Pathophysiology of Cardiac failure and oedema

Question 1

What is Darcy`s law?

Answer 1

Blood flow = pressure gradient over resistance

Question 2

What is congestion?

Answer 2

Relative excess of blood in vessels of tissue or organ

Question 3

What are the three clinical pathologies of congestion?

Answer 3

• Local acute congestion
• Local chronic congestion
• Generalised acute congestion

Question 4

Give an example of local acute congestion?

Answer 4

Deep vein thrombosis

Question 5

Give an example of local chronic congestion?

Answer 5

Hepatic cirrhosis

Question 6

Give an example of generalised acute congestion?

Answer 6

-Congestive cardiac failure

Question 7

What causes hepatic cirrhosis?

Answer 7

HBV alcohol

Question 8

What happens to the structure of the liver in hepatic cirrhosis?

Answer 8

Regenerating liver forms nodules of hepatocytes with intervening fibrosis

Question 9

What does the altered structure of the liver cause?

Answer 9

• altered hepatic blood flow
• Congestion in portal vein and branches
• collateral circulation

Question 10

What are two consequnces of portal-systemic shunts?

Answer 10

• Oesophageal varices

- Caput Medusae

Question 11

What is congestive cardiac failure?

Answer 11

-Heart unable to clear blood, right and left ventricles

Question 12

What causes heart congestion?

Answer 12

Ischaemia

valve disease

Question 13

What are the pathophysiology steps of congestive cardiac failure?

Answer 13

-Decreased CO
-Renal Glomerular filtration rate
(activation of renin-angiotensin-aldosterone system)
-Na And H2O retention
-Increase in fluid in body

Question 14

Whats the treatment for cardiac failure?

Answer 14

Diuretics

Question 15

Right heart failure causes?

Answer 15

Blood dams back to systemic
Increase JVP
hepatomegaly
peripheral oedema

Question 16

Left heart failure causes?

Answer 16

Blood dams into lungs

Pulmonary Oedmea

Question 17

What appearances of the liver can be seen when hepatic central venous congestion?

Answer 17

-Nutmeg

Question 18

What is Oedema?

Answer 18

Accumulation of abnormal amounts of fluid in the extravascular compartment

Question 19

What is an effusion?

Answer 19

Fluid collection in body cavities

Question 20

What is ascites?

Answer 20

Fluid in abdominal cavity

Question 21

What are the features of transudate?

Answer 21

Not much protein/albumin

Lots of H20 & electrolytes

Question 22

What part of starlings law does pulmonary oedema affect?

Answer 22

Capillary hydrostatic

Question 23

what part of starlings law does peripheral oedema affect?

Answer 23

Capillary hydrostatic

Question 24

What can breast cancer radiotherapy to the axilla cause?

Answer 24

-Fibrosis=decreased outflow=oedema of the upper lip

Question 25

How does hypoalbuminaemia cause oedema?

Answer 25

Decreases oncotic capillary pressure meaning water is not dragged back into capillary so filtration in creases

Question 26

What is starlings equation?

Answer 26

look that shit up

Question 27

What can cause hypoproteinaemia (which can lead to oedema)?

Answer 27

Nephrotic syndrome (leaky basement membrane)
Hepatic cirrhosis
Malnutrition

Question 28

What happens in permeability oedema?

Answer 28

• Damage to endothelial lining

- proteins and larger molecules can leak out.. NO oncotic cap pressure to bring water back in.