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General Pathology > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

What does the health of cells and tissue depend on?

A

circulation of blood

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2
Q

What is delivered to cells and tissues by the circulatory system?

A

Oxygen and glucose`

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3
Q

What does Hyperemia entail?

A

Too much blood volume within tissue

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4
Q

_____ Is an active process resulting from arteriolar dilation and increased blood inflow._____ causes Erythema in inflammation and it is also a result of inflammation

A

Hyperemia

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5
Q

______ is a passive process which results in lowered venous outflow and causes tissue cyanosis

A

Congestion

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6
Q

What does congestion result from?

A

venous obstruction

Ex. Congestive heart failure, DVT, testicular torsion

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7
Q

What does acute pulmonary congestion entail?

A

blood-engorged alveolar capillaries and variable degrees of alveolar septal edema and intra-alveolar hemorrhage

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8
Q

What does Chronic pulmonary congestion entail?

A

The alveolar septa becomes fibrotic and thhe alveolar spaces contain numerous macrophages laden with hemosiderin (“heart failure cells”)

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9
Q

What are hemosderin derived from?

A

phagocytosed red cells

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10
Q

What happens to the central veins and sinusoids in acute hepatic congestion ?

A

The central veins and sinusoids are distended with blood.

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11
Q

What happens to the periportal hepatocytes in acute hepatic congestion?

A

experience less severe hypoxia and may develop only reversible fatty change

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12
Q

What is the most common result of congestive heart failure?

A

acute hepatic congestion

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13
Q

What is edema?

A

abnormal accumulation of ISF within tissues or cavities

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14
Q

What are examples of localized edemas?

A

LE, Ascites and Hydrothroax

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15
Q

What are examples of generalized edemas?

A

anasarca

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16
Q

Approximately ___ of lean body weight is water, two thirds of which is intracellular.

A

60%

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17
Q

only ___ of the bodys water is in blood plasma

A

5%

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18
Q

What is anasarca?

A

severe, generalized edema marked by profound swelling of sub- cutaneous tissues and accumulation of fluid in body cavities.

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19
Q

What is fluid movement within between the vascular and Interstitial spaces governed by?

A

Vascular hydrostatic pressure and colloid osmotic pressure

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20
Q

What is produced by hydrostatic pressure at the arteriolar end of the microcirculation?

A

outflow of fluid

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21
Q

The edema fluid that accumulates owing to increased hydrostatic pressure or reduced intravascular colloid typi- cally is _____

A

Transudate

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22
Q

What are the causes of EDEMA?

A

Increased hydrostatic pressure, Lymphatic obstruction, sodium and water retention

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23
Q

Local impaired venous return increases in intravascular pressure can result from _______

A

impaired venous return

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24
Q

What could cause edema to the distal portion of a leg?

A

a deep venous thrombosis in the lower extremity

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25
Q

Generalized impaired venous returns might result in ____

A

congestive heart failure

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26
Q

In order to reverse damage to the heart caused by Gen. Impaired venous return what would need to happen?

A

restoration of cardiac output or reduction of renal water retention

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27
Q

Under normal circumstances ______accounts for almost half of the total plasma protein

A

albumin

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28
Q

What is one cause for reduced plasma osmotic pressure?

A

syndromes where albumin is either lost from the circulation or synthe- sized in inadequate amounts

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29
Q

in ___ ____ damaged glomerular capillaries become leaky, leading to the loss of albumin (and other plasma proteins) in the urine and the development of generalized edema. Reduced albumin synthesis occurs in the setting of severe liver disease

A

neprotic syndrome

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30
Q

What could lead to cirrhosis?

A

nephrotic syndrome

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31
Q

What usually results from a localized obstruction of the lymph canal?

A

Lymphedema

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32
Q

What is lymphedema generally caused by?

A

Inflammatory or neoplastic conditions

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33
Q

What is peau d’ orange?

A

Edema on the skin that is superficial to the lymph canal (typically in breast cancer) the skin has pitted appearance

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34
Q

One complication of therapy could be _____

A

lymph edema

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35
Q

What could excessive retention of salt and water lead to?

A

Edema

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36
Q

How does excessive retention of salt and water lead to edema?

