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
Define phlethrombosis
Thrombosis in vein
26
Define thrombophlebitis
Inflammatory reaction to phlethrombosis
27
Most common cause of cariogenic shock
Acute myocardial infarction due to death of left ventricular myocardium reducing heart functional capacity (decreased SV)
28
Define hypovolaemic shock
Loss of effective circulating blood volume due to haemorrhage