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MD1 > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the main differences between hyperaemia and congestion

A

Hyperaemia
- Flushed, hot, red (after running, embarrassed)
- Arteriolar dilatation and increased blood flow
- Active process

Congestion
- Cardiac failure, DVT
- Cyanotic (blue-red) (oxygen depletion)
- Obstructed venous outflow +/- lymphatic -
drainage
- Passive process

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2
Q

what is the difference between transudate and exudate oedema

A

Exudate = fluid + proteins +/- debris
usually inflammatory

Transudate = mostly just fluid, usually non-inflammatory

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3
Q

What are the two causes of transudative oedema

A
  1. Increased capillary hydrostatic pressure
  2. decreased plasma osmotic pressure
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4
Q

What is the defition of haemorrhage?

A

loss of blood from vasculature

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5
Q

What are some different types of haemorrhages?

A

haemotoma, petechiae and pupura, ecchymoses

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6
Q

Describe the features of a heamotoma

A

○ Collected blood in tissues or a body cavity
§ Haemothorax = lung area
§ Hemarthrosis = joint
§ Hemoperitoneum = body cavity
○ Small or large
○ Large can be life-threatening due to exsanguination (draining, severe blood draining/loss) and hypovolaemia (loses fluid)
Normal part of healing especially in bone fracture

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7
Q

Describe the features of petechiae and pupura

A

○ Small bleeds into skin or mucous membranes
§ 1-2mm = petechiae
§ 3-5mm = purpura
○ Causes:
§ Defective and low platelets (thrombocytopaenia)
§ Vitamin C deficiency
§ Infection
Vasculitis

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8
Q

Describe the features of petechiae and pupura

A

○ Small bleeds into skin or mucous membranes
§ 1-2mm = petechiae
§ 3-5mm = purpura
○ Causes:
§ Defective and low platelets (thrombocytopaenia)
§ Vitamin C deficiency
§ Infection
- Vasculitis

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9
Q

Describe the features of Ecchymoses

A

○ Bruises or contusions
○ 2-5cm
○ Bleeding into subcutaneous tissues
○ Changes of colour due to breakdown of
haemoglobin to bilirubin and haemosiderin

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10
Q

What are the three features of Virchows triad?

A

○ Endothelial injury (vessel wall problem - intrinsic pathway)
○ Abnormal blood flow
○ Hypercoagulability (blood problem - congenital or acquire condition = increased coagulation)

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11
Q

Define thrombosis and what vessels does it affect?

A

The formation of clots within the cardiovascular system

Arterial/cardiac: sites of vessel injury or turbulence
Venous: sites of stasis (pooling of blood in limbs)

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12
Q

Describe the endothelial injury point of virchows triad

A

Endothelial exposure encourages platelet adhesion and promotes inappropriate coagulation and clot formation
○ Hypertension
○ Vasculitis
○ Toxins (cigarette)
○ Hypercholesterolaemia
○ Radiation injury

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13
Q

Describe the flow problem point of virchows triad

A

Abnormal cardiac function reduced laminar flow of blood: areas of turbulence and stasis create opportunities for platelet aggregation and clot formation
○ Atrial fibrillation
○ Acute myocardial infarction
○ Valvular dysfunction

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14
Q

Describe the blood problem point of virchows triad

A

Dysfunctions of coagulation cascade factors promote inappropriate clot formation
○ Inherited conditions (primary)
§ Factor V Leiden mutation
○ Induced (secondary)
§ Pregnancy
§ Oral contraceptive pill
§ Procoagulant tumours
§ Smoking
§ Obesity

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15
Q

What are some examples of thrombosis

A

DVT, AMI

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16
Q

Define embolism

A

A bolus of substance transported in the blood
Can be fatal when blocking blood flow to brain, heart or lungs

17
Q

What are some causes of embolism

A
  • Thrombus (thromboembolism, clot caused from blockage breaking off)
    • Fat (fractures bone/surgery, bone marrow forced into blood vessel)
    • Air (IV admin)
      • Amniotic fluid
18
Q

What is a systemic thromboembolism?

A

Arise within the heart
○ Can end up anywhere in the vasculature
○ Brain, lower limbs common
○ Pathology depends on size of thrombus and area affected by ischemia/infarction

19
Q

What is a venous thromboembolism?

A

Usually arise in superficial or deep veins (DVT) of lower limbs
○ Risk factors: hypercoagulability, immobility, especially post-op
○ Can be asymptomatic
Pathology depends on size of thrombus and area affected by ischemia/infarction

20
Q

What is a pulmonary embolism?

A

An embolus that blocks the pulmonary vasculature (in the lung)
○ Most are sub-clinical
○ Large are often fatal
○ Ischaemic pain (sharp)
○ Reduced lung function
-> respiratory distress

21
Q

Define Ischaemia

A
  • Reduced blood flow to tissues
    • Results in pain and dysfunction
    • Change of skin colour, temperature, pulses
      Will eventually lead to infarction and tissue death (necrosis) if not fixed
22
Q

Define infarction

A
  • Blocked blood flow to tissues
    • Results in downstream tissue death and necrosis
    • Death of a certain part of tissue
23
Q

What is the difference between pale infart and red infarct

A

Anaemic infarct - “Pale infarct
- Macroscopic definition, usually wedge-shaped and pale
- EG: heart, brain, spleen, kidney
- Usually one blood supply

Haemorrhagic infarct - “Red infarct”
- Macroscopic description
- Non-viable/dead tissue have weak intracellular integrity, which is easily bled into by any communicating source of blood
- Usually consequence of:
○ Tissues with dual/collateral blood supply (e.g. lung, liver)
○ Venous insufficiency
Reperfusion into dead (infarcted)/dying (ischaemic) tissue

24
Q

What are the common causes of a red infarct/hemorrhagic infarct

A

○ Tissues with dual/collateral blood supply (e.g. lung, liver)
○ Venous insufficiency
○ Reperfusion into dead (infarcted)/dying (ischaemic) tissue

25
Q

What are some signs of hypervolaemia?

A
  • Shortness of breath, fluid in lung tissue causing wheeze, crepitations, visible fluid on CXR
    • Pitting oedema of lower limbs
    • Elevated blood pressure
    • Increased JVP
    • Bounding pulse
      • Headache and altered mental state - increased intracranial pressure
26
Q

What are some signs of hypovolemia?

A
  • Acute hypovolaemia due to rapid fluid loss over minutes or hours (haemorrhage, burns, diarrhoea)
    • Signs and symptoms similar to dehydration but may be more extreme
    • If not identified and treated early, can lead to SHOCK
27
Q

Describe the features of shock

A
  • Systemic hypoperfusion of tissues
    ○ Cardiogenic: low cardiac output
    ○ Hypovolaemic: low blood volume
    ○ Septic: systemic peripheral dilation, blood pooling, DIC (disseminated intravascular coagulopathy)
    ○ Rare: neurogenic, anaphylactic
    • Risks of organ damage:
      ○ Renal
      ○ Cerebral
    • Signs and symptoms:
      ○ Early compensation
      § Increased heart rate and BP
      § Peripheral vasoconstriction -> cool, clammy skin
      § Renal fluid conservation -> reduced urine output
      ○ Progressive decompensation
      § Increasing tachycardia, dropping BP, changing conscious state
      Increasing acidosis and metabolic derangement

MD1 (6 decks)

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