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Section 3: Hemodynamic Disorders Flashcards

1
Q

Hemostasis

A

Process which causes bleeding to stop

Keeps blood in a damaged blood vessel

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2
Q

Increased blood volume can be due to ___ or ___

A

Hyperemia

Congestion

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3
Q

Congestion is a ___ process

A

Passive

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4
Q

Venous obstruction can lead to ___ (bluish color)

A

Cyanosis

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5
Q

Congestion can be caused by

A

Congestive Heart Failure

Deep Vein Thrombosis

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6
Q

Chronic pulmonary congestion causes fibrotic

A

Alveolar septa

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7
Q

Heart failure cells are composted of

A

Macrophages

Hemosiderin

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8
Q

Heart failure cells are found in

A

Chronic pulmonary congestion

In lungs after heart failure

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9
Q

Congestive hepatopathy can be caused by anything that obstructs

A

Hepatic venous drainage

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10
Q

Necrosis caused by congestive hepatopathy can cause

A

Nutmeg liver

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11
Q

Centrilobular necrosis

A

Central lobule of liver dying due to congestive hepatopathy

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12
Q

Edema

A

Abnormal accumulation of interstitial fluid

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13
Q

2/3 of body’s H2O is

A

Intracellular fluid

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14
Q

1/3 of body’s H2O is

A

Interstitial fluid

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15
Q

Interstitial fluid is drained by

A

Lymphatics

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16
Q

2 types of edema

A
  1. Localized (MC)

2. Generalized (rare)

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17
Q

Types of localized edema

A
  1. Lower extremities
  2. Peritoneal cavity
  3. Pleural cavity
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18
Q

Edema in peritoneal cavity can be called

A

Ascites

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19
Q

Ascites occurs due to occlusion of hepatic veins, which can occur due to

A

Cirrhosis

Cancer

Blood clots

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20
Q

Edema in pleural cavity can be called

A

Hydrothorax (fluid around lungs)

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21
Q

Generalized edema occurring in subcutaneous tissues can be called

A

Anasarca

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22
Q

Anasarca is bodywide edema due to

A

Low dietary protein

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23
Q

Edema can be caused by

A
  • inflammation
  • too much hydrostatic pressure
  • too little osmotic pressure
  • lymphatic obstruction
  • retention of sodium or H2O
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24
Q

Increased hydrostatic pressure is from

A

Impaired venous return

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25
Q

Localized impaired venous return

A

Deep vein thrombosis

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26
Q

Generalized impaired venous return

A

Congestive heart failure

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27
Q

Reduced osmotic pressure can be from

A

Too few plasma proteins

Hypoalbuminemia

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28
Q

Most common plasma protein

A

Albumin

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29
Q

Too few plasma proteins can be due to

A

Reduced production of proteins

Increased loss of proteins

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30
Q

Increased loss of plasma proteins can be due to

A

Nephrotic syndrome

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31
Q

Nephrotic Syndrome

A

Peripheral edema
Proteinuria
Hyperlipidemia
Hypoalbuminemia

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32
Q

Lymphatic obstruction can occur due to

A

Inflammation / fibrosis
Tumors
Inactivity

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33
Q

Damage to which organs are most likely to be involved with edema

A

Liver
Heart
Kidney

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34
Q

Filariasis aka

A

Elephantiasis

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35
Q

Filariasis caused by

A

Extreme lymphatic obstruction due to bacterial infection

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36
Q

A mastectomy can cause ___ due to scar tissue obstructing lymph drainage

A

Lymphedema

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37
Q

Peau d’orange

A

Tethering of sweat glands of the breast due to edema pushing upward

Due to severe lymphatic obstruction

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38
Q

Causes of sodium and water retention

A

A. High salt diet
B. Hypoperfusion to kidneys
C. Acute renal failure
D. Poststreptococcal glomerulonephritis

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39
Q

Increased water volume causes increased

A

Pressure

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40
Q

Exudate

A

Protein rich edema

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41
Q

Dependent edema

A

Ankles or sacrum (pressure ulceration)

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42
Q

Cerebral edema

A

Increased intracranial pressure

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43
Q

Cerebral edema can be caused by

A

Abnormal BBB (tumors, infection, trauma)

Cell membrane injury (toxins, hypoxia)

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44
Q

Pitting edema

A

Transudate accumulates

Protein poor

No osmosis

Non-inflammatory

Ex. Heart Failure

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45
Q

Non-Pitting Edema

A

Exudate accumulates

Protein rich

Osmosis

Inflammatory

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46
Q

Hemorrhage

A

Extravasation of blood from vessels

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47
Q

Hypovolemic shock

A

Rapid loss of greater or equal 20% of blood volume

48
Q

Hematoma

A

Large accumulation of blood within tissue

49
Q

Contusion

A

Trauma causing bruise (hematoma)

50
Q

Ecchymosis

A

Minor trauma

Hematoma from unlikely trauma

51
Q

Petechiae

A

Small area of hemorrhage (1-2mm)

52
Q

Common cause of petechiae

A

Low platelets
Vit K deficiency
Vit C deficiency causing vessel fragility

53
Q

Purpura

A

Slightly larger hemorrhage (3-5 mm)

54
Q

Common causes of purpura

A

Mechanical trauma
Vasculitis
Vessel fragility from Vit C deficiency

55
Q

Progressive change of color in contusions

A

Red/blue —green— yellow

56
Q

Transition of color in contusions is due to hemoglobin broken down to ___ and ____

