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RUSVM Pathology I > Circulatory Disorders > Flashcards

Circulatory Disorders Flashcards

1
Q

What role does the vascular endothelium play in hemostatic

A

Anti-thrombotic and pro-fibrinolytic in normal state

Pro-thrombin and anti-fibrinolytic during injury

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2
Q

What are the roles of the vascular endothelium?

A

Role in homeostasis
Modulate perfusion
Role in inflammation

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3
Q

How does the vascular endothelium modulate perfusion?

A

NO relaxes and causes vasodilation

Endothelin causes vasoconstriction

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4
Q

What is the role of vascular endothelium in inflammation?

A

Regulate cellular traffic
Produce-proinflmmatory cytokines
Control angiogenesis and tissue repair

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5
Q

Most body fluid is _________

A

Intracellular (40%)

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6
Q

Space between tissue compartments where all metabolic products must pass between microcirculation and the cells

A

Intersitium

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7
Q

What is transcellular fluid

A

Fluid present in body cavity
Eg cerebrospinal fluid
Aqueous humor of eye

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8
Q

What is the extracellular max trip?

A

Composed of structural molecules (collagen, reticulin, and elastic fibers) and ground substance (glycoproteins and glycosaminoglycans)

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9
Q

What two forces determine water distribution between plasma and interstitium

A 
Hydrostatic pressure 
And osmotic (oncotic)  pressure
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10
Q

Increased hydrostatic pressure or diminished plasma oncotic pressure can cause ________

A

Tissue edema

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11
Q

What functions to remove excess volume from the intersitium and will return this fluid back to the circulation

A

Lymphatic

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12
Q

What are the circulatory disorders ?

A 
Edema 
Hyperemia and Congestion 
Hemostatis 
Hemorrhage 
Thrombosis and embolism 
Infarction 
Shock
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13
Q

Abnormal accumulation of excess extracellular water in interstitial spaces or in body cavities

A

Edema

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14
Q

What are the two classifications of edema?

A

Inflammatory -> increase vascular permeability (exudate)

non-inflammatory

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15
Q

What are the 4 main causes of edema?

A

Increased body hydrostatic pressure
Decreased plasma colloidal osmotic - protein not absorbed/ not produced/ lost
Lymphatic obstruction
Increased vascular permeability

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16
Q

Increased blood hydrostatic pressure can occur in ____________ which causes generalized edema

A

Right sided congestive heart failure

Eg pulmonary stenosis (narrowing) -> right ventricle cannot maintain normal output to lung -> accumulation -> back up to atrium and venous system =increased hydrostatic pressure

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17
Q

Example of localized increased hydrostatic pressure

A

Tightly bandaged limb resulting in venous occlusion

Blood trapped in vein -> increased pressure ->
Fluids escapes into intersitium=> edema

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18
Q

How can severe liver disease lead to edema ?

A

Proteins are not produced -> low albumin levels -> decreased osmotic pressure -> fluids not reabsorbed from interstitium

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19
Q

How can renal disease result in generalized edema?

A

Glomerular disease-> loss of protein -> loss of oncotic pressure -> decreased absorption-> edema

Intrarenal proteinuria

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20
Q

What type of edema is protein rich

A

Inflammatory (increased vascular permeability )

“Exudate”

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21
Q

What type of edema is protein poor

A

Non-inflammatory
Eg. Liver failure
“Transudate”

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22
Q

Gross appearance of edema

A 
Wet
Gelatinous and heavy 
Swollen organs 
Fluid weeps from cut surface 
May be yellow
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23
Q

What is the histological appearance of edema?

A 
Clear(non-inflammatory)/pale eosinophilic(inflammatory) 
Spaces are distended 
Blood vessels may be filled with RBC
Lymphatic are dilated 
Collagen bundles are separated
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24
Q

Type of edema, where pressure is applied to an areas resulting in a depression/dent

A

Pitting edema

Interstitial fluid is forced to adjacent areas

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25
Q

Fluids in the thoracic cavity

A

Hydrothorax

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26
Q

Fluid within the pericardial space

A

Pericardial effusion

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27
Q

What is mulberry heart disease

A

Pericardial effusion- Inflammatory edema

Fibrin strands and cloudy appearance

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28
Q

Fluid within the peritoneal cavity

A

Acites/hydroperitoneum

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29
Q

Generalized edema with profuse accumulation of fluid within subcutaneous tissue?

