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Y1 Fwong MCD Cell Path Mubarak > Haemodynamic Disorders > Flashcards

Haemodynamic Disorders Flashcards

1
Q

Define Oedema?

A

An abnormal increase in interstitial fluid

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2
Q

Name the causes of Oedema?

A

Increased hydrostatic pressure ( regional or generalised) Reduced plasma oncotic pressure ( reduced albumin) Lymphatic obstruction Sodium retention Inflammation

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3
Q

What is generalised oedema?

A

Widespread accumulation of fluid in subcutaneos tissues and serous cavities

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4
Q

What is pitting oedema?

A

Pitting edema: Observable swelling of body tissues due to fluid accumulation that may be demonstrated by applying pressure to the swollen area (such as by depressing the skin with a finger).

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5
Q

Name the common causes of generalised Oedema?

A

Left Ventricular failure - high BP

Nephrotic Syndrome

Hepatic Failure

kidney and hepatic problems can both lead to drop in oncotic pressure in blood. (they regulate protein levels in blood)

nb pathophysiology of generalised oedema is complex. A lot of theories surrounding Renin ang system faultiness leading to excess Na retention

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6
Q

Summarise the process which causes oedema?

A

Low renal blood flow  renin  angiotensin  aldosterone  absorption of sodium and water from kidneys  generalised oedema Renin- released from kidney Adosterone-acts on the kidneys to stimullate reabsorption of salt and water Reduced renal blood flow activation of the renin-angiotensin system  =arrow

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7
Q

How is Pulmonary Oedema caused?

WHats the consequence of this? (symptoms and what disease is the patient susceptible to)

A

Pulmonary oedema is usually the result of raised pulmonary capillary hydrostatic pressure due to pulmonary venous congestion.

The most common cause of this is left ventricular failure.

Consequences include breathlessness and susceptibility to pneumonia.

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8
Q

Name the most common cause of Pulmonary Oedema?

A

Left ventricular failure

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9
Q

Name the consequences of Pulmonary Oedema?

A

Breathlessness(typically worse laying flat-orthopnoea) and susceptibility to pneumonia. Breathlessness(dyspnoea) is the main symptom.

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10
Q

In an pulmonary oedema , fluid accumalates first in the ………… …….. and then eventually spills into the ………. ……..

A

First- Interstitial space Second-Alveolar Spaces

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11
Q

What causes a Cerebral Oedema?

A

Cerebral Oedema is usually the result of breakdown of the normal capillary barrier

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12
Q

Where does a cerebral oedema usually occur?

A

Typically occurs in brain tissue surrounding lesions such as cerebral contusions, haemorrhages, infarcts and tumours.

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13
Q

What does a cerebral oedema cause?

A

Rise in intra-cranial pressure which can be fatal.

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14
Q

Name some stratagies to reduce Cerebral Oedema?

A

Strategies to reduce ICP include raising the head, inducing dehydration with drugs (e.g. mannitol), surgical decompression.

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15
Q

What does general oedema cause?

A

pitting peripheral oedema

pleural effusion

ascites

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16
Q

Define Thrombosis?

A

Pathological clot formation in a blood vessel

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17
Q

Name the three broad factors that predispose an individual to thrombosis?

A

Changes in vessel wall Changes in blood flow Changes in blood coagulability

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18
Q

What condition is almost always related to vessel wall injury caused by atherosclerotic plaques?

A

Arterial Thrombosis

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19
Q

How does arterial Thrombosis cause infarction of tissue?

A

Complete blockage (occlusion) of the artery by thrombus causes infarction of the tissue supplied by the artery

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20
Q

How does arterial Thrombosis cause ischaemia of tissue?

A

Narrowing(stenosis) of the artery by thrombus causes ischaemia of the tissue supplied by the artery.

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21
Q

What condition is related to stasis of blood in a cardiac chamber?

A

Cardiac Thrombosis is usually related to stasis of blood in a caridac chanber, most commonly the left atrium in association with atrial fribulation or the left ventricle in association with a myocardial infarct

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22
Q

What does a prior myocardial infarction leave you more susceptible to?

A

Left ventricular thrombosis

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23
Q

What causes cardiac thrombosis?

A

Abnormal cardiac contractibility and myocardial injury

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24
Q

What is the most important potential complication of cardiac thrombosis?

A

Systemic embolisation is the most important potential complication

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25
Q

What is an embolism?

A

An embolus is a detached mass within the circulatory system that is carried in the blood to a site distant from its point of origin

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26
Q

Where do most emboli originate from?

A

Most emboli are fragments of dislodged thrombus (thromboemboli).

27
Q

Name some rare types of embolic material?

A

Fat air amniotic fluid tumour

28
Q

What can an emboli lead to?

A

Emboli are important because they can lodge in vessels and block them off.

29
Q

Where do most venous thrombo embolism originate from?

