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MSF Pathology > 04 - Hemodynamic Disorders, Thrombosis and Shock > Flashcards

04 - Hemodynamic Disorders, Thrombosis and Shock Flashcards

1
Q

Extravasation of fluid into interstitial spaces due to increases in vascular volume or pressure, decreases in plasma protein content or alterations in endothelial function.

A

Edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.81

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2
Q

It is a severe and generalized edema with profound subcutaneous tissue swelling.

A

Anasarca (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.81

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3
Q

The edema fluid occuring with volume or pressure overload or under conditions of reduced plasma protein.

A

Transudate (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.82

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4
Q

Edema secondary to increased vascular permeability and inflammation.

A

Exudate (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.82

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5
Q

The serum protein most responsible for maintaining intravascular colloid osmotic pressure.

A

Albumin (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.83

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6
Q

In breast cancer, infiltration and obstruction of superficial lymphatics can cause edema of the overlying skin, called _______ appearance.

A

Peau d’ orange (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.83

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7
Q

Microscopically, it is reflected primarily as a clearing and separation of the extracellular matrix elements with subtle cell swelling.

A

Edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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8
Q

Diffuse edema usually more prominent in certain body areas as a result of the effects of gravity.

A

Dependent edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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9
Q

True or False: Dependent edema is a prominent feature of left-sided heart failure.

A

False. Dependent edema is a feature of right-sided HF, while pulmonary congestion is a feature of left-sided HF. (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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10
Q

Edema due to renal dysfunction which manifests disproportionately in tissues with loose connective tissue matrix, e.g. Eyelids.

A

Periorbital edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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11
Q

Finger pressure over significantly edematous subcutaneous tissue displacing the interstitial fluid, leaving a finger-shaped depression on the skin.

A

Pitting edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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12
Q

Condition wherein the lungs weigh 2-3x the normal, and on sectioning reveals frothy, sometimes blood-tinged mixture of air, fluid and extravasated red cells.

A

Pulmonary edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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13
Q

Condition wherein the brain is grossly swollen, with narrowed sulci and distended gyri showing signs of flattening against the underlying skull.

A

Brain edema (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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14
Q

It is an active process resulting from augmented blood flow due to arteriolar dilation.

A

Hyperemia (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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15
Q

The affected tissue is redder than normal, because of engorgement with oxygenated blood.

A

Hyperemia (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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16
Q

It is a passive process resulting from impaired venous return out of a tissue.

A

Congestion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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17
Q

Tissue has a blue-red color due to accumulation of hemoglobin in the affected tissue.

A

Congestion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.84

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18
Q

Characterized by alveolar capillaries engorged with blood, with associated alveolar septal edema or focal minute intra-alveolar hemorrhage.

A

Acute pulmonary congestion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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19
Q

Pulmonary septa are thickened and fibrotic, with hemosiderin-laden macrophages in alveolar spaces.

A

Chronic pulmonary congestion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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20
Q

Hemosiderin- laden macrophages

A

Heart- failure cells (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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21
Q

The central vein and sinusoids of the liver are distended with blood, with central hepatocyte degeneration. The periportal hepatocytes are better oxygenated.

A

Acute hepatic congestion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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22
Q

The central regions of the hepatic lobules are grossly red-brown and slightly depressed and are accentuated against the surrounding zones of uncongested tan, sometimes fatty liver (nutmeg liver).

A

Chronic passive congestion of the liver (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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23
Q

Presence of centrilobular necrosis with hepatocyte drop-out, hemorrhage and hemosirin-laden macrophages

A

CPC of the liver (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.85

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24
Q

Extravasation of blood from vessels into the extravasclar space.

A

Hemorrhage (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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25
Q

Accumulation of blood within a tissue.

A

Hematoma (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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26
Q

1-2mm hemorrhages into skin, mucous membranes, or serosal surfaces.