A

Anasarca

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30
Q

Type of edema commonly associated with severe GI parasitism and hypoproteinemia

A

Submandibular edema (bottle jaw)

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31
Q

After prolonged edema, what can occur to tissue?

A

Become firm and distorted due to increased in fiberous CT

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32
Q

Sudden, diffused and direct- increase in vascular permeability in the lungs

A

Acute respiratory distress syndrome (ARDS)

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33
Q

Chronic pulmonary edema is most commonly associated with what condition?

A

Cardiac failure

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34
Q

What is chronic pulmonary edema?

A

Alveolar walls become thickened->fibrosis

Congestion, micro-hemorrhages-> accumulation of heart failure cells

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35
Q

What is the gross appearance of pulmonary edema ?

A

Lungs enlarged in thoracic cavity ( can have rib indents)
Surface is wet/moist and heaven
On section of trachea -> froth/fluid in airway

36
Q

What are heart failure cells and what stain can be used to visualize them?

A

Cells in alveoli-> macrophages (aka siderophages) containing hemosiderin (iron->metabolic products of heart failure)

Iron (perl’s) stain

37
Q

What is the difference between hyperemia and congestion?

A

Hyperemia-> increase of arteiole-mediated engorgement (oxygenated blood)

Congestion-> passive venous engorgement (deoxy blood)

38
Q

Physiological hyperemia can be due to?

A

Digestion
Exercise
Dissipate heat
Neurovascular

39
Q

What are causes of pathological hyperemia?

A

Inflammation

  • > inflammatory mediators cause arteriolar dilation
  • > rubor, tumor, calor, pain, loss of function
40
Q

Condition of obstruction due to twisting of an the stomach

A

Gastric volvulus (torsion)

41
Q

Are torsion/volvus due to hyperemia/congestion?

A

Severe venous congestion –> ischemia and necrosis

42
Q

_______________ is usually the result of hart failure and associated with edema

A

Pulmonary congestion

43
Q

What cells will be present in pulmonary hemosiderosis?

A

Heart failure cells

44
Q

Subacute/chronic hepatic congestion is usually the result of ________

A

Right-sided CHF

45
Q

In chronic hepatic congestion you can usually see a build up of __________

A

Fiberous CT

46
Q

Chronic hepatic congestion is also called?

A

Nutmeg liver

47
Q

Nutmeg liver is due to ?

A

Increased congestion of hepatic vein

48
Q

Chronically, low grade hypoxia and increased centrolobular hepatocytes leads to ??

A

Atrophy and necrosis

49
Q

Escape of blood from the blood vessels

A

Hemorrhage

Extravasation

50
Q

What are the causes of hemorrhage?

A

Trauma
Sepsis/viremeia/bactereimia/toxins
Abdominal neoplasia
Coagulation abnormalities

51
Q

How does hemorrhage differ from hyperemia and congestion

A

Hemorrhage - outside vessels wall

Hyperemia and congestion - within the blood vessel

52
Q

What is the most common cause of hypovolemic shock?

A

Hemorrhage

53
Q

Hemopericardium can lead to a fatal ___________

A

Cardiac tamponade (increased pressure on heart and unable to fill properly)

Due to:
Trauma
Malignant tumor ->hemangiosarcoma rupture (common in dog)

54
Q

Blood loss due to substantial tear in the vascular wall

A

Hemorrhage by Rhexis

55
Q

________________ is a blood filled channel within the aortic wall and can result in rupture and fatal hemorrhage? What species is this usually seen?

A

Dissecting aneurysm

Pig and turkey-> copper deficiency
Horse -> thoracic injury
Young male racing greyhounds-> coronary and renal arteries

56
Q

Hemorrhage that is due to small defect in vessel wall or RBC passing through the vessel in case of inflammation or congestion

A

Hemorrhage by diapedesis

57
Q

Increased tendency to hemorrhage from usually insignificant injury

A

Hemorrhagic diathesis

58
Q

Blood in the thoracic cavity

A

Hemothorax

59
Q

Blood in peritoneal cavity

A

Hemoperitoneum

60
Q

Blood in a joint space

A

Hemarthrosis

61
Q

Coughing up blood or blood-stains sputum from lungs or airways

A

Hemoptysis

62
Q

Bleeding from the nose

A

Epistaxis

63
Q

What is petechia

A

Hemorrhage within tissue up to 1-2mm

Found on skin, mucosa, and serosal surfaces

64
Q

What is ecchymosis?