A

By increasing hydrostatic pressure and reducing plasma osmotic pressure

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37
Q

What diseases cause retention of salt and water?

A

Acute renal failure

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38
Q

Where does subcutaenous edema usually happen?

A

accumulates preferentially in parts of the body positioned the greatest distance below the heart where hydrostatic pres- sures are highest

39
Q

What is dependent edema?

A

Pooling of the edema fluid is dependent on gravity or gravity pull

40
Q

Wound healing is decreased in edema because

A

Blood has to push harder through the edema fluid in order to get to the target tissue

41
Q

Edema may indicate pathologies such as___

A

CHF, Renal failure

42
Q

In pitting edema vs non pitting edema, which would have more protein content and capacity for osmosis?

A

non pitting edema

43
Q

What is the definition of a hemorrhage?

A

extravasation of blood from vessels which causes external or internal bleeding

44
Q

What is a hematoma?

A

accumulation of blood within tissue (product of internal hemorrhage)

45
Q

What determines the severity of hemorrhage?

A

The extent of damage and the site where injury occurs

46
Q

Losing more than 20% of blood rapidly or slowly causes no damage to healthy adults (t or F)

A

true, greater losses cause Hypovolemic Shock

47
Q

What three elements are involved in hemostasis and thrombosis?

A

the vascular wall, platelets, and the coagulation cascade.

48
Q

What are the regulators of hemostasis?

A

Endothelial cells

49
Q

What facilitates platelet adherence, activation, and aggregation?

A

Exposure of ECM caused by endothelial injury

50
Q

which cells express anticoagulant factors?

A

Endothelial cells

51
Q

What are the three primary abnormalities that lead to Thrombosis?

A

Endothelial injury, Stasis or turbulent of blood flow, and hypercoagulability of the blood

52
Q

What is Thrombosis?

A

Clot formation inside of a blood vessel

53
Q

What are inherited mutations that could cause Thrombosis?

A

Factor V which is Antithrombotic or Prothrombrin which is pro thrombotic

54
Q

what contributes to arterial and cardiac thrombosis by causing endothelial injury or dysfunction, as well as by forming countercurrents and local pockets of stasis?

A

Turbulence

55
Q

a major factor in the development of venous thrombi would be turbulence and/or _______

A

stasis

56
Q

Abnormal aortic and arterial dilations called _______create local stasis and consequently a fertile site for thrombosis

A

Aneurysms

57
Q

Arterial thrombosis usually occurs in the site of _____ and grows ______ of flow

A

injury; against

58
Q

Venous thrombosis usually occurs in the site of ______ and grows ______of flow

A

in direction

59
Q

What are types of infective thrombosis?

A

Fungal infections and bacterial infections

60
Q

What are the fates of the Thrombi if the patient survives?

A

Propagation, embolization, dissolution, organization and recanalization

61
Q

What is propagation when talking about thrombii?

A

Enlargement of the thrombus ; Increase risk for embolism

62
Q

What is embolization?

A

A thrombus is dislodged and transported elsewhere in the vascular system

63
Q

What is dissolution?

A

shrinkage and complete dissolution of thrombus due to activation of fibronolytic factors

64
Q

How can older thrombi become organized?

A

the ingrowth of endothelial cells, smooth muscle cells, and fibroblasts into the fibrin-rich throm- bus

65
Q

What is an Embolism?

A

a travelling detached intravascular mass could be a thrombus or anything else

66
Q

What are the risks of embolism?

A

Vascular occlusion

67
Q

Less common types of emboli include

A

fat droplets, bubbles of air or nitro- gen, atherosclerotic debris (cholesterol emboli), tumor frag- ments, bits of bone marrow, and amniotic fluid.

68
Q

What is a pulmonary embolism?

A

• Embolic occlusion of a pulmonary artery

69
Q

What is the incidence of PE?

A

The incidence of pulmonary embolism is 2 to 4 per 1000 hospitalized patients

70
Q

Where do the emboli to the lung usually come from?

A

95% from DVT (femoral vein, thigh)

71
Q

Are pulmonary thromboembolisms usually silent?

A

yes 80% of them are usually silent

72
Q

What are some symptoms of pulmonary embolism?

