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3
Q

What are three characteristics of an infarct after the first 24 hours

A
  1. Pallor visible
  2. Inflammatory reaction at age of ischaemia site
  3. Striations disappear from cardiac myocytes
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4
Q

What are three characteristics of an infarct during the first few weeks

A
  1. Dead myocytes removed by macrophages

2. Replacement by fibrous tissue

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5
Q

What is the characteristic of an infarct months after it took place

A

Fibrous scar

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6
Q

At what stage of an infarct is the tissue at the site weakest

A

When macrophages and polymorphs clear dead tissue

why people with a myocardial infarction can die 10 days after due to rupture of healing process

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7
Q

Is the scarred area where the infarction took place functional?

A

Nope - still protrudes into the lumen and can cause more problems for the patient in the future

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8
Q

What problem can arise from a scarred area of a myocardial infarction

A

Aneurysms as scar can be stretched at high pressure but can’t recoil

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9
Q

Define Gangrene

A

When whole areas of a limb or region of a gut have their arterial supply cut off and tissues die in bulk

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10
Q

Define dry gangrene

A

Tissue dies, mummifies and healing occurs above it

dead area drops off

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11
Q

What condition does dry gangrene take place in

A

Diabetes

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12
Q

Define wet gangrene

A

Bacterial infection supervenes and patient dies from sepsis

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13
Q

What mechanism other than dry and wet can cause gangrene

A

Torsion

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14
Q

What is a torsion

A

Twist on a mesentery, ovary or testes occluding venous return

Organ swells and oedema compresses drainage further

Arteries continue to pump blood into organ causing an infarction

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15
Q

How can capillary ischaemia take place

A
  1. Capillaries damaged so severely that area supplied becomes ischaemic
  2. Blocked by parasites
  3. Balance of thrombotic and thrombolytic mechanism is disturbed
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16
Q

why does susceptibility to ischaemia change in different parts of th body

A

Less susceptibility - another artery can take over the job and still supply area + low tissue needs
More susceptibility - Only one artery is supplying the area
+ high tissue metabolic needs (retinal artery leads to blindness)

17
Q

What are watershed areas

A

Tissue at interface between adjacent territories of two arteries (no collateral circulation to provide blood from alternative vessels)

18
Q

Examples of watershed areas

A

Splenic flexure of colon (between superior and inferior mesenteric) + regions of cerebral hemispheres
+ myocardium

19
Q

What cells are most exposed to infarction and why?

A

Cereal neurones because they have a large metabolic requirement + Cardiac myocytes

20
Q

Define shock

A

Profound circulatory failure resulting in life-threatening hypo perfusion of vital organs. Compensatory mechanisms maintain BP until they fail. Ends in hypotension

21
Q

What can shock be classified as

A

Cardiogenic: due to myocardial infarction
Hypocolaemic: due to reduction in effective circulating blood volume

22
Q

What are compensatory mechanisms

A

These increase peripheral vascular resistance to maintain BP supplying vital organs

23
Q

What is the consequence of mechanisms failing

A

Vulnerable to ischaemic injury

24
Q

What can shock result in

A
  1. Irreversible neuronal injury
  2. Renal failure due to acute tubular necrosis
  3. Acute pancreatitis
25
Q

Define phlethrombosis

A

Thrombosis in vein

26
Q

Define thrombophlebitis

A

Inflammatory reaction to phlethrombosis

27
Q

Most common cause of cariogenic shock

A

Acute myocardial infarction due to death of left ventricular myocardium reducing heart functional capacity (decreased SV)

28
Q

Define hypovolaemic shock

A

Loss of effective circulating blood volume due to haemorrhage