A

Larger than petechia (up to 1/ 2 cm

65
Q

What is agonal hemorrhanges?

A

Petechiae and ecchymoses associated with terminal hypoxia

66
Q

What is suffusive hemorrhage?

A

Larger than ecchymosis and contiguous.

67
Q

What is Paint-brush hemorrhage? And what tissue is it most commonly found?

A

A terrible paint job

Mucosal and serosal surfaces.

68
Q

How are hematoma resolved?

A

Hemoglobin (dark red/blue) -> enzymatically converted to bilirubin (blue-green)-> hemosiderin (yellow brown)

69
Q

What is the pathological form of hemostatis in which a clot forms in a vessel

A

Thrombosis

70
Q

What is required for hemostasis to occur?

A

Vascular wall endothelium
Platelets
Coagulation cascade

71
Q

Describe normal hemostasis

A

Injury of arteriolar wall -> vasoconstriction -> exposure of glycoproteins Ib rector on platelets to von Willebrand factor->platelet activation -> shape change -> aggregation

Factor 3 thromboplastin exposed -> activate coagulation cascade -> thrombin cleaves fibrinogen to fibrin ->further platelet recruitment ad granule release

72
Q

Describe formation of a thrombus clot

A

Polymerized fibrin and platelet aggregated

Tissue plasminogen activator and thrombomodulin activated to limit side of thrombus

73
Q

Coagulation factors are produced mainly in the ?

A

Liver

74
Q

Thrombosis

A

Formation/presence of solid mass within the CV system

Can result in occlusion of lumen and embolism

75
Q

What factors can lead to thrombosis formation?

A

Endothelial injury
Alteration in blood flow (turbulence or stasis)

Hypercoagulability (increase factors or decreased inhibitors)

76
Q

How can severe renal glomerular disease lead to thrombosis formation?

A

Protein losing neuropathy -> loss of antithrombin III

77
Q

Thrombus formation due to strongylus vulgaris infection is called?

A

Verminous thrombosis

Equine - crainial mesenteric artery common

78
Q

What are the outcomes of thrombus??

A

Lysis
Propagation
Organization/recanalization

79
Q

What is an embolism/embolus ??

A

Piece of thrombus breaks off from original mass and lodges at a different site

Embolus =mass that breaks off

80
Q

What embolism can be a complication of long bone fractures?

A

Fat embolism

Eg. Secondary to CPR efforts -> bone break->bone marrow embolus -> pulmonary artery

81
Q

Thrombotic meningoencepalitis is often due to what?

A

Bacterial infection by Histophilus so nice =>vasculitis and thrombosis formation

82
Q

Pathologic, generalized activation of the blood coagulation system

A

Disseminated intravascular coagulation (DIC)

Often due to :

  • neoplasia injury
  • anaphylaxis
83
Q

Localized area of ischemic necrosis in a tissue or organ caused by occlusion of arterial supply or venous drainage

A

Infarction

84
Q

how does a venous infarction differ from arterial infarction

A

Venous- intensely hemorrhagic as blood backs up into tissue

Arterial- initially hemorrhagic but becomes pale and coagulation necrosis becomes evident

85
Q

___________ gives rise to systemic hypoperfusion

A

Shock

Due to reduced CO or reduced effective circulating blood volume

86
Q

What are the types of shock?

A

Cardiogenic - decreased CO

Hypovolemic - fluid loss

Blood maldistribution

  • anaphylactic
  • neurogenic -loss of vascular tone
  • septic -host innate immune response to infectious organism
87
Q

What is the pathogenesis of septic shock?

A

Usually from endotoxin-producing gram negative bacilli (endotoxin shock) -> bacterial LPS -> Lipid A component -> induce injury and activate WBC -> cytokine release ->vasodilation and pro-thrombotic dathesis (DIC)

RUSVM Pathology I (17 decks)

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