bleeding disorders

Question 1

Petechiae

Answer 1

– pinpoint hemorrhages

–> scurvy “petechial rash” vitamin c deficiency

Question 2

Purpura

Answer 2

– larger than a pinpoint, but

Question 3

Ecchymoses

Answer 3

– bruises > 2 cm

Question 4

types of ecchymoses

Answer 4

• cushing’s syndrome (overproduction of corticosteroids from adrenal cortex)
• raccoon sign
• battle sign

Question 5

hematoma

Answer 5

• leak of blood into cavities or into tissues (i.e. muscle belly)
• rupture of middle meningeal artery—> epidural hematoma

Question 6

Hemorrhagic Disorders

Answer 6

• Thrombocytopenia
• Von Willebrand’s disease
• hemophilia

Question 7

Thrombocytopenia

Answer 7

o Normal amount of platelets in blood: 250,000 – 300,000 o

Question 8

Von Willebrand’s Disease

Answer 8

• Do not produce von Willebrand factor (no platelet activation, cannot form plug
• hereditary only
• Menorrhagia (increased blood loss during period)

Question 9

Hemophilia →

Answer 9

• non-production of certain protein clotting factors
• X chromosome linked – females pass the trait to their sons
• 2 types

Question 10

hemophilia A

Answer 10

non production of CF 8

Question 11

hemophilia B

Answer 11

• AKA christmas disease

- nonproduction of christmas factor CF 9

Question 12

hemoarthritis

Answer 12

• blood in joint
• iron in hemes destroy going cartilage
• joint degeneration

Question 13

hemodynamic Disorders



Answer 13

Disorders that arise from interruptions in normal blood flow

Question 14

Thrombosis (thrombus formation)

Answer 14

platelet activation and platelet aggregation

without threat of blood loss or vascular damage; platelet plug without blood clot

Question 15

Blood clot

Answer 15

can be formed inside and/or outside of a vessel

Question 16

Thrombus

Answer 16

always originates from a vascular wall and always maintains
point of contact with the vascular wall through von Willebrand factor-
platelet activaton and platelet aggregation

Question 17

Thrombus in the arterial system 

Answer 17

Dense and strong , firm and small (fast)

Question 18

Thrombus in the venous system 

Answer 18

Loose and weak , loose and large (slow)

Question 19

Lines of Zahn

Answer 19

– represent a special type of thrombi characterized by visible and
microscopic laminations produced by alternating layers: pale layer composed of
platelets mixed with fibrin and dark layer composed of RBCs

Question 20

2 areas where thrombi with lines of Zahn can be found

Answer 20

1- heart
2- aorta (usually in the arch)
mitral stenosis would cause thrombi with lines of Zhan to be formed due to slowed blood flow

Question 21

Endothelial damage

Answer 21

• hemodynamic stress (normal wear and tear)
  – stretching of endothelial cells from the inner surface of
  blood vessel  collagen fibers are exposed  thrombus formed

Question 22

Hypertension

Answer 22

• increase resistance of the vascular wall to the fluid. Serious factor
  that promotes endothelial damage.

Question 23

Hemodynamic stress

Answer 23

= normal wear and tear resulting in

arteriosclerosis, accelerated and strengthen by hypertension

Question 24

Artherosclerosis

Answer 24

– specific changes, such as formation of plaque, in arterial walls ..leads to endothelial damage in the arteries.
 Artherosclerotic plugs  Damaged endothelia cells

Question 25

Iatrogenic thrombosis

Answer 25

– caused by medical care; e

Question 26

Myocardial infarction (MI)

Answer 26

– dead heart tissue heals/scars over with fibrotic tissue which is non-contractile tissue  decreased cardiac output ..near the dead/or tissues replaced the death tissure.

Question 27

Mural thrombus

Answer 27

– thrombi formed in chambers of the heart

Question 28

Rheumatic heart disease

Answer 28

– mitral stenosis slows blood flow in the left atrium  thrombus formation likely, usually kills the patient

Question 29

Increased blood viscosity

Answer 29

- Psoriatic arthritis - Polycytemia – increased RBCs (normal = 3 – 5 million/mm3) up to double the normal amount; increased friction with the vascular wall; - ex. erythemia – a type of leukemia

Question 30

Turbulence (disruption of laminar flow) | 

Answer 30

May be due to: - Narrowed portion of lumen  - Expanded lumen, aneurysm - Twists and turns in a vessel (as seen in varicose veins)

Question 31

Blood hypercoagulation

Answer 31

– increased ability of the blood to coagulate o Extensive burns-increase coagulation o Some kidney diseases-usually associated with kidney failure o Heart failure o Widespread metastatic tumor growth-when too many metastatic usually malignant tumor o Birth control pills due to endocrine imbalance  MCC of hypercoagulation ..promotes artherosclerosis

Question 32

Sequela/ae (pl.)

Answer 32

– the pathological consequence(s) of an event

Question 33

White infarct

Answer 33

– develops in tissues that have 1 blood vessel supply |  Heart – coronary artery

Question 34

Red infarct

Answer 34

– when a tissue is supplied by 2+ blood vessels  | Lungs – pulmonary artery and bronchial artery

Question 35

Ischemic stroke (AKA brain infarction)

Answer 35

i. Most common area for stroke ii. Liquefactive necrosis with cavity formation iii. Neuroglia (neuroglial cells) are responsible for repairing the lost brain tissue

Question 36

Gliosis

Answer 36

= process of repair via neuroglia in the brain does not | shrink which is a huge advantage for the brain.

Question 37

Heart sources of thrombus:

Answer 37

- Mitral stenosis  - Bacterial endocarditis – MCC of ischemic stroke  - Artificial valve – thrombus forms around it

Question 38

Fat embolism:

Answer 38

-From long bone fracture (in 1 or 2 days) → enters the venous circulation → travel towards the lungs  -Can cross capillaries and travel in reverse direction to the brain causing purpuric brain hemorrhages

Question 39

air embolism

Answer 39

- At least 300ml  Gas within the vessels would increase pressure → blockage of fluid flow  Air lock – pathology in which air embolism blocks blood flow  Bends (aka caisson disease, divers’ disease) – elevation changes and changes in concentration of nitrogen in blood due to pressure change ; appearance of gas in blood circulation