Lecture 21

Question 1

In what cirucumstances does venous hypertension develop

Answer 1

impairment of outflow of venous blood from tissues

Question 2

pulmonary hypertension

Answer 2

sustained inc in systolic BP in the pulmonary artery

Question 3

Cor pulmonale

characterized by

Answer 3

right heart disease caused by pulmonary hypertension

inc work load (pressure overload) on right ventricle during systole

Question 4

Some causes of pulmonary hypertension

Answer 4

congenital cardiac anomalies causing left to right shunting of large volumes of blood(PDA, atrial septal defect)
inc resistance to pulmonary arterial blood flow(heartworm,pulmonary thromboembolism)

Question 5

What is eisenmeyers complex

Answer 5

pulmonary arterial pressure inc so much that shunting of blood is reversed to right to left->poorly O2 blood circulating-> hypoxia

Question 6

systemic hypertension

Answer 6

sustained inc in systemic arterial bP

Question 7

What factors contribute to systemic arterial BP

Answer 7

COxTPR

Question 8

Some diseases responsible for hypertension in cats/dogs (5)

Answer 8

renal disease
hypERthryroidism (cats)
hypOthyroidism (dOgs)
diabetes mellitus
obesity

Question 9

Why does systemic hypertension become self perpetuating over time if not treated(2)

Answer 9

dec GFR-> inc proximal tubular reabsorption of Na and H2O

dec BP within glomerular afferent arterials->activation of RAAS

Question 10

Which body organs are most susceptible to damage from systemic hypertension(4)

Answer 10

eyes
kidneys-PU/PD
heart-aortic aneurysm
brain-stroke

Question 11

Systemic hypOtension

Answer 11

sustained dec in systemic arterial BP

Question 12

shock

Answer 12

general phenomenon of peripheral circulatory failure

Question 13

Cardiogenic shock

most common cause

Answer 13

rapid dec in systolic cardiac output despite the presence of adequate blood volume
severe DCM

Question 14

Hypovolemic shock

Answer 14

significant reduction in circulating blood volume

Question 15

Distributive shock

Answer 15

inappropriate vasodilation of arterioles with pooling of blood in capillary beds and venous channels->dec TPR and effective circulating blood volume(heat stroke)

Question 16

What circumstances can trigger neurogenic shock

what does it do

Answer 16

severely frightened, emotionally stressed or suffering severe pain
->inappropriate peripheral vasodilation and bradycardia

Question 17

What can trigger anaphylactic shock

what does it do

Answer 17

bee sting, drugs, peanuts

arteriolar and venous dilation and inc vascular permeability->dec circulating blood volume

Question 18

What can trigger septic shock(3)
what does it do
what contributes to poor prognosis

Answer 18

gram negative bacterial infections, superantigens, endotoxin
release of TNF, IL1,NO, PGI2, platelet activating->systemic arteriolar vasodilation
DIC

Question 19

Compensatory neurohumoral mechanisms that are activated in the initial stage of cardiogenic or hypovolemic shock (5)

Answer 19

hypotension detected by baroreceptors
release of glucocorticoids
aldosterone release
activation of RAAS
ADH release from posterior pituitary

Question 20

What happens during stage 2 (progressive) shock(3)

Answer 20

GFR dec-> oliguria (dec urine volume)
sustained vasoconstriciton in non essential organs-> hypoxia
pooling of blood in peripheral microcirculation

Question 21

What has happened by stage 3 of shock(2)

Answer 21

widespread hypoxic cell necrosis

failure of multiple organs and maybe DIC

Question 22

when do you therapy by during shock to improve outcome

Answer 22

stage 1 preferable or at least stage 2

Question 23

Clinical signs of shock(5)

hypovolemic and cardiogenic

Answer 23

hypovolemic and cardiogenic: hypotension, tachycardia, weak and rapid pulse, inc resp rate, cool dry or clammy skin, prolonged capillary refill time

Question 24

what form of shock has best prognosis if treatment given stage 1 or 2

Answer 24

hypovolemic

Question 25

clinical signs of shock
cardiogenic shock(3)

Answer 25

arrythmia, murmur, muffled heart sounds

Question 26

clinical signs of shock
distributive shock(2)

Answer 26

dark red mucous membranes (peripheral vasodilation, rapid capillary refill time