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Mechanisms of Disease > Ischaemia, infarction and shock > Flashcards

Ischaemia, infarction and shock Flashcards

1
Q

Define hypoxia

A

any state of reduced tissue oxygen availability

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2
Q

Define ischaemia

A

pathological reduction in blood flow to tissues

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3
Q

Are the effects of ischaemia reversible?

A

only if limited/for a short duration (otherwise cell death occurs)

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4
Q

How can the effects of ischaemia be reversed?

A

with therapueutic reperfusion

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5
Q

Does therapeutic reperfusion have an effect on infarcted tissue?

A

no

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6
Q

Define infarction

A

ischaemic necrosis caused by occlusion of the arterial supply or venous drainage

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7
Q

Define infarct

A

an area of infarction in tissues

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8
Q

What are the 2 most common causes of infarction?

A

thrombosis and embolism

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9
Q

Name some less common causes of infacrtion (5)

A

vasospasm, atheroma expansion, extrinsic compression, twisting of vessel roots, rupture of vascular supply

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10
Q

Describe red infarction

A

haemorrhagic - dual blood supply/venous infacrtion

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11
Q

Describe white infarction

A

anaemic - single blood supply hence totally cut off

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12
Q

What shape are most infarcts?

A

wedge

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13
Q

What four factors influence the degree of ischaemic damage?

A

nature of blood supply, rate of occlusion, tissue vulnerability to hypoxia, blood oxygen content

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14
Q

If there is an alternative blood supply, will the damage be more or less?

A

Less

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15
Q

Why are the kidneys, spleen and testis vulnerable to infarction?

A

they have single blood supplies

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16
Q

Are slow developing occlusions more or less likely to infarct tissues?

A

less likely

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17
Q

Why are slow developing occlusions less likely to infarct tissues?

A

allows time for development of alternative (collateral) perfusion pathways

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18
Q

What does ischaemia in the heart cause?

A

ischaemic heart disease (angina, MI)

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19
Q

What does ischaemia of the brain cause?

A

cerebrovascular disease (TIA/CVA)

20
Q

What does ischaemia of the intestines cause?

A

ischaemic bowell

21
Q

What does ischaemia of the extremities cause?

A

peripheral vascular disease/gangrene

22
Q

What is meant by cerebrovascular disease?

A

Any abnormality in the brain caused by a pathological process involving the blood vessels

23
Q

What causes ischaemic stroke?

A

thrombosis secondary to atherosclerosis r embolism

24
Q

What causes haemorrhagic stroke?

A

intracerebral haemorrhage or ruptured aneurysm in circle of Willis

25
Q

What is dry gangrene?

A

ischaemic coagulative necrosis only

26
Q

What is wet gangrene?

A

superimposed infection

27
Q

What is gas gangrene?

A

superimposed infection with gas producing organism

28
Q

What is gangrene?

A

Infarction of entire portion of limb/organ

29
Q

Define shock

A

a physiological state characterised by a significant reduction of systemic tissue perfusion resulting in decreased oxygen delivery to tissues

30
Q

how does shock lead to cellular hypoxia?

A

impaired tissue perfusion and prolonged oxygen deprivation

31
Q

What are the cellular effects of shock? (5)

A
  • membrane ion pump dysfunction
  • intracellular swelling
  • leakage of intracellular contents
  • inadequate regulation of intracellular pH
  • anaerobic respiration
32
Q

What are the systemic effects of shock? (4)

A
  • alterations in the serum pH
  • endothelial dysfunction
  • stimulation of inflammatroy and anti-inflammatory cascades
  • end-organ damage
33
Q

What is hypovolaemic shock?

A

intra-vascular fluid loss

34
Q

What effects does hypovolaemic shock have?

A

decreased venous return to heart, decreased stroke volume

35
Q

How do you compensate for the effects of hypovolaemic shock?

A

increase systemic vascular resistance

36
Q

What causes hypovolaemic shock?

A

haemorrhage, diarrhoea, vomitting

37
Q

What is third spacing?

A

acute loss of fluid into internal body cavities

38
Q

What is cardiogenic shock?

A

cardiac pump failure

39
Q

What are the effects of cardiogenic shock and how do you compensate for this?

A

decreased cardiac output, combatted by increasing systemic vascular resistance

40
Q

What are the 4 categories of cardiogenic shock?

A

myopthic, arrythmia-related, mechanical, extra-cardiac

41
Q

What cause myopathic cardiogenic shock?

A

MI

42
Q

What causes mechanical cardiogenic shock?

A

valvular defects, ventricular septal defects

43
Q

What causes extra-cardiac cardiogenic shock?

A

anything that imparis cardiac filling or ejection of blood from heart

44
Q

What is distributive shock?

A

decreased systemic vascular resistance sue to severe vasodilation

45
Q

Which type of shock are all of the following?:

septic shock, anaphylactic shock, neurogenic shock, toxic shock syndrome

A

distributive shock

Mechanisms of Disease (16 decks)

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