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CMBM exam 5 > Hemodynamics, DIC and shock > Flashcards

Hemodynamics, DIC and shock Flashcards

1
Q

The starling hypothesis

A

The flow of fluids across capillary walls depends on the balance between the force of blood pressure on the walls

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2
Q

Describe the pathophysiology of edema

A 
Inc hydrostatic pressure
Reduced oncotic pressure
Sodium retention 
Lymphatic obstruction 
Inflammation
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3
Q

What would you see in a sample of transudate?

A

Dec protein concentration, clear color, not WBCs

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4
Q

What would you see in a sample of exudate?

A

Inc protein content and inc WBCs (neutrophils)

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5
Q

What is a subfalcine herniation?

A

First herniation in hydrocephalous

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6
Q

where does an uncinate hernia enter into?

A

Foramen magnum

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7
Q

What is the most dangerous hernia which moves into the spinal cord?

A

Tonsiliar herniation

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8
Q

Lymphedema

A

Blockage in the lymphatic system leading to swelling

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9
Q

Hyperemia

A

Active process resulting from augmented tissue inflow because of arteriolar dilation causing a red color

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10
Q

Congestion

A

Passive process resulting from impaired tissue outflow causing a blue-red color (cyanosis)

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11
Q

Hemorrhage

A

Extravasation of blood due to vessel rupture (internal or external to tissue)

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12
Q

Hematoma

A

Accumulation of blood within tissues

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13
Q

Petechiae

A

Minute hemorrhages into skin, mucous membranes or serosal surfaces

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14
Q

Larger endothelial hemorrhages similar to petechiae are called;

A

Purapura

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15
Q

What are the steps in hemostatsis?

A
  1. Vasoconstriction
  2. Primary hemostatis
  3. Secondary hemostatis
  4. Thrombic events
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16
Q

What are the factors of the intrinsic pathway?

A

8, 9, 11, 12, prekallikrein, HMWK

17
Q

What are the factors in the extrinsic pathway?

A

7, TNF (tissue factor; 3)

18
Q

What are the factors in the common pathway?

A

1 (fibrinogen), 2, 5, 10

19
Q

Which pathway is slow and which is fast?

A

Intrinsic is slow

Extrinsic is fast

20
Q

What occurs when to cogaulation cascade enters the common pathway?

A

Thrombin is released altering fibrinogen to fibrin

21
Q

How is the intrinsic pathway activated? What happens after it is active?

A

Activated when factor 12 binds to a neg charged foreign surface
Activates 11, 9, 8, 10, 2 I in the order) and fibrinogen is converted to fibrin

22
Q

Which intrinsic factors are related to bleeding disorders?

A

8, 9, 11

23
Q

How is the extrinsic pathway activated what what occurs once active?

A

TF at the site of injury activates it
TF complexes with 7 to form TF/7 (7a) which activates 10 and 9
9 activates more than 10 which activates 2 to form thrombin

24
Q

What is the extrinsic pathway shut down by?

A

TFPI

25
Q

If you have a deficiency in von Willebrand factor what occurs?

A

von Willebrand disease, a clotting disorder

26
Q

What is thrombine time (TT)?

A

Citrated plasma + thrombin = hear end product clot

27
Q

What is reptilase time?

A

Modification of TT where heparin inhibits via AT-3

Reptilase can still cleave fibrinogen in presence of heparin

28
Q

Thrombin

A 
Serine protease
Cleaves fibrinogen to fibrin
Activates V to Va, VIII to VIIIa 
Activates platelets-cleaves thrombin receptors 
Activates XIII to XIIIa
29
Q

In the presence of what does thrombin activate protein C to APC?

A

Thrombomodulin

30
Q

What does prothrombin time (PT) measure?

A

The clotting time of the EP; from factor 7 through fibrin

General measure EP and CP

31
Q

What is the PTT?

A

Clotting time from 12 through fibrin formation (include 8, 9, 10, 5)
General measure of the IP and CP

32
Q

What occurs if you have an inc in PTT but normal PT?

A

IP deficiencies

VIII, XI, XI, lupus anticoagulant

33
Q

What occurs if PTT is normal but PT is inc?

A

EP deficiencies

Liver disease, VII, mild to moderate II, V, X deficiency

34
Q

What occurs if both PTT and PT are inc?

A

Common pathway deficienies

vWD, liver disease II, V, X or multiple

35
Q

What occurs if PTT and PT are normal?

A

Dec PTL function, deficiency in XIII, mild deficiency in other factors, mild vWD
(this is from an external wound)

CMBM exam 5 (19 decks)

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