A

Bilirubin

Hemosiderin

57
Q

3 main components of normal hemostasis

A

Platelets
Endothelium
Coagulation cascade

58
Q

Primary hemostasis occurs when ___ aggregate on vessel wall following endothelial damage

59
Q

Endothelial Damage exposes sub-endothelial ___ and ___ to contents of blood, activating platelets to form ___

A

Von Willebrand factor (vWF)

Collagen

Primary plug

60
Q

Secondary hemostasis involved formation of

A

Fibrin-rich clot

61
Q

Endothelium normal ____ thrombosis

62
Q

Injury to vascular endothelia exposes _____

A

Tissue factor

63
Q

Thrombin cleaves ____ into ___

A

Fibrinogen

Fibrin

64
Q

Coagulation cascade activates

65
Q

____ (in bone marrow) produce platelets

A

Megakaryocytes

66
Q

Virchow’s Triad

A

Endothelial injury
Hypercoagulability
Abnormal blood flow

67
Q

Endothelial activation

A

Normal anti-thrombotic endothelia become pro-thrombotic

68
Q

Stimuli that may cause endothelial injury

A 
Atherosclerotic plaques 
Inflammation
Abnormal blood flow 
Hypercholesterolemia 
Toxic exposure
69
Q

Aspirin is an ___ drug

A

Antiplatelet

70
Q

Warfarin and heparin are ___ drugs

A

Anticoagulants

71
Q

Abnormal blood flow promotes

A

Endothelial activation

72
Q

Excessively viscous blood results in stasis, which makes the blood prone to

73
Q

Polycythemia

A

Increased RBC

74
Q

Highly viscous blood may be caused by

A

Polycythemia

Sickle cell disease

75
Q

Mutations that may cause hyper-coagulability

A

Factor V

Prothrombin

76
Q

4 fates of a thrombus

A

Dissolve

Enlarge

Embolize

Organization

77
Q

Features of a venous thrombus

A

Congestion

Tenderness

Pitting edema

78
Q

Features of arterial thrombus

A

Cell injury

Inflammation

Infarction

79
Q

Venous thrombosis grows ____ venous blood flow

A

Along with

Anterograde

80
Q

Venous thrombi begins at site of

81
Q

Common locations of venous thrombi

A

Popliteal or femoral

82
Q

90% of venous thrombi occur in

A

Lower extremities (DVT)

83
Q

Arterial thrombi grow ___ arterial blood flow

A

Against

Retrograde

84
Q

Arterial thrombi begins at

A

Site of injury/ turbulence

85
Q

Common locations of arterial thrombi

A

Coronary
Cerebral
Femoral

86
Q

All thrombi roads lead to the

87
Q

Lines of Zahn

A

Microscopic light and dark layers of a thrombus due to platelets and RBCs at a site of high blood pressure

88
Q

For lines of Zahn to form, the patient must be

A

Alive when the clot formed

89
Q

Disseminated Intravascular Coagulation (DIC)

A

Widespread thrombosis/ coagulopathy

Complication of severe trauma

Widespread organ failure

90
Q

Embolism

A

When a detached intravascular mass (embolus) becomes lodged in a vessel

91
Q

Types of emboli

A

Solid

Liquid

Gas

92
Q

Ex of solid emboli

A

Thrombus, fat, plaque

93
Q

Ex of liquid emboli

A

Amniotic fluid

94
Q

Ex of gas emboli

A

Air

Nitrogen (Caisson Disease)

95
Q

Pulmonary embolism occurs due to

A

Occlusion of pulmonary artery

96
Q

____ of PE are recurrent

97
Q

___ of PE originate from DVTs

98
Q

____ of PE are small and clinically silent

99
Q

___ of PE are massive and fatal

100
Q

Tachypnea

101
Q

Systemic thromboembolism occurs within the

A

Arterial system

102
Q

Paradoxical embolism

A

Crosses from venous to arterial system

103
Q

For someone to have a paradoxical embolism, there must be either _____ or ____

A

Atrial septal defect

Ventricular septal defect

104
Q

Infarction

A

Death of tissue, due to obstructed blood supply

105
Q

Red (hemorrhagic) infarction occurs in lungs due to

A

Natural cavities and dual blood supply

106
Q

White (pale/anemic) infarction occurs in

A

Solid walled organs

107
Q

Shock

A

Inadequate blood supply (perfusion) to tissues, resulting in cellular injury dysfunction and possibly death

108
Q

Types of shock with peripheral vasoconstriction and SNS activation

A
  1. Cardiogenic

2. Hypovolemic

109
Q

Cardiogenic shock occurs due to

A

Pump failure —decreased output

110
Q

Hypovolemic shock occurs due to

A

Loss of blood/plasma volume

111
Q

Types of sock with peripheral vasodilation

A
  1. Septic
  2. Neurogenic
  3. Anaphylactic
112
Q

Septic shock

A

Systemic immune reaction

113
Q

Neurogenic shock

A

<60 BPM

CNS trauma

114
Q

Anaphylactic shock

A

Severe allergy

115
Q

Vasovagal syncope

A

Decreased HR
Decreased BP
Lightheaded
Vision problems

116
Q

Stages of shock

A
  1. Nonprogressive
    SNS compensatory mechanisms
  2. Progressive
    Widespread hypoperfusion
  3. Irreversible
    Widespread membrane damage

Gen Path (10 decks)

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