Neoplasia 6 Flashcards
Difference between clot and thrombus
Thrombus involves three competents: platelets, endothelial cell interaction and coagulation cascade; friable and attached to vessel wall
Clot: only fibrin and is not attached to the vessel wall and gelatinous
In __________ you will see lines of Zahn
Thrombus (but not in clot)
Compare and contrast arterial thrombi vs venous thrombi; how does the difference affect therapy
Arterial: high flow so ↓ RBC and ↑ Platelets; pale in color
Venous: low flow so ↑ RBC and ↓ Platelets; red in color
If there is an arterial thrombi, antiplatelet therapy is useful but not as effective if it was a venous thrombus
Antiplatelet agents are more effective in _________ thrombi
Arterial
Most commonly involved artery for thrombosis
Coronary artery
Trousseau’s Syndrome
Recurrent thrombophlebitis; recurrent inflammation of veins throughout the body and whenever you see this look for an underlying malignancy esepecially pancreatic adenocarcinoma
___________________ carcinoma is most commonly associated with Trousseau’s Syndrome
Pancreatic adenocarcinoma
Statistically the most common origin of embolisms is ________ but are clinically silent
Deep leg veins which reaches the lungs
The most clinically significant (most often shows symptoms) is thromboemboli that arise from the _______ and embolize to _________
Heart; embolize to lower extremities and brain
Classification of embolisms
Massive: sudden obstruction causing sudden death an NO time to develop infarction
Major: dyspnea and pain and infarction only 10% if bronchial arteries are compromised
Minor: asymptomatic and no change in lungs
Mechanisms of damage by fat embolism: (2)
- mechanical damage: globules enlarge in the circulation and platelets adhere
- biochemical injury: FFA are released in the circulation and are toxic to endothelial cells and cause DIC, clogged pulmonary and systemic capillaries
What kind of symptoms are typically seen in fat embolism and when do they occur?
- Pulmonary insufficiency
- neurological symptoms such as: irritability, restlessness, and can progress to delirium/coma
- anemia
- thrombocytopenia
Sudden onset of: tachypnea, dyspnea and tachycardia and petechiae
Other symptoms occur 1-3 DAYS after injury
Where do you see nitrogen embolism?
Deep sea diving without using Caisson’s chamber
Bends Disease and mechanism
Acute nitrogen embolism
High pressure causes O2 and N2 to dissolve in blood and tissues but as the person resurfaces, O2 is reabsorbed and N2 bubbles out and ruptures tissues and vessels and forms thrombi
What is the chronic form of nitrogen embolism and what are some signs
Caisson’s disease;
Persistent gas emboli in bones; necrosis in femur, tibia, humerus
Bone marrow embolism is seen in _______________ and is an incidental finding at autopsy
Small pulmonary vessels after vigorous cardiac resuscitation
What would you see in the pulmonary vessels in amniotic fluid embolism and what are some effects
Squares, hair and mechanism
Causes DIC, pulmonary edema and diffuse alveolar damage
Factors that influence the development of infarction
- nature of vascular supply (most important) such as dual blood supply or collateral circulation
- rate of development of occlusion
- tissue vulnerability to hypoxia
- oxygen carrying capacity of blood
__________ is the most common cause of cerebral infarcts and are mainly form ____________
Embolisms; cardiac mural thrombi
Thrombotic occlusion of the brain is caused by __________ and squally at the following sites: (3)
Atherosclerosis;
Carotid, original fo MCA or end of basilar artery
Instead of scar formation in brain, we see ________
Gliosis