A

Dyspnea, tachypnea (>20 BPM), cough, chest pain,
cyanosis, hypoxia, collapse
• Pulmonary HTN → cor pulmonale

73
Q

What are the risks of developing a pulmonary embolism?

A 
previous PE (30% recur), bedrest, burns,
CHF, CA, surgery (knee, hip)
74
Q

What is a systemic thromboembolism?

A

an embolism within the arterial system (not venous though)

75
Q

80% of systemic thromboembolisms arise from?

A

cardiac mural thrombi

2/3 LT Ventricle after MI
1/4 LT atrial dilation after mitrial stenosis

76
Q

20% of systemic thromboembolisms arise from ____ and ____

A

aortic aneurysms and atheromas

77
Q

The most common embolization site for systemic thromboembolisms are

A

Lower Extremities with a 75% prevalence

78
Q

What is a paradoxial embolism?

A

Emboli that cross from venous system to the arterial system they originate as a DVT and cross to the arterial system

79
Q

A common way for emboli to cause paradoxical embolism is

A

Atrial Septal defect

80
Q

A paradoxical embolism could typically cause _____

A

stroke

81
Q

What is an infarction?

A

area of ischemic necrosis caused by occlusion of the vascular supply to the affected tissue; the process by which such lesions form termed infarction

82
Q

What underlies the majority of infarctions?

A

Arterial thrombosis or arterial embolism

83
Q

What affects the severity of an infarct?

A

(1) the anatomy of the vascular supply; (2) the time over which the occlusion develops; (3) the intrinsic vulnerability of the affected tissue to ischemic injury; and (4) the blood oxygen content.

84
Q

What is a red infarct?

A

Infarct that typically occurs in (1) with venous occlu- sions (such as in ovarian torsion); (2) in loose tissues (e.g., lung) where blood can collect in infarcted zones; (3) in tissues with dual circulations such as lung and small intestine

Also known as a hemorrhagic infarct

85
Q

What is a white infarct?

A

occur with arterial occlusions in solid organs with end-arterial circulations (e.g., heart, spleen, and kidney), and where tissue density limits the seepage of blood from adjoining patent vascular beds

wedge-shaped

Infarcts resulting from arterial occlusions in organs without a dual circulation typically become progressively paler and sharply defined with time

86
Q

What is shock?

A

final common pathway for several potentially lethal events, including exsanguination, extensive trauma or burns, myocardial infarction, pulmonary embolism, and sepsis.

87
Q

What is shock characterized by?

A

hypoperfusion of tissues; it can be caused by diminished cardiac output or by reduced effective circulating blood volume which could lead to dysfunction or death due to celullar hypoxia

88
Q

What is the most common or prevalent “Shock” occurence or pathology?

A

Cardiogenic shock results from low cardiac output due to myocardial pump failure. It may be caused by myo- cardial damage (infarction), ventricular arrhythmias, extrinsic compression (cardiac tamponade)

cyanosis and sns stimulation

89
Q

What is hypovolemic shock?

A

Hypovolemic shock results from low cardiac output due to loss of blood or plasma volume (e.g., due to hemor- rhage or fluid loss from severe burns).

Cyanosis and sns stimulation

90
Q

What is septic shock?

A

results from arterial vasodilation and venous blood pooling that stems from the systemic immune response to microbial infection.

91
Q

What is neurogenic shock?

A

result from loss of vascular tone associated with anesthesia or secondary to a spinal cord injury

92
Q

What is anaphylactic shock?

A

Anaphylactic shock results from systemic vasodilation and increased vascular perme- ability that is triggered by an immunoglobulin E–mediated hypersensitivity reaction

93
Q

What could shock lead to?

A

Shock is a progressive disorder that leads to death if the underlying problems are not corrected because of widespread hipoxia and thrombosis

94
Q

What are the stages of shock?

A
  • An initial nonprogressive stage, during which reflex com- pensatory mechanisms are activated and vital organ perfusion is maintained
  • A progressive stage, characterized by tissue hypoperfu- sion and onset of worsening circulatory and metabolic derangement, including acidosis
  • An irreversible stage, in which cellular and tissue injury is so severe that even if the hemodynamic defects are corrected, survival is not possible

General Pathology (10 decks)

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