vascular disease Flashcards
pulmonary edema ensues due to (4)
- increased intracapullary hydrostatic pressure 2. decreased intracapillary oncotic pressure 3. obstructs excess fluid reabsorption by lymphatics 4. compromises capillary wall integrity
what type of cells do we fins in pulm edema
heart failure cells
clinical syndrome of severe hypoxemic respiratory failure
ARDS
what is the pathophysiology of ARDS and what do we see histologic
pathophysiology: damage to the alveolar wall-capillary endothelium and the alveolar epithelial cells histologic: diffuse alveolar damage
DAD time course: acute
- pulm. edema and hyaline membranes
DAD time course: subacute organizing stage
- alveolar pneumocyte hyperplasia and interstitial fibrosis - start to lose hyaline membranes
mortality rate of DAD
-35 to 50% - if pt. survives minimal residual abnormal respiratory function
most emboli are
thromboemboli
pulm. embolism often will have elevated
D-dimer
pulmonary infarction
death/necrosis of lung tissue
pulm HTN classifie as
mean pulm artery pressure <25
most cases of PH are secondary to another disease process
true
what becomes thickened in PH
smooth muscle media between internal and external elastic laminae
residual vessel replaced by slit-like proliferative vascular spaces
plexiform lesion
consist of proliferation of thin-walled dilates and congested vessels
angiomatoid lesion usually peripheral to plexiform lesion
concentric intimal hyperplasia in PH signifies what
severe PH
primary idiopathic PH
- affects women >men - age of onset 36
primary PH show mutation in up to 50% cases in
coding region for BMPR2
endothelial cushion with an organized olf thromboembolu
concentric intimal hyperplasia with vasculitis and fibrinoid necrosi
plexiform and angiomatoid lesion
muscularization of an arteriole
medial hypetrophy
normal muscular artery
refractile partciles in a drug user causing a pulm embolism
multinucleated giant cell pulm embolism caused by drug us
bone marrow embolism- fat
pulm infarction- showing congestion of the capillaries
saddle thromboembolism
pulmonary thromboembolus
reactive pneumocyte hyperplacia with squamous metaplasia
expansion of fibroblast and decreased hyaline membrane in DAD subacute
hyaline membranes in acute DAD stage
chronic pulm. edema may show fibrotic thickening of alveolar septa
heart failure cells
interstitial vascular congestion and fluid in alveolar spaces
