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BDS2.5 Human Disease > Pathophysiology of ischaemia and infraction (part 1) > Flashcards

Pathophysiology of ischaemia and infraction (part 1) Flashcards

1
Q

Define ischaemia?

A

relative lack of blood supply to tissue/organ leading to inadequate O2 supply to meet needs of tissue/organ: hypoxia

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2
Q

What is hypoxic?

A

a) low inspired O2 level

b) normal inspired O2 but low PaO2

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3
Q

What is anaemic?

A

normal inspired O2 but blood abnormal

not enough haemoglobin to carry oxygen

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4
Q

What are the 4 types of hypoxia?

A

hypoxic

anaemic

stagnant

cytotoxic

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5
Q

What is stagnant hypoxia?

A

normal inspired O2 but abnormal delivery

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6
Q

What are 2 types of stagnant hypoxia?

A

local e.g. occlusion of vessel

systemic e.g. shock

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7
Q

What is cytotoxic hypoxia?

A

normal inspired O2 but abnormal at tissue level

tissue cannot use oxygen that is being delivered to it

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8
Q

What factors effect oxygen supply?

A

inspired O2

pulmonary function

blood constituents

blood flow

integrity of vasculature

tissue mechanisms

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9
Q

What are 2 factors affecting oxygen demand?

A
  1. tissue itself - different tissues have different requirements
  2. activity of tissue above baseline value
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10
Q

What are examples of supply issues in ischaemic HD?

A

coronary artery atheroma

cardiac failure (flow)

pulmonary function - other disease or pulmonary oedema (LVF)

Anaemia

previous MI

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11
Q

What does it mean that the heart has a high intrinsic demand?

A

the control of the hearts output/ contraction force

increase cardiac output

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12
Q

What is atheroma/ atherosclerosis?

A

localized accumulation of lipid and fibrous tissue in intima of arteries

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13
Q

What is the clinical correlation of established atheroma in a cornionary artery?

A

stable angina

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14
Q

What is the clinical correlation of complicated atheroma in coronary artery?

A

unstable angina

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15
Q

What is angina?

A

when the coronary arteries receive not a sufficient blood supply

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16
Q

What are the clinical manifestations of stable angina?

A

pain on exertion but not at rest

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17
Q

When does a complicated atheroma in coronary artery occur?

A

something has happened to the atheroma, hemorrhage or plaque rupture

18
Q

What happens if the plaque ulcerates of fissures?

A

thrombosis –> ischemia/infarction

19
Q

What is the clinical consideration of atheroma in the aorta?

A

aneurysm

20
Q

What is infarction?

A

lecture definition:
ischemic necrosis within a tissue/organ in living body produced by occlusion of either the arterial supply or venous drainage

death of tissue as a result of failure of blood supply

commonly due to obstruction of blood vessel by a atheroma or narrow of vessel channel

21
Q

List 6 clinical consequences of atheroma/ischemia?

A

MI

TIA (transient ischemic attack)

cerebral infarction

abdominal aortic aneurysm

peripheral vascular disease

cardiac failure

22
Q

Put these terms in order of events

  • MI
  • coronary artery disease
  • cardiac failure
A

coronary artery disease

MI

cardiac failure

23
Q

What can a change in the vessel wall cause? (Virchow’s triad)

A

thrombosis

24
Q

Name the components of Virchow’s triad?

A
25
Q

What are 3 categories of the effects of ischaemia?

A

acute

chronic

acute-on-chronic

26
Q

What are the biochemical effects of ishaemia?

A

decrease oxygen –> anaerobic metabolism –> cell death

27
Q

Are all cells equally susceptible to ischemia?

A

no, different tissues have variable o2 requirement and are variably susceptible to ischemia

28
Q

What tissues are more affected ischaemia?

A

cells with high metabolic rate

29
Q

Name cells with a high metabolic rate

A

specialized cells…
neurons

heart muscles cells

nerve cells

30
Q

What are the clinical effects of ischaemia?

A

dysfunction

pain

physical damage - specialized cells

31
Q

In the heart what can little bits of ischemia cause?

A

arrhythmia

32
Q

What would you call myocardial pain?

A

angina

33
Q

What are the outcomes of ischaemia?

A

no clinal effect

resolution versus therapeutic intervention

infarction

34
Q

What is the aetiology of infarction?

A

cessation of blood flow

35
Q

Name 4 things that can cause infarction? (cessation of blood flow)

A

thrombosis

embolism

strangulation e.g. gut

trauma - cut/ ruptured vessel

36
Q

What are 4 factors which dictate the scale of damage of ischemia?

A

time period

tissue organ

pattern of blood supply

previous disease

37
Q

How does anaerobic metabolism cause necrosis?

A

causes cell death –> liberation of enzymes –> breakdown of tissues (necrosis)

38
Q

Where would you get coagulation necrosis?

A

lung

heart

39
Q

Where would you get colliquitive necrosis?

A

brain

40
Q

How long does it take to get myocyte necrosis?

A

20-40 minutes

BDS2.5 Human Disease (9 decks)

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