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PVS > Pathology 4 > Flashcards

Pathology 4 Flashcards

1
Q

Name the disorders of haemostasis

A
  • Haemorrhage

- Thrombosis

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2
Q

What factors may be affected leading to haemorrhage?

A
  • Endothelium/blood vessel
  • Platelets
  • Coagulation factors
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3
Q

How might the endothelium/blood vessels be altered in order to lead to haemorrhage?

A
  • Trauma
  • Erosion by inflammation/neoplasia
  • Endotoxaemia
  • Toxins
  • Inherited conditions (e.g. Ehlers-Danlos syndrome)
  • Acquired conditions (vit C deficiency)
  • Vascular fragility
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4
Q

How might platelets be altered leading to haemorrhage?

A
  • Decreased paltelet number (thrombocytopaenia)

- Abnormal platelet function (thrombocytopathy)

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5
Q

How might coagulation factors be altered leading to haemorrhage?

A
  • Inherited deficiencies (e.g. haemophilia A/B, Von Willebrand’s disease)
  • Acquired defects (e.g. severe liver disease, warfarin intoxication)
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6
Q

What is petechia?

A

Pinpoint (1-2mm) haemorrhage

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7
Q

What is ecchymosis?

A

Haemorrhage up to 2-3cm

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8
Q

What is haematoma?

A

Haemorrhage in focal, confined space i.e. bruise

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9
Q

What is haemoabdomen?

A

Blood in the abdomen

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10
Q

What is haemoperitoneum?

A

Blood in the periotoneal cavity

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11
Q

What is haemothorax?

A

Blood in the thoracic cavity

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12
Q

What is haemopericardium?

A

Blood in the pericardial sac

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13
Q

What determines the significance of a haemorrhage?

A

The amount, rate and location of blood loss

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14
Q

What is thrombosis?

A

Formation of inappropriate clot of fibrin and/or platelets along with other blood elements

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15
Q

What is a mural thrombus?

A

A thrombus that forms on the wall of blood or lymphatic vessel or the heart

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16
Q

What is a thromboembolus?

A

A thrombus free in the lumen of a vessel

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17
Q

What may lead to thrombosis?

A
  • Endothelial injury
  • Alterations in blood flow
  • Hypercoagulability
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18
Q

Give examples of endothelial injury that may lead to thrombosis

A
  • Infectious agents
  • Immune-medaited
  • Toxins
  • disseminated intravascular coagulation (DIC)
  • Faulty intravenous injections
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19
Q

Give examples of alterations in blood flow that may lead to thrombosis

A
  • Local stasis/decreased blood flow
  • Cardiac disease
  • Aneurysm
  • Hypovolaemia
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20
Q

Give examples of hypercoagulabity conditions that may lead to thrombosis

A
  • Inflammation
  • Increased platelet activity
  • Increased clotting factor activation
  • Antithrombin III deficiency
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21
Q

What is Virchow’s triad?

A

The factors (endothelial injury, hypercoagulability and abnormal blood flow) that may lead to thrombosis

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22
Q

What determines the significance of a thrombus?

A
  • Location
  • Ability to disrupt perfusion in a dependent tissue (depends on size, rate of formation, and method or resolution or repair)
23
Q

What is a thromboembolus?

A

Portion or whole thrombus can break loose and enter circulation as an embolus

24
Q

Where are venous thromboemboli often found?

A

Typically lodge in pulmonary circulation

25
Q

Where are arterial thromboemboli often found?

A

Typically near sites of vascular bifurcation

26
Q

What are the consequences of pulmonary venous thromboemboli?

A
  • Lead to respiratory problems

- Eventually lead to heart disease

27
Q

What are the potential alterations in blood flow called?

A
  • Hyperaemia (increased blood flow)
  • Congestion (decreased blood flow)
  • Decreased tissue perfusion
28
Q

What are the characteristics of hyperaemia?

A
  • Active engorgement of vascular beds
  • Inflow increased (via arteriolar dilation)
  • Outflow may be normal or decreased
29
Q

What may cause hyperaemia?

