PATH: Hemmorrhagic Disorders, Thrombosis, and Shock

Question 1

What are the potential causes of the pathophysiology of edema?

Answer 1

Increased hydrostatic pressure, decreased oncotic pressure/ hypoproteinemia, increased capillary permeability, or lymphatic obstruction

Question 2

How does increased hydrostatic pressure contribute to edema?

Answer 2

The increased hydrostatic presssure causes more fluid to leak into the interstitial space than can be reabsorbed by the lymphatic system

Question 3

What are the mechanisms by which hydrostatic pressure increases?

Answer 3

Arteriolar dilation, increased venous pressure, and hypervolumia

Question 4

What are the effects of congestive left and right heart failure?

Answer 4

Left- Pulmonary edema, Right- Systemic edema

Question 5

What conditions could be responsible for causing decreased osmotic pressure or hypoproteinemia?

Answer 5

Nephrotic syndrome, cirrhosis, protein-losing gastroenteropathy, or malnutrition

Question 6

What is dependent or pitting edema?

Answer 6

When you can push down on a patient’s edema and it causes a depression that is slow to resolve

Question 7

What is a hematoma?

Answer 7

A localized accumulation of blood in several layers of tissue

Question 8

What is petechia?

Answer 8

small, needle-pin type skin or surface bleeding

Question 9

What is purpura?

Answer 9

Small (

Question 10

What is ecchymosis?

Answer 10

Larger (>1-2 cm), blotchy subcutaneous bleeding (bruise)

Question 11

What is the difference between active and passive hyperemia?

Answer 11

Active is due to arterial dilation w/ increased flow into capillary beds, usually resulting in redness; Passive is due to impaired venous drainage usually resulting in blue-red color

Question 12

What is nutmeg liver?

Answer 12

Statis of blood and passive congestion in hepatic venous circulation, mostly due to heart failure

Question 13

What is shock?

Answer 13

Widespread hypoperfusion of tissues due to reduction in blood volume, cardiac output, or redistribution of blood, resulting in inadequate effective circulatory volume

Question 14

What is the pathophysiology of shock?

Answer 14

Decreased CO–> decreased arterial pressure–> decreased cap. perfusion–> decreased venous return–> decreased preload–> decreased CO–> etc.

Question 15

What is the body’s initial defense to shock?

Answer 15

Vasoconstriction , redistribution of blood flow, shunting blood to vital organs, fluid mobilization and/or retention

Question 16

What is the most common cause of septic shock?

Answer 16

Gram positive cocci

Question 17

What is endotoxin?

Answer 17

Bacterial wall lipopolysaccharide cnsisting of toxic lipid A core and complex polysaccharide coat

Question 18

What are the causes of cardiogenic shock?

Answer 18

Myocardial infarct, pericardial tamponade, massive pulmonary embolus, tension pneumothorax, acute valvular regurgitation, electrical dysfunction

Question 19

What are the clinical stages of shock?

Answer 19

Early or Compensated shock (nonprogressive); decompensated but reversible shock (progressive), and irreversible shock

Question 20

What signs are associated with nonprogressive shock?

Answer 20

Tachycardia, vasoconstriction, reduced urine production

Question 21

What signs are associated with progressive shock?

Answer 21

Hypotension, tachypnea, and shortness of breath, oliguria, and worsening ciculatory and metabolic imbalances leading to acidosis