Ischaemia, infarction and shock Flashcards

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1
Q

Limitations of therapeutic reperfusion

A

Only works in reversible ischaemia

Risk of reperfusion injury due to the generation of reactive O2 species

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2
Q

Causes of infarction

A
Thrombus
Embolus
Vasospasm
Atheroma expansion
Tumour
Volvulus
Rupture
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3
Q

This type of infarction has a single blood supply

A

White infarction

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4
Q

This type of infarction has a dual blood supply

A

Red infarction

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5
Q

Difference between thrombus and embolus

A

Thrombus: solid mass of blood constituents formed in vascular system in life

Emboli: derived from thrombi. Can be exogenous

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6
Q

Neurone death vs cardiac myocyte death time?

A

3 minutes for neurone in absence of oxygen

20-30 minutes for myocytes

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7
Q

Reduced O2 in blood increases chances of what?

A

Infarction

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8
Q

What occurs at the point of anastomosis of two vessels?

A

Watershed region

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9
Q

Arteries occluded which lead to ischaemic bowel disease?

A

Superior / inferior mesenteric

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10
Q

Types of gangrene and explanation

A

Dry - ischaemic coagulative necrosis
Wet - superimposed infection
Gas - Superimposed infection with gas producing organisms

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11
Q

Define shock

A

Physiological state characterised by significant reduction of systemic tissue reperfusion resulting in decreased oxygen delivery to the tissues

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12
Q

Critical imbalance between oxygen delivery and oxygen consumption

A

Effect of shock

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13
Q

Systemic effects of shock

A

Changes to serum pH
Vascular leakage
Stimulation of inflammatory and anti-inflammatory cascades
End organ damage

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14
Q

Cellular effects of shock

A

Membrane ion pump dysfunction
Intracellular swelling
Anaerobic respiration

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15
Q

Types of shock

A
Hypovalaemic
Cardiogenic
Distributive
Anaphylactic
Neurogenic
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16
Q

Characteristics of hypovalaemic shock

A

Intravascular fluid loss
Leads to decreased preload
Decreased SV=Decreased CO
Counteracted by increased systemic vascular resistance

17
Q

Characteristics of cariogenic shock

A

Cardiac pump failure
Decreased CO
Counteracted by increasing systemic vascular resistance

18
Q

Causes of cariogenic shock

A

Myopathic
Arrhythmia related
Mechanical
External cardiac

19
Q

Characteristics of distributive shock

A

Severe vasodilation leading to decrease in systemic vascular resistance
Compensated for by increasing CO

20
Q

Subcategories of septic shock

A

Septic
Anaphylactic
Neurogenic

21
Q

Causative agents of septic shock

A

S. aureus

S. pyogenes

22
Q

Mechanism in toxic shock syndrome

A

SA and SP release exotoxins which do not require processing by APCs
Non specific binding of C2MHC to TCRs
Widespread release of massive amounts of cytokines
Decreased systemic vascular resistance