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PVS > Pathology: Haemodynamic disorders > Flashcards

Pathology: Haemodynamic disorders Flashcards

1
Q

What is the overall distribution of intracellular and extracellular water like in the body?

A

2/3 intracellular and 1/3 extracellular

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2
Q

What is the distribution of extracellular fluid like?

A

80% in the interstitium and 20% in the plasma

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3
Q

What is oedema?

A

Accumulation of excess interstitial fluid

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4
Q

How does oedema occur?

A

Increased microvascular permeability: inflammation/toxins/anaphylaxis

Increased intravascular hydrostatic pressure: portal/ pulmonary hypotension, localised venous obstruction, fluid overload

Decreased intravascular osmotic pressure: decreased albumin production or increased loss

Decreased lymphatic drainage: Lymphatic obstruction

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5
Q

What are the two coagulation cascade pathways, what is their end product?

A

Intrinsic and extrinsic

Both cause activation of factor X and accumulation of proteolytic enzymes that initiate fibrin formation

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6
Q

Where does the intrinsic coagulation pathway take place?

A

Triggered by the effects of abnormal surfaces on components normally found in the blood

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7
Q

Where does the extrinsic pathway usually take place?

A

Occurs outside the blood vessel when shed blood contacts tissue debris
Thromboplastin plays a major role

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8
Q

What cause haemorrhage?

A

Loss of integrity of the endothelium/blood vessels: Due to trauma, erosion by inflammation, vascular fragility, toxins

Decrease in platelet numbers or abnormal platelets

Deficiencies in coagulation factors (inherited or acquired)

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9
Q

What is Ehlers-danlos syndrome?

A

Inherited vascular fragility as apposed to acquired via vitamin C deficiency

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10
Q

What is thrombocytopenia?

A

Decreased platelet numbers

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11
Q

What is thrombocytopathy?

A

Abnormal platelet function

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12
Q

Name an inherited and acquired coagulation factor defect

A

I: Von Willebrand
A: Warfarin or severe liver disease

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13
Q

What are petechiae (one petechia)?

A

Pinpoint 1-2mm haemorrhage

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14
Q

What are ecchymoses (one ecchymosis)?

A

haemorrhage up to 2-3cm

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15
Q

What is a haematoma?

A

Haemorrhage in a focal confined space

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16
Q

What is a haemoperitoneum?

A

Blood in the peritoneal cavity

17
Q

What is a thrombosis ?

A

An inappropriate formation of a clot of fibrin and/or fibrin
On the wall of vessel/ heart: mural thrombus
Free in the lumen: thromboembolus

18
Q

What causes a thrombosis?

A

Endothelial injury: Infectious agents/ IV injections
Alterations in blood flow: local stasis, cardiac disease, hypovolaemia
Hypercoaguability: Inflammation, increased platelet activity, increased clotting factor activation, antithrombin 3 deficiency

19
Q

What is an embolus?

A

A piece of free floating material in the blood

20
Q

Where do thromboemboli tend to lodge?

A

Venous: in the pulmonary circulation
Arterial: At vascular bifurcations

21
Q

What causes disseminated intravascular coagulation (DIC)?

A

Diffuse vascular damage, systemic infections

22
Q

What is the mechanism of DIC?

A

Excess thrombin –> Platelet aggregation and fibrin formation –> widespread microvascular clots –> consumption of the coagulation factors –> widespread haemorrhages

23
Q

What is hyperaemia?

A

Increased blood flow, which causes active engorgement of vascular beds as inflow increases and outflow is te same or decreased

24
Q

What causes hyperaemia?

A

Physiologic: Heat, postprandial
Pathological: Inflammation

25
Q

What is congestion?

A

Passive engorgement of the vascular beds as outflow decreases and inflow is either normal or increased

26
Q

What causes congestion?

A

Acute: Heart failure, anaesthesia, euthanasia
Chronic: Obstruction, heart failure, pulmonary disease

27
Q

What is an infarction?

A

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

28
Q

What is shock?

A

Circulatory dyshomeostasis, associated with the loss of circulating blood volume, decreased cardiac output and inappropriate peripheral perfusion

29
Q

What is the mechanism of shock?

A

Hypotension –> decreased tissue perfusion –> cellular hypoxia –> shift to anaerobic metabolism –> cellular degeneration –> Cell death

30
Q

What is cardiogenic shock?

A

Failure of the heart to adequately pump blood

31
Q

What is hypovolaemic shock?

A

Decrease in the circulating blood volume caused by blood or fluid loss

32
Q

What are the types of maldistribution shock:

  1. Anaphylactic shock
  2. Neurogenic shock
  3. Septic shock
A
  1. Generalised type 1 hypersensitivity
  2. Trauma to the nervous system eg. electrocution, fear
  3. Peripheral vasodilation caused by components of bacteria (endotoxin) or fungi that induce release of excessive amounts of vascular inflammatory mediators

PVS (43 decks)

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