Parsa - Hemodynamic Disorders

Question 1

Edema is an accumulation of fluid (interstitial tissue space) in body cavities:

Answer 1

1. Hydrothorax: pleueral effusion
2. Hydroperitoneum: Ascites
3. Hydropericardium: pericardial effusion

Question 2

Excess fluid accumulates when

Answer 2

1. hydrostatic pressure is increased
2. osmotic prssure is decreased
3. lymphatics are blocked
4. inc. vascular permeability associated with inflammation

Question 3

Localized edema is due to inc. in vascular permeablity:

Answer 3

1. inflammation
2. allergic reaction
3. venous obstruction
4. lymphatic obstruction

Question 4

Systemic edema is cause by increased retention of total body ____ and water

Answer 4

sodium

Question 5

refers to edema all over the body

Answer 5

anasarca

Question 6

In transudate edema there is ____ change in vascular permeability. It contans little ____ and has a low specific gravity

Answer 6

no; protein

Question 7

_____ fluid has increased protein and specific gravity is usually greater than 1.

Answer 7

exudate

Question 8

Hyperemia occurs as a result of ____ vasodilation and leads to increased blood flow (inflammation). They will be redder and warmer than normal. In congestion, inc. blood volume occurs as a passive process due to impaired ____ outflow of a tissue. Tissues will appear blue

Answer 8

arterial; venous

Question 9

What happens in left sided heart failure

Answer 9

can’t pump out oxygenated blood properly and backs up blood and incerases hydrostatic venous pressure in LUNG which results in pulmonary edema.

Question 10

what happens in right sided failure

Answer 10

pooling of blood on to venous side of circulation; affects central vein and become deoxygenated. All of the areas surrounding central vein become congested.

Question 11

what is a hemorrahage

Answer 11

results from escape of RBCs across intact vessels or from vascular rupture

Question 12

A hemorrhage can be intact and can occur from a vessel or can be external. An intact hemorrage results from:

Answer 12

1. congestion
2. inc hydrostatic pressure
3. bleeding disorders

Question 13

A vascular rupture results from

Answer 13

1. trauma
2. atherosclerosis
3. congenital aneurysms
4. inflammatory conditions
5. erosion by a mass

Question 14

What is petechiae

Answer 14

minute 1 -2 mm hemorhages into skin, mucous membranes or serosal surfaces and are associated with locally inc. intravascular pressure, low platelet counts, or defective platelet function

Question 15

purpura is hemorrhages that are greater than ___ mm

Answer 15

3

Question 16

____ refers to 1-2 cm subcutaneous hematomas (bruise)

Answer 16

ecchymosis

Question 17

what is hemostasis

Answer 17

arrest of blood flow; patients who are bed ridden; usually a precursor to thrombosis.

Question 18

what is thrombosis

Answer 18

pathological counterpart of hemostasis

Question 19

what are 3 components of hemostasis

Answer 19

1. subendothelial collagen
2. platelets
3. coagulation system

Question 20

Exposure to ___ collagen leads to platelet binding and activation

Answer 20

subendothelial; platelets adhere and aggregate at the site of injury to form a primary platelet plug and start the coagulation cascade

Question 21

____ counterbalances response to the definitive platelet plug. Once clot is formed plasmin is crucial to its disruption and healing of plug. ___ don’t allow procoagulants to be activated too much

Answer 21

fibrinolysis; Anticoagulants

Question 22

____ is the clot forming pathway. ____ is the clot lysing pathway. ____ is the regulation pathway

Answer 22

coagulation; fibronylysis; anticoagulation

Question 23

Anticoagulation inhibit_____

Answer 23

thrombosis

Question 24

What favors thrombosis

Answer 24

1. endothelial injury –>vWF–> platelet binding
2. Endothelial cells synthesize tissue factor
3. Catalytic activation of coagulation factors

Question 25

What is anticoagulation mediated by

Answer 25

1. heparin like molecules 2. Tissue factor pathway inhibitor 3. Thrombomodulin

Question 26

Thrombosis occurs as a result of dysregulation of Pro and anti ____mechanisms

Answer 26

coagulation

Question 27

what is thrombus

Answer 27

solid mass formed by both the platelets and coagulation mechanisms

Question 28

blood clot = _____only!

Answer 28

coagulation

Question 29

What are the ways a blood clot develops

Answer 29

1. When blood collects in extravascular areas after being spilled from injured vessels. (hematoma) 2. in vitro 3. vessels after death

Question 30

postmortem blood clot resembles currant ____ and chicken ____

Answer 30

jelly; fat

Question 31

What are the factors that promote thrombus

Answer 31

1. Endothelilal injury 2. Abnormal blood flow 3. Hypercoagulability

Question 32

Describle laminar blood flow vs turbulent blood flow

Answer 32

Laminar blood flow: platelets and cells flow in the center of the vessel, while plasma flows along the vessel periphery. Turbulent blood flow increases the chances of contact between platelets and vessel wall.

Question 33

Hypercoagulability can arise from:

Answer 33

1. Genetics 2. neoplasms 3. pregnancy 4. surgery

Question 34

What are types of thrombosis

Answer 34

1. arterial 2. cardiac 3. venous

Question 35

Arterial thrombosis occurs as a result of atherosclerosis which is due to:

Answer 35

1. Endothelial damage | 2. turbulent blood flow

Question 36

Where are the most common sites of arterial thrombosis

Answer 36

1. coronary arteries 2. cerebral arteries 3. femoral arteries

Question 37

Arterial thrombi tend to grow in a ____ direction from their point of attachment

Answer 37

retrograde

Question 38

What are lines of Zahn

Answer 38

red layers in heart containing RBCs trapped by the fibrin

Question 39

What are the two types of venous thrombosis

Answer 39

1. Superficial venous thrombosis | 2. Deep venous Thrombosis aka phlebothrombosis; is prone to embolism! Seen in lower extremities

Question 40

what is recanalization

Answer 40

some of the budding capillary channels may anastomose to form a patent lumen that traverses the length of the thrombus and thus re establish blood flow in the vessel. While it dosent prevent acute effects of thrombosis, it may slightly improve tissue perfusion over the long term.