A

Petechiae (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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27
Q

3-5mm hemorrhages which can occur with trauma, vascular inflammation, or increased vascular fragility.

A

Purpura (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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28
Q

1-2cm subcutaneous hematomas/bruises.

A

Ecchymoses (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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29
Q

It is a consequence of tightly regulated processes that maintain blood in a fluid, clot-free state in normal vessels while inducing the rapid formation of a localized hemostatic plug at the site of vascular injury.

A

Normal hemostasis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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30
Q

Pathologic form of hemostasis.

A

Thrombosis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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31
Q

It occurs after an initial injury, as a result of reflex neurogenic mechanisms.

A

Arteriolar vasoconstriction (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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32
Q

A potent endothelium-derived vasocontrictor.

A

Endothelin (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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33
Q

Receptors responsible for platelet adhesion.

A

GpIb receptors- platelet, Von Willebrand factor - endothelium (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.88

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34
Q

Deficiency of GpIb receptors.

A

Bernard-Soulier syndrome (TOPNOTCH)

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35
Q

Deficiency of GpIIb-IIIa receptors.

A

Glanzmann thrombasthenia (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.88

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36
Q

Deficiency of Factor VIII.

A

Von Willebrand Disease (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.88

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37
Q

It is a membrane-bound procoagulant glycoprotein synthesized by endothelium, which becomes exposed at the site of injury.

A

Thromboplastin/Factor III (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.88

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38
Q

Formation of a hemostatic plug due to platelet aggregation

A

Primary hemostasis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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39
Q

Hemostasis characterized by activation of thrombin through the coagulation cascade.

A

Secondary hemostasis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.86

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40
Q

True or False: The primary aggregation of platelets is irreversible.

A

False. Reversible (TOPNOTCH)

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41
Q

Two substances essential for the formation of a primary hemostatic plug.

A

ADP and TXA2 (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.87

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42
Q

True or False: Activation of the coagulation cascade and subsequent thrombin formation is reversible.

A

False. Irreversible (TOPNOTCH)

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43
Q

Substance that activates the coagulation proteins.

A

Calcium (TOPNOTCH)

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44
Q

Substance that mediates further platelet aggregation and degranulation.

A

ADP (TOPNOTCH)

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45
Q

Substance that increases platelet activation and causes vasoconstriction. Synthesized by activated platelets.

A

TXA2 (TOPNOTCH)

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46
Q

Most important initiator of the coagulation cascade.

A

Tissue factor (TOPNOTCH)

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47
Q

A protein found on endothelial cells involved in the breakdown of blood clots which catalyzes conversion of plasminogen to plasmin.

A

Tissue plasminogen activator (t-PA) and Urokinase (TOPNOTCH)

48
Q

Components of Virchow’s triad?

A

Stasis, Hypercoagulability, Endothelial injury (TOPNOTCH)

49
Q

It is a major contributor to the development of VENOUS thrombi.

A

Stasis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.94

50
Q

Type of blood flow found in normal blood vessels, wherein platelets flow centrally in the vessel lumen, separated from the endothelium by a slow moving clear zone of plasma.

A

Laminar flow (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.94

51
Q

This contributes to arterial and cardiac thrombosis by causing endothelial injury or dysfunction as well as formation of countercurrents and local pockets of stasis.

A

Turbulence (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.94

52
Q

Any alteration of the coagulation pathway that predisposes to thrombosis.

A

Hypercoagulability (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.95

53
Q

A detached, intravascular solid, liquid or gaseous mass that is carried by the blood distal to its point of origin.

A

Embolus (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.95

54
Q

Apparent laminations seen in a thrombus, representing pale platelet and fibrin layers alternating with darker erythrocyte-rich layers.

A

Lines of Zahn (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

55
Q

Significance of Lines of Zahn?

A

Represents thrombosis in the setting of blood flow, seen in antemortem clots. (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

56
Q

Thrombi occuring in heart chambers or in aortic lumen

A

Mural thrombi (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

57
Q

Gelatinous thrombi with a dark red dependent portion where red cells have settled by gravity with a yellow “chicken fat” supernatant. Usually unattached to underlying wall.