A
  • Physiologic: heat (skin), postprandially (GI)

- Pathologic: inflammation

30
Q

What are the characteristics of congestion?

A
  • Passive engorgement of vascular beds
  • Outflow decreased
  • Inflow normal or increased
31
Q

What may cause congestion?

A
  • Acute: heart failure, euthanasia, anaesthesia

- Chronic: obstruction of venous outflow, heart failure, pulmonary disease

32
Q

What may lead to decreased tissue perfusion?

A
  • Obstruction of a blood vessel
  • Local vascular congestion
  • Decreased cardiac output
33
Q

What is an infarct?

A

An area of ischaemic necrosis caused by the occlusion of either arterial supply or venous drainage

34
Q

What does infarction commonly occur secondary to?

A

Thrombosis/thromboembolism

35
Q

What factors influence the development of an infarct?

A
  • Nature of vascular supply (e.g. kidney and spleen have end-arterial supply)
  • Rate at which occlusion develops
  • Vulnerability to hypoxia
  • Oxygen content of the blood (i.e. venous or arterial)
36
Q

What is the effect of slow infarct development?

A

Provides time to develop alternate perfusion pathways

37
Q

What are the characteristics of infarct following arterial obstruction?

A
  • Loss of blood flow to downstream tissue

- Abrupt coagulative necrosis downstream of obstruction

38
Q

What are the characteristics of infarct following venous obstruction?

A
  • Stagnation of blood flow, reduction or loss of venous return
  • Progressive ischaemia and ultimately coagulative necrosis of tissue upstream of obstruction site
39
Q

What is DIC?

A

Disseminated Intravascular Coagulation

40
Q

What is DIC?

A

Serious manifestation of abnormal coagulation that leads to severe dyshaemostasis, caused by generation of excess thrombin

41
Q

What are the potential causes of DIC?

A
  • Diffuse vascular damage
  • Systemic infections
  • Any other stimuli that activate release of inflammatory mediators
  • Massive anaphylactic events
42
Q

Describe the mechanism of DIC

A
  • Excess thrombin leads to platelet aggregation and fibrin formation
  • Get widespread microvascular clots
  • Consumption of coagulation factors
  • Widespread haemorrhages occur as clots are using up coagulation factors
43
Q

What is shock?

A

Cardiovascular collapse

44
Q

Give the sequence of events in shock

A
  • Hypotension
  • Decreased tissue perfusion
  • Cellular hypoxia
  • Shift to anaerobic metabolism
  • Cellular degeneration
  • Cell death
45
Q

What are the different types of shock?

A
  • Cardiogenic
  • Hypovolaemia
  • Blood maldistribution
46
Q

What is cardiogenic shock?

A

Failure of the heart to adequately pump blood

47
Q

What is hypovolaemic shock?

A

Decreased circulating blood volume due to blood or fluid loss

48
Q

What are the 3 types of blood maldistribution shock?

A
  • Anaphylactic
  • Neurogenic
  • Septic
49
Q

What causes anaphylactic shock?

A

Generalised type 1 hypersensitivity

50
Q

What causes neurogenic shock?

A

Trauma to the nervous system, may be elctrocution, fear, emotional stress

51
Q

What causes septic shock?

A
  • Peripheral vasodilation caused by components of bacteria (endotoxin) or fungi
  • Induce release of excessive amounts of vascular and inflammatory mediators
52
Q

What factors need to be included in the gross description of an abnormality in post mortem?

A
  • Location
  • Number/extent
  • Demarcation (well/poor)
  • Distribution (focal, multifocal, locally extensive, diffuse etc)
  • Colour
  • Size (metric units)
  • Shape
  • Consistency and texture
  • Extent (% of organ affected)
  • Any other information e.g. odour, sound
53
Q

What factors relating to the carcase need to be described in post mortem?

A
  • Main features
  • Weight
  • Age
  • Breed
  • Species
  • Sex
  • Body condition
  • Any identifying feature e.g. tattoos, tags
  • Abnormaities
  • Degree of post-mortem decomposition
54
Q

In what way should a morphological diagnosis be written?

A

Organ: severity, duration, distribution, descriptors, diagnosis

PVS (23 decks)

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