A

Deep ;eg vein (DVT)

30
Q

Name the most significant consequence of a venous thrombo-embolism?

A

Pulmonary (thrombo)embolism Embolism to the lungs with blockage of a pulmonary artery is the most significant consequence.

31
Q

What is an pulmonary (Thrombo) embolism

A

Embolism to the lungs with blockage of a pulmonary artery

32
Q

what does an emboli lodged in the major pulmonary artery cause?

A

Emboli lodging in a major pulmonary artery cause instantaneous death.

33
Q

What do patients with an emboli lodging in a medium sized arteries present with?

A

Breathlessness

34
Q

What do emboli lodging in small arteries present with?

A

subtle symptoms of breathlessness, chest pain, and dizziness – these are the hardest to diagnose.

35
Q

Where do most arterial thromboemboli orginate from?

A

Most originate in the carotid arteries

36
Q

What is the most likely impact of arterial thromboemboli be and what artery are they most likely going to impact?

A

Most likely to impact in cerebral arteries causing cerebral infarction (stroke).

37
Q

Where do most cardiac thromboemboli originate from ?

A

Most originate in the left side of the heart (left atrium or left ventricle)

38
Q

What condition has impact in cerebral artery (stroke) mesenteric artery (bowel infarction) or lower limb artery (acute lower limb ischaemia)?

A

Cardiac Thromboemboli

39
Q

Defenition of infart?

A

An area of ischemic necrosis caused by occlusion

40
Q

Defenition of infarction?

A

Tissue necrosis due to ischaemia

41
Q

What happens when infarction occurs by venous obstruction?

A

The tissue becomes massively suffused with blood and appears dark purple of black - testicular tortion

42
Q

how to infarcts heal.

A

Infarcts heal by repair. Although structural integrity is maintained ( laying down of granulation tissue which is replaced by a fibrous scar), there is permanent loss of functional tissue

43
Q

define haemorrhage?

A

Extravasation of blood due to vessel rupture

44
Q

What can cause a haemorrhage?

A

May be due to traumatic rupture or an intrinsic disease of the vessel

45
Q

What does a rupture of a major vessel cause?

A

Rupture of a major vessel causes acute haemorrhage with risk of hypovolaemia, shock and death. hypovolaemia- a decreased volume of circulating blood in the body.

46
Q

how can a rupture of a small vessel be fatal?

A

Rupture of a small vessel can still be rapidly fatal if it occurs at a vital site e.g. brainstem haemorrhage.

47
Q

how can a formation of a solid haematoma within the enclosed cranial cavity cause death?

A

Formation of a solid haematoma within the enclosed cranial cavity can also be fatal by causing a rise in intracranial pressure and tonsillar herniation.

48
Q

What can a patient with chronic low grade haemorrhage be misdiagnosed for?

A

Chronic low grade haemorrhage may present with iron deficiency anaemia e.g. bleeding from a colonic carcinoma.

49
Q

define shock?

A

A generalised failure of tissue perfusion perfusion- Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue

50
Q

What can cause shock?

A

pump failure (e.g. acute myocardial infarction) or peripheral circulation failure (e.g hypovolaemia, sepsis, anaphylaxis, neurogenic,iatrogenic)

51
Q

What can shock lead to?

A

it leads to circulatory collapse which leads to ischemia of multiple organs

52
Q

What are the symptoms of shock?

A

Patient looks grey and feels clammy. There is tachycardia and hypotension

53
Q

what causes a cardiogenic shock?

A

Cardiogenic shock 1)Pump failure; myocardial damage, arrhythmias, etc 2)outflow obstruction ; Pulmonary embolism

54
Q

what can cause Hypovolaemic shock?

A

Fluid loss ; Haemorrhage, vomiting, burns etc

55
Q

Whar is SIRS and what does it stand for?

A

Systemic inflammatory response syndrome SIRS is a serious condition related to systemic inflammation, organ dysfunction, and organ failure. It is a subset of cytokine storm, in which there is abnormal regulation of various cytokine

56
Q

What is sepsis?

A

SIRS + Infection

57
Q

What is severe sepsis?

A

Sepsis + organ hypoperfusion

58
Q

what is septic shock?

A

Severe sepsis + hypoperfusion despite adequate fluid resuscitation , or the use of vasopressors/inotropes to maintain blood pressure

59
Q

Name the different types of oedema?

A

Generalised oedema

Localised oedema (eg pulmonary and cerebral)

60
Q

What does a generalised oedema cause (the consequences)?

A

pitting peripheral oedema plueral effusions ascites

61
Q

Name types of localised oedema?

A

Pulmonary and cerebral oedemas

62
Q

Where can a thrombi form?

A

arteries, veins and the heart

63
Q

What is the most common cause of Venous thrombosis and where do they commonly form?

A

stasis of the blood and increase in blood coagulability Deep leg veins

Y1 Fwong MCD Cell Path Mubarak (6 decks)

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