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Principles of Physiopathology > Infarction and Shock > Flashcards

Infarction and Shock Flashcards

1
Q

What is infarction?

A

Ischemic necrosis within a tissue or organ

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2
Q

What is infarction most often caused by?

A

Thrombotic or embolic occlusion

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3
Q

What is white infarct?

A

Ischemic; turns pale, classic wedge shape

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4
Q

What is red infarct?

A

Hemorrhagic; bleeding into tissue or organ

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5
Q

What are the determining factors of clinical significance for infarction?

A
  • Nature of vascular supply
  • Rate of development of occlusion
  • Vulnerability of tissue to hypoxia
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6
Q

If an occlusion has a very quick development, what is the likely result?

A

Necrosis

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7
Q

If an occlusion develops over years, what is the likely result?

A

Tissue atrophy

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8
Q

What tissues are vulnerable to hypoxia?

A

Heart, nerve, brain

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9
Q

Infarction has margins lined by rim of…

A

hyperemia/inflammation

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10
Q

The surface of an infarct is covered by…

A

fibrinous exudate

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11
Q

Heart attack/myocardial infarction leads to what type of necrosis?

A

Coagulative necrosis

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12
Q

What is the most common shape of an infarct?

A

Wedge-shaped

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13
Q

What is shock?

A

Hypoperfusion of tissues

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14
Q

What are five major subtypes of shock?

A
  • Cardiogenic
  • Hypovolemic
  • Septic
  • Anaphylactic
  • Neurogenic
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15
Q

Myocardial infarction and myocarditis lead to what type of shock?

A

Cardiogenic

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16
Q

Cardiac tamponade and pulmonary embolus lead to what type of shock?

A

Cardiogenic

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17
Q

Hemorrhage leads to what type of shock?

A

Hypovolemic

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18
Q

Diarrhea and dehydration lead to what type of shock?

A

Hypovolemic

19
Q

Burns lead to what type of shock?

A

Hypovolemic

20
Q

A severe infection will lead to what type of shock?

A

Septic

21
Q

Type 1 hypersensitivity reactions lead to what type of shock?

A

Anaphylactic

22
Q

Brain damage and/or spinal cord injury lead to what type of shock?

A

Neurogenic

23
Q

What are three results of myocardial pump failure?

A
  • Decreased blood volume
  • Increased vasodilation
  • Increased vascular permeability
24
Q

What happens during cardiogenic shock?

A

Heart fails as a pump

25
Q

After myocardial infarction, necrotic tissue will appear ___ and scar tissue will appear ___

A

necrotic tissue = dark
scar tissue = pale/white

26
Q

What is cardiac tamponade?

A

Survival of heart attack leads to tear in myocardium and bleeding into pericardial sac; atria will collapse

27
Q

Is cor pulmonale acute or chronic?

A

Acute

28
Q

What is cor pulmonale?

A

Right ventricular dilation (fills with blood that can’t leave) and hypertrophy

29
Q

Cor pulmonale is an extension of…

A

what happens with embolized deep vein thrombosis: saddle embolus

30
Q

What is hypovolemic shock?

A

Not enough blood due to blood loss

31
Q

What are potential causes of cardiogenic shock?

A
  • Myocardial infarction
  • Cardiac tamponade
  • Cor pulmonale
32
Q

What are potential causes of hypovolemic shock?

A
  • Hemorrhage
  • Severe trauma
  • Extensive burns (2nd and 3rd degree)
33
Q

How does an extensive burn lead to hypovolemic shock?

A

Blisters are filled with edema fluid which is derived from blood plasma, thus decreasing blood volume

34
Q

What is septic shock?

A

Sock due to blood borne infection

35
Q

septic shock

Endotoxins are released from gram ___ bacteria (role of LPS)

A

gram negative bacteria

36
Q

septic sock

Endotoxins stimulate release of ___

A

cytokines (IL-1, 6, and 8, TNF)

37
Q

septic shock

Cytokines trigger the release of…

A

PAF, NO, bradykinin, complement, prostaglandins, and leukotrienes

38
Q

septic shock

What is the result of released PAF, NO, bradykinin, complement, prostaglandins, and leukotrienes by cytokines?

A

Systemic vasodilation

39
Q

What are the stages of shock?

A
  • Non-progressive stage
  • Progressive stage
  • Irreversible stage
40
Q

What is the non-progressive stage of shock?

A

Compensatory mechanisms are maintaining blood pressure: SNS, RAA axis, autoregulation

41
Q

What is the progressive stage of shock?

A

Tissue hypoxia and metabolic acidosis but the tissue is not dying yet

42
Q

What is the irreversible stage of shock?

A

Enzyme leakage and organ shutdown over a short time course

43
Q

If increased BUN, creatinine, and decreased GFR are found in the blood, what is the likely cause?

A

Irreversible stage of shock due to kidney failure

44
Q

If increased troponin, pancreatic lipase, and amylase are found in the blood, what is the likely cause?

A

Irreversible shock

Principles of Physiopathology (36 decks)

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