A

Postmortem thrombi (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

58
Q

Thrombi on heart valves.

A

Vegetations (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

59
Q

Sterile, verrucous endocarditis occuring in patients with SLE.

A

Libman-Sacks endocartidis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

60
Q

Vegetations occuring in the presence of non-infected valves in hypercoagulable states.

A

Nonbacterial thrombotic endocarditis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.96

61
Q

Fate of a thrombus wherein the thrombus accumulates additional platelets and fibrin, eventually causing vessel obstruction.

A

Propagation (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

62
Q

Fate of a thrombus wherein it may dislodge or fragment and transported elsewhere in the vasculature.

A

Embolization (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

63
Q

Fate of a thrombus as a result of of fibrinolytic activity leading to rapid shrinkage and even total lysis of recent thrombi.

A

Dissolution (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

64
Q

Fate of a thrombus wherein it may induce inflammation and fibrosis and establish some degree of blood flow.

A

Organization and recanalization (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

65
Q

True or False: Therapeutic administration of fibrinolytic agents is generally effective only within a few hours of thrombus formation.

A

True (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

66
Q

Most common site of venous thrombosis.

A

Superficial or deep veins of the leg (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

67
Q

Most common sequelae of deep venous thrombosis.

A

Pulmonary embolism (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.97

68
Q

Tumor-associated procoagulant release largey responsible for the increased risk of thromboembolic phenomena seen in disseminated cancers.

A

Migrating thrombophlebitis or Trousseau’s syndrome (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.98

69
Q

Hardening or thickening of the arteries as a result of the accumulation of fatty materials, macrophages, platelets and other inflammatory mediators.

A

Atherosclerosis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.98

70
Q

Fates of a thrombus (4)

A

Propagation, Resolution/Dissolution, Organization and recanalization, Embolization (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.98

71
Q

Embolus occluding a bifurcation in the pulmonary tree.

A

Saddle embolus (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

72
Q

True or False: A patient who has had one pulmonary embolus has a decreased risk of developing another embolus.

A

False.The patient is at risk of developing more pulmonary emboli. (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

73
Q

A venous embolus which entered the systemic circulation through an interarterial or interventricular defect.

A

Paradoxical embolus (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

74
Q

Most common symptom of pulmonary embolism.

A

None/ Asymptomatic (60-80%) (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

75
Q

Right Ventricular failure secondary to pulmonary hypertension.

A

Cor pulmonale (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

76
Q

Emboli in the arterial circulation.

A

Systemic thromboembolism (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

77
Q

Most common origin of systemic thrombi.

A

Intracardiac mural thrombi (80%) (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

78
Q

Major site of arteriolar embolization.

A

Lower extremities (75%)Brain (10%) (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

79
Q

Microscopic fat globules found in the circulation after fractures of long bones or after soft-tissue trauma.

A

Fat embolism (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

80
Q

Symptoms of pulmonary insufficiency, neurologic symptoms, anemia, and thrombocytopenia characterize what syndrome?

A

Fat embolism syndrome (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

81
Q

Gas bubbles within the circulation obstructing vascular flow and causes distal ischemic injury.

A

Air embolism (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

82
Q

Amount of air in the circulation which produces clinical effects of air embolism.

A

> 100 mL (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.99

83
Q

This occurs when individuals are exposed to sudden changes in atmospheric pressure (e.g. Deep sea divers, scuba divers).

A

Decompression sickness (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

84
Q

The rapid formation of gas bubbles within skeletal muscles and supporting tissues in and around joints causing pain.

A

Bends (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

85
Q

Gas bubbles in the lung vasculture causing edema, hemorrhages, focal atelectasis and emphysema.

A

Chokes (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

86
Q

More chronic form of decompression sickness where persistence of gas emboli in the bones leads to multiple foci of ischemic necrosis.

