Vascular Disorders I

Question 1

Edema

Answer 1

Fluid in interstitium

Question 2

Effusion

Answer 2

Fluid in cavity

Question 3

Appearance of SQ edema

Answer 3

Shiny, clear (pink) instead of normal white fat

Question 4

Appearance of intestinal edema

Answer 4

Enlargement of submucosa (under mucosa but over muscularis) by clear gelatinous fluid

Question 5

Appearance of pulmonary edema

Answer 5

• Foam = fluid mixed with surfactant
• Interlobar septa engorged w/ fluid
• Lungs will NOT collapse -> no loss of (-) pressure

Question 6

Describe fluid flow moving from arteries to veins

Answer 6

Flow into vessels is constant

Flow out of vessels decreases

Question 7

Which substances cause LOCAL edema via endothelial contraction of venules?

Answer 7

• Histamine (mast cells)
• Serotonin (platelets)
  PG and PAF

Question 8

Which substances cause SYSTEMIC edema via endothelial cytoskeleton rearrangement in capillaries and venules?

Answer 8

• TNF-a

- IL-1

Question 9

Where does VEGF cause vascular leakage?

Answer 9

Venules only

Question 10

Where does leukocyte-mediated vascular leakage occur?

Answer 10

Capillary and venules

Question 11

Which substances mediate Leukocyte-mediated vascular injury?

Answer 11

Chemokines, C5a, LTB4

Question 12

Lymphadenitis

Answer 12

Inflammation of lymph node

Question 13

Lymphangitis

Answer 13

Inflammation of lymphatic vessels

Question 14

Why does liver disease cause ascites and generalized edema?

Answer 14

• Ascites b/c portal hypertension

- Generalized edema b/c low albumin

Question 15

Right sided heart failure causes

Answer 15

1) Pleural effusion
2) +/- general edema
3) GENERALIZED congestion

Question 16

Left sided heart failure causes

Answer 16

1) Pulmonary edema
2) Pulmonary congestion

CATS may also have pleural effusion and chylothorax [lymph]

Question 17

Transudate effusion

Answer 17

Contents:

• Low protein (unless “modified”)
• Low cellularity

Appearance:
- clear/yellow, watery

Causes:

• Increased hydrostatic pressure
• Low oncotic pressure

Prefix:

• “Hydro-“
• EXCEPT abdomen; just “ascites”

Question 18

Exudate effusion

Answer 18

Contents:
- High protein/cellularity

Appearance:

• Opaque or nearly opaque
• white/tan/yellow/red/brown

Cause:
- Inflammation [b/c need to release cells from blood vessels]

Prefix:
- “Pyo-“ if neutrophils

Question 19

Lymph effusion

Answer 19

Contents:
- High TGs

Appearance:
- Thin and milky-white

Cause:

• Disrupted thoracic duct
• Obstructed lymphatics
• Left heart failure in cats

Question 20

What is hyperemia and under which circumstances does it occur?

Answer 20

Active, arterial-mediated increase in inflow and outflow

Manifests as bright red

• Inflammation
• Exercise

Question 21

What is congestion and when does it occur?

Answer 21

Passive, reduced outflow w/ normal inflow

Generalized if right heart failure

Pulmonary if left heart failure

Hypostatic congestion = post-mortem, gravity-dependent

Question 22

Hematoma

Answer 22

Hemorrhage into a confined space

Forms a “mass” of blood

Question 23

List the three classifications of hemorrhage in order of increasing size

Answer 23

Petechia(e) < Purpura < Ecchymosis

0-3 mm, 3mm - 1 cm, 1 - 3 cm

Question 24

When is fluid resuscitation called for?

Answer 24

Rapid loss of > 1-2% body weight

Question 25

Fibrin (finger-like extensions on organ) is associated w/

Answer 25

1) Inflammation
2) Leaky vessels
3) Exudate or MODIFIED transudate

EXCEPTION: Right-sided heart failure is the ONLY time you’ll see fibrin w/ CLEAR transudate

Question 26

Primary hemostasis

Answer 26

• Contraction of endothelium and platelet plug formation

- SMALL hemorrhage per diapedesis on surfaces

Question 27

Secondary hemostasis

Answer 27

• Clot formation

- MASSIVE hemorrhage in body cavities

Question 28

von Willebrand factor

Answer 28

enhances binding between platelets and collagen

Question 29

Which clotting factors depend on vitamin K?

Answer 29

II, VII, IX, X

Question 30

Which clotting factors aree amplified by Thrombin?

Answer 30

5 (common), 8 and 11 (intrinsic)

Question 31

The intrinsic clotting pathway is triggered by

Answer 31

contact with negatively charged compounds and collagen

Question 32

The major initator of clotting in vivo is

Answer 32

Extrinsic pathway

Question 33

Clotting Factor IV (4) is

Answer 33

Calcium

Question 34

What performs fibrinolysis (specifically)?

Answer 34

Plasmin