IV - Hemodynamic Disorders, Thrombosis and Shock Flashcards
Edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.81
Extravasation of fluid into interstitial spaces due to increases in vascular volume or pressure, decreases in plasma protein content or alterations in endothelial function.
Anasarca(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.81
It is a severe and generalized edema with profound subcutaneous tissue swelling.
Transudate(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.82
The edema fluid occuring with volume or pressure overload or under conditions of reduced plasma protein.
Exudate(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.82
Edema secondary to increased vascular permeability and inflammation.
Albumin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.83
The serum protein most responsible for maintaining intravascular colloid osmotic pressure.
Peau dā orange(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.83
In breast cancer, infiltration and obstruction of superficial lymphatics can cause edema of the overlying skin, called _______ appearance.
Edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
Microscopically, it is reflected primarily as a clearing and separation of the extracellular matrix elements with subtle cell swelling.
Dependent edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
Diffuse edema usually more prominent in certain body areas as a result of the effects of gravity.
False.Dependent edema is a feature of right-sided HF, while pulmonary congestion is a feature of left-sided HF.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
True or false:Dependent edema is a prominent feature of left-sided heart failure.
Pulmonary edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
Condition wherein the lungs weigh 2-3x the normal, and on sectioning reveals frothy, sometimes blood-tinged mixture of air, fluid and extravasated red cells.
Pitting edema(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84
Finger pressure over significantly edematous subcutaneous tissue displacing the interstitial fluid, leaving a finger-shaped depression on the skin.
Heart-failure cells(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
Hemosiderin- laden macrophages *SEE SLIDE 4.1
Hyperemia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84 *SEE SLIDE 4.2
It is an ACTIVE process resulting from augmented blood flow due to arteriolar dilation. Affected tissue is redder than normal, because of engorgement with oxygenated blood.
Congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.84 *SEE SLIDE 4.3
It is a passive process resulting from impaired venous return out of a tissue.Tissue has a blue-red color due to accumulation of hemoglobin in the affected tissue.
Acute pulmonary congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
Characterized by alveolar capillaries engorged with blood, with associated alveolar septal edema or focal minute intra-alveolar hemorrhage. *SEE SLIDE 4.4
Chronic pulmonary congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
Pulmonary septa are thickened and fibrotic, with hemosiderin-laden macrophages in alveolar spaces. *SEE SLIDE 4.5
Acute hepatic congestion(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
The central vein and sinusoids of the liver are distended with blood, with central hepatocyte degeneration. The periportal hepatocytes are better oxygenated. *SEE SLIDE 4.6
Chronic passive congestion of the liver(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
The central regions of the hepatic lobules are grossly red-brown and slightly depressed and are accentuated against the surrounding zones of uncongested tan, sometimes fatty liver (nutmeg liver). *SEE SLIDE 4.7
Chronic passive congestion of the liver(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.85
Presence of centrilobular necrosis with hepatocyte drop-out, hemorrhage and hemosirin-laden macrophages
Hemorrhage(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
Extravasation of blood from vessels into the extravascular space.
Hematoma(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86 *SEE SLIDE 4.8
Accumulation of blood within a tissue.
Petechiae(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86 *SEE SLIDE 4.8
1-2mm hemorrhages into skin, mucous membranes, or serosal surfaces.
Purpura(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86 *SEE SLIDE 4.8
3-5mm hemorrhages which can occur with trauma, vascular inflammation, or increased vascular fragility.
Ecchymoses (TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86 *SEE SLIDE 4.8
1-2cm subcutaneous hematomas/bruises.
Thrombosis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
Pathologic form of hemostasis.
Arteriolar vasoconstriction(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
It occurs after an initial injury, as a result of reflex neurogenic mechanisms.
Endothelin(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
A potent endothelium-derived vasocontrictor.
GpIb receptors on platelet, Von Willebrand factor on endothelium(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
Receptors responsible for platelet adhesion.
Bernard-Soulier syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
Deficiency of GpIb receptors.
Glanzmann thrombasthenia(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
Deficiency of GpIIb-IIIa receptors.
Thromboplastin/Factor III(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.88
It is a membrane-bound procoagulant glycoprotein synthesized by endothelium, which becomes exposed at the site of injury.
ADP and TXA2(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.87
Two substances essential for the formation of a primary hemostatic plug.
Primary hemostasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
Formation of a hemostatic plug due to platelet aggregation. Reversible.
Secondary hemostasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.86
Hemostasis characterized by activation of thrombin through the coagulation cascade. Irreversible.
Tissue factor(TOPNOTCH)
Most important initiator of the coagulation cascade.
Tissue plasminogen activator (t-PA) and Urokinase(TOPNOTCH)
A protein found on endothelial cells involved in the breakdown of blood clots which catalyzes conversion of plasminogen to plasmin.
Endothelial injury, Stasis, Hypercoagulability(TOPNOTCH)
Components of Virchowās triad?
Stasis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
It is a major contributor to the development of VENOUS thrombi.
Laminar flow(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
Type of blood flow found in normal blood vessels, wherein platelets flow centrally in the vessel lumen, separated from the endothelium by a slow moving clear zone of plasma.
Turbulence(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.94
Alteration in blood flow that contributes to arterial and cardiac thrombosis by causing endothelial injury or dysfunction as well as formation of countercurrents and local pockets of stasis.
Hypercoagulability(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.95
Any alteration of the coagulation pathway that predisposes to thrombosis.
Embolus(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.95
A detached, intravascular solid, liquid or gaseous mass that is carried by the blood distal to its point of origin.
Lines of Zahn(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
Apparent laminations seen in a thrombus, representing pale platelet and fibrin layers alternating with darker erythrocyte-rich layers. *SEE SLIDE 4.9
Represents thrombosis in the setting of blood flow, seen in antemortem clots.(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
Significance of Lines of Zahn?
Mural thrombi(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
Thrombi occuring in heart chambers or aortic lumen
Postmortem thrombi(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
Gelatinous thrombi with a dark red dependent portion where red cells have settled by gravity with a yellow āchicken fatā supernatant. Usually unattached to underlying wall.
Vegetations(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96
Thrombi on heart valves.
Libman-Sacks endocartidis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96 *SEE SLIDE 4.10
Sterile, verrucous endocartidis occuring in patients with SLE.
Nonbacterial thrombotic endocarditis(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.96 *SEE SLIDE 4.10
Vegetations occuring in the presence of non-infected valves in hypercoagulable states.
Propagation(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
Fate of a thrombus wherein the thrombus accumulates additional platelets and fibrin, eventually causing vessel obstruction.
Organization and recanalization(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
Fate of a thrombus wherein it may induce inflammation and fibrosis and establish some degree of blood flow.
Propagation, Resolution/Dissolution, Organization and recanalization, Embolization(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.98
Fates of a thrombus (4)
Superficial or deep veins of the leg(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
Most common site of venous thrombosis.
Pulmonary embolism(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
Most common sequelae of deep venous thrombosis.
Migrating thrombophlebitis or Trousseauās syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.98
Tumor-associated procoagulant release largely responsible for the increased risk of thromboembolic phenomena seen in disseminated cancers.
True(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.97
True or false:
Therapeutic administration of fibrinolytic agents is generally effective only within a few hours of thrombus formation.
Saddle embolus(TOPNOTCH)Robbins Basic Pathology, 8th ed. p.99
Embolus occluding a bifurcation in the pulmonary tree.