Lecture 5- Thromboembolic Disease 8/31

Question 1

A… is an intravascular clot often impeding or preventing blood flow and … is the formation or presence of a thrombus that may result in infarction

Answer 1

thrombus

thombosis

Question 2

The components of Virchows triad are

Answer 2

1. endothelial injury
2. alt. in blood flow
3. hypercoagulability

Question 3

Alteration in blood flow can be either… or … which both cause endothelial activation

Answer 3

stasis

turbulence

Question 4

Endothelial injury leads to a loss of …. and increase in…. activity

Answer 4

barrier

prothrombotic

Question 5

Hypercoagulability can be an … or … condition

Answer 5

inherited

acquired

Question 6

3 inherited conditions of hypercoagulability are…

Answer 6

Factor V leiden
Prothrombin mutation
ATIII deficiency

Question 7

5 acquired conditions of hypercoagulability

Answer 7

1. prolonged bed rest
2. extensive tissue injury
3. pregnancy
4. cancer
5. anti- PL ab

Question 8

Thrombosis on the arterial side results in a thrombus that is … which can be occlusive or mural and has … lines of Zahn

Answer 8

white

distinct

Question 9

Thrombosis on the venous side results in a thrombus that is … and has…. lines of Zahn

Answer 9

red

indistinct

Question 10

4 possible fates of thrombi

Answer 10

1. propagation
2. embolization
3. dissolution
4. organization/recanalized

Question 11

… is the widespread activation of the coag cascade and fibrinolytic systems

Answer 11

Disseminated intravascular coagulation

Question 12

DIC is called a “… coagulopathy”

Answer 12

consumptive

Question 13

DIC results in the depletion of … and … and the elevation of … products leading to both … and …

Answer 13

coagulation factors
platelets
fibrin split
microthrombi
hemorrhage

Question 14

5 etiologies of DIC

Answer 14

1. infection (gram neg bact)
2. obstetric complications
3. neoplasm
4. shock
5. massive tissue injury

Question 15

The treatment for DIC is highly … and dependent upon management of ….

Answer 15

variable

underlyind disorder

Question 16

DIC is potentially ….

Answer 16

life-threatening

Question 17

An … is an intravascular solid, liquid, or gaseous mass carried by the blood to a site distant from its point of origin

Answer 17

embolus

Question 18

The vast majority of emboli are …

Answer 18

dislodged thrombus material (thromboembolism)

Question 19

the origin of a pulmonary thromboembolism is usually from a

Answer 19

deep leg vein

Question 20

5 possible clinical consequences of pulmonary thromboembolism

Answer 20

1. no manifestations
2. pulmonary hemorrhage
3. pulmonary infarction
4. sudden death (saddle embolus)
5. pulmonary HTN

Question 21

The origin of a systemic embolization is either …, … or …

Answer 21

LA
LV
atherosclerotic plaque

Question 22

A paradoxical systemic embolus is when the embolus arises in a … then crosses into the … side often through a ….

Answer 22

vein
arterial
patent foramen ovale

Question 23

5 types of embolism

Answer 23

air
fat
amniotic fluid
thrombus
atherosclerotic plaque material

Question 24

an … is an area of ischemic necrosis secondary to occlusion of arterial supply or venous drainage. this is a major contributor to mortality assoc. with CV dz

Answer 24

infarction

Question 25

4 factors that influence infarct development

Answer 25

1. nature of vascular supply 2. rate of occlusion 3. vulnerability to hypoxia 4. O2 carrying capacity of CV system

Question 26

.... is systemic hypoperfusion

Answer 26

shock

Question 27

5 pathophysiologic categories of shock

Answer 27

``` cardiogenic hypovolemic septic (endotoxin) anaphylactic neurogenic ```

Question 28

.... is the #1 cause of death in ICUs (... annually in the U.S.) 20% mortality

Answer 28

septic shock | 200,000

Question 29

3 stages of shock

Answer 29

nonprogressive progressive irreversible

Question 30

... shock is when compensatory mechanisms maintain perfusion

Answer 30

nonprogressive

Question 31

... shock is when there is inadequate perfusion, lactic acidosis, DIC, anaerobic metab.

Answer 31

progressive

Question 32

... shock is when tissue injury is unrecoverable, multiple organ failure, death occurs

Answer 32

irreversible

Question 33

9 clinical manifestations of shock

Answer 33

``` tachypnea tachycardia confusion low UO acidosis high lactic acid hypotension cool clammy skin pallor/cyanosis ```