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Principles > Pathology > Flashcards

Pathology Flashcards

1
Q

What is the difference between a blood clot and a thrombosis?

A

clots are extravascular coagulation

thrombosis is intravascular coagulation- static

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2
Q

Excess intravascular coagulation results in what?

A

Thrombosis

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3
Q

What is the end point of coagulation?

A

Aggregate of platelets, RBCs and fibrin

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4
Q

What cascade is associated with inflammation?

A

Complement cascade

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5
Q

What cascade is associated with apoptosis?

A

caspase cascade

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6
Q

What cascade is associated with thrombosis?

A

Coagulation cascade

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7
Q

what is the most common pathway of the coagulation cascade?

A

The extrinsic pathway

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8
Q

what would you measure Intrinsic coagualtion pathway with?

A

prothrombin time

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9
Q

what would you measure extrinsic coagulation pathway with?

A

Activated partial thromboplastin time

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10
Q

what are the 2 end reactions of the coagulation cascade?

A

Prothrombin- thrombin

Fibrogen- fibrin

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11
Q

What is Virchow’s triad?

A

Locations where thrombosis is favoured

  1. sites of endotheial injury
  2. turbulent blood flow
  3. hypercoaguable blood
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12
Q

what is present at sites of endothelial injury?

A 
Increased exposure to tissue factor
Weak vessel walls
Atheroma
Aneurysms
Surface thrombosis
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13
Q

what can cause endothelial injury?

A 
toxins
infectious agents
smoking
autoimmune disease
primary vasculitis
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14
Q

what can cause turbulence?

A

Endothelial cell injury

Stasis

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15
Q

what can cause Hypercoaguability?

A

lots of inherited disorders
e.g. factor V Lieden, protein C deficency, antithrombin III deficiency
Prolonged immobility
Significant tissue injury

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16
Q

How does cancer effect coagulation?

A

Predisposes thrombosis
Some produce tissue factor- stimulated thrombosis
Also, chemotherapy can increase thrombosis risk

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17
Q

What is an embolism?

A

A thrombus that has been transported through the vasculature to a point where it gets stuck

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18
Q

what characteristic on an x-ray indicates a PE?

A

White wedge shape

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19
Q

what is ischaemia?

A

Insufficient blood supply

20
Q

what is infarction?

A

death of tissue as a result of ischaemia

21
Q

What are some emboli other than PE?

A 
Air
Amniotic Fluid
Fat
Tumour
Septic
22
Q

What is another word for atheroma?

A

Atherosclerosis
Hardening of the arteries
Coronary artery disease
Ischaemic heart disease

23
Q

What is the underlying principle of atheroma?

A

Endothelial cell injury

24
Q

Where does haemodynamic injury occur?

A

Sites of turbulent blood flow

25
Q

How does hypertension contribute to atheroma?

A

Damages endothelium

26
Q

How is hyperlipidaemia a risk factor?

A

lots of low density lipoproteins can lead to hypercholesterolaemia, which can cause atheroma on it’s own

27
Q

how is diabetes a risk factor?

A 
Increases cholesterol levels
Advanced Glycation end products
Abnormal cross linking in vessel walls
Loss of elasticity
Trapping of cholesterol
28
Q

What are the stages of atheroma formation?

A
  1. Primary endothelial injury
  2. Accumulation of lipids and macrophages
  3. Migration of smooth muscle cells
  4. Increase in size
29
Q

What happens after endothelial injury?

A

Increased permeability & white cell adhesion
Increased VCAM-1
So monocytes attach and migrate through wall & become macrophages

30
Q

What happens with fat after endothelial injury?

A

Macrophages engulf cholesterol
Initially cholesterol volume is low
LDL is deposited
HDL is “shuttled” back to the liver

31
Q

What happens to smooth muscle after endothelial injury?

A

Migrated from tunica media to intima
Gets stuck and takes on cholesterol
Produce extracellular matrix- collagen
Changes lesion from fatty streak to fibrofatty plaque

32
Q

Small changes in patency of a vessel have what effect on the flow?

A

Large reduction

33
Q

What happens as atheromatous plaques enlarge?

A

blood flow is compromized

34
Q

what is the progress of atheromatous plaques?

A

Fatty streak
Fibrofatty plaque
Complicated plaque with overlying thrombus

35
Q

What are three factors that would make atherosclerosis critical?

A
  1. If its the only artery supplying an organ/tissue
  2. If the artery diameter is small (eg. coronary artery)
  3. Overall blood flow is reduced
36
Q

What are some complications of atheroma?

A

Stenosis
Aneurysm
Dissection
Thrombosis and embolism

37
Q

What is arterial stenosis?

A

Narrowing of the arterial lumen
Reduced elasticity
Reducced flow in systole
Tissue ischaemia

38
Q

What are some effects of cardiac ischaemia?

A 
Reduced exercise tolerance
Angina
Unstable angina
Myocardial Infarction
cardiac failure
39
Q

What is cardiac fibrosis?

A

Loss of cardiac myocytes
Replacement by fibrous tissue
Loss of contractility
Reduced elasticity & filling

40
Q

What is the impact of arterial stenosis on carotid arteries?

A

TIA
Stroke
Vascular dimentia

41
Q

What is the impact of arterial stenosis on renal arteries?

A

Hypertension

Renal failure

42
Q

What is the impact of arterial stenosis on peripheral arteries?

A

Claudication

Foot/leg ischaemia

43
Q

what is the most common site of aneurism formation?

A

abdominal aorta

44
Q

What are some aneurysm complications?

A 
Rupture
Thrombosis
Embolism
Pressure erosion of adjacent structure
Infection
45
Q

what is arterial Dissection?

A

Splitting within the media by flowing blood
False lumen filled with blood within the media
Sudden collapse and high mortality

46
Q

Other associations with aortic dissection?

A 
Atheroma
Hypertension
Trauma
Coarctation
Marfan's
Pregnancy

Principles (12 decks)

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