A

Caisson disease (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

87
Q

Treatment of choice for decompression sickness.

A

Hyperbaric compression chamber (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

88
Q

Underlying cause of amniotic fluid embolism.

A

Entry of amniotic fluid into the maternal circulation through a tear in the placetal membranes and rupture of uterine veins. (TOPNOTCH)

89
Q

Presence of marked pulmonary edema, diffuse alveolar damage, and presence of squamous cells in the pulmonary circulation shed from fetal skin, lanugo hair, fat and mucin.

A

Amniotic fluid embolism (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

90
Q

White or red infarct? Venous occlusion

A

Red infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

91
Q

White or red infarct? Lung infarction

A

Red infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

92
Q

White or red infarct? Intestinal infarct

A

Red infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

93
Q

White or red infarct? Myocardial infarction

A

White infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

94
Q

White or red infarction? Splenic infact

A

White infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

95
Q

White or red infarction? Wedge infarct

A

White infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.100

96
Q

The dominant histologic characteristic of infarction.

A

Ischemic coagulative necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.101

97
Q

Histologic characteristic of brain infarcts.

A

Liquefactive necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.101

98
Q

This infarct occurs when bacterial vegetations from a heart valve embolize or when microbes seed an area of necrotic tissue.

A

Septic infarct (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.101

99
Q

Most common sequalae of septic infarcts.

A

Abscess (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.101

100
Q

Major determinants of the eventual outcome of an infarct. (4)

A

Nature of vascular supply, Rate of development of occlusion, Vulnerability to hypoxia, Oxygen content of blood (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.101

101
Q

Neurons undergo irreversible damage when deprived of their blood supply for _______.

A

3-4 minutes (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

102
Q

Myocardial cells undergo irreversile damage after ______ minutes of ischemia.

A

20-30 minutes (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

103
Q

It is the final common pathway for severe hemorrhage, extensive trauma, burns, large MI, pulmonary embolism and sepsis.

A

Shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

104
Q

End results of shock (3)

A

Hypotension, Impaired tissue perfusion, Hypoxia (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

105
Q

This type of shock results from failure of the cardiac pump which maybe caused by MI, ventricular arrythmias, cardiac tamponade or outflow obstruction.

A

Cardiogenic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

106
Q

This type of shock results from loss blood or plasma volume.

A

Hypovolemic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

107
Q

This type of shock is caused by microbial infection, caused by gram negative and gram positive bacteria and fungi

A

Septic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

108
Q

True or False: Systemic bacteremia must be present to induce septic shock.

A

False. Host inflammatory response to local extravascular infections may be sufficient to induce septic shock. Robbins Basic Pathology, 8th ed. p.102

109
Q

Type of shock which occurs in the setting of an anesthetic accident or spinal cord injury as a result of loss of vascular tone and peripheral pooling of blood.

A

Neurogenic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

110
Q

This type of shock represents systemic vasodilation and increased vascular permeability caused by IgE hypersensitivity reaction.

A

Anaphylactic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.102

111
Q

Septic shock caused by gram negative bacilli.

A

Endotoxic shock (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.103

112
Q

Criteria for SIRS.

A

Temp 38 Celsius, HR >90 bpm, RR >20 or PaCO2, 12,000 cells/mm3 or 10% bands. Robbins Basic Pathology, 8th ed. p.103

113
Q

Adrenal changes in shock.

A

Cortical cell lipid depletion (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.106

114
Q

Kidney changes in shock.

A

Acute tubular necrosis resulting in oliguria, anuria, and electrolyte disturbances. (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.106

115
Q

Gastrointestinal changes in shock.

A

Focal mucosal hemorrhage and necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed. p.106

116
Q

Lung changes in shock.

A

Diffuse alveolar damage if due to bacterial sepsis and trauma. Robbins Basic Pathology, 8th ed. p.106

MSF Pathology (24 decks)

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