V- Hemodynamics Flashcards
diseases of reduced plasma oncotic P
- nephrotic syndrome
- end stage liver dz
- malnutrition
- gastroenteropathy aka diarrhea
anything that dec proteins (albumin)
anascara
severe generalized edema from dec onctoic P
-early sign is periorbital edema
diseases of inc hydrostatic P
- CHF
- constrictive pericarditis
- ascities (from liver cirrhosis)
- venous obstruction
L heart vs R heart edema
CHF in L heart = complain of trouble breathing bc lungs fill with fluid
CHF in R heart = JVD, edema in legs, h/smegaly
sodium retention causes
- renin angiotensin aldosterone system
- renal insufficiency
causes of lymphatic obstruction
- inflamm
- neoplastic
- surgery (removal axillary nodes)
- postirradiation > fibrosis
subcutaneous tissue edema
not serious unless have a wound healing problem
-histology may only show subtle changes like inc clear spaces b/t cells
dependent edema
from inc hydrostatic P like CHF
pitting edema from
transient fluid displacement
edema in lungs symptoms
-dyspnea
-cyanosis
-tachypnea
-cough with copious sputum, frothy, bloody
-bounding pulse
-crackles
-hemosiderin macrophages
lung edema shows
if interstitial:
-poorly defined vessels with septal lines
-thick bronchial walls
if alveolar:
-bilateral lung consolidation
edema in the brain
generalized
if generalized can push brainstem into foramen magnum and impair breathing centers
-from encephalitis, hypertensive crisis, obstruction venous outflow, trauma
edema in brain local
herniate into adj compartments like cerebellar
-from abcess, neoplasm, trauma
active hyperemia from
-muscles during exercise, inflamm, blushing
arteriolar dilation inc oxygenated blood flow into tissues = erythematous
passive congestion from
impaired outflow of deoxy blood from tissues i.e. CHF or local venous obstruction
nutmeg liver
chronic hepatic congestion from R sided problem (in heart or upstream of liver)
-hepatic lobules are red/brown and depressed and necrotic around central vein of zone 3
-can lead to fibrosis
causes of hemorrage
- trauma
- atherosclerosis
- aneurysm
- neoplasia- polyps, cancer
- inflamm
- fragile vessles
- platelet dysfunctin
- coagulation defect
signs of hemorrhage
- petechiae, smallest tiny lesions
- purpura
- ecchymoses
PT
diagnostic measure of extrinsic coagulation pathway
-prolonged by warfarin
PTT
diagnostic measurement of intrinsic coagulation pathway
-prolonged by heparin
Bernard Soulier dz
mutation in GPIb (platelet formation) so very large platelets
-only mild bleeding
Glanzmann thrombasthenia
mutation in GPIIb/IIIa (platelet aggregation)
-show varying amounts of bleeding
thrombotic thrombocytopenic purpura
antibodies vs ADAMTS-13 (cleaves vWF)
idiopathic thrombocytopenic purpura
autoimmune dz vs platelets so dangerously low
-treatment with splenectomy