Blood and Haemodynamic Pathology Flashcards

1
Q

What are the two types of edema?

A

Local and generalised

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2
Q

What are the mechanisms of edema?

A

Increased vascular permeability, increased capillary hydrostatic pressure (venous obstruction, CHF, gravity), decreased osmotic pressure (hypoproteinemia), lymphatic obstruction

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3
Q

What causes edema in CHF?

A

Humoral/neurohumoral mechanisms promote sodium and water reabsorption by kidneys and expansion of extra cellular fluid

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4
Q

Describe the Starling forces in CHF.

A

Abnormal, due to increased venous capillary pressure and decreased plasma oncotic pressure

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5
Q

What does fast vs. slow build up of fluid in CHF result in?

A

Fast= fluid in lungs, slow= leg edema

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6
Q

How can edema from CHF be treated?

A

Diuretics, vasodilators, angiotensin converting enzyme inhibitors

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7
Q

What is elephantiasis?

A

Type of lymphatic obstruction caused by filariasis worms which live in lymphatic system

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8
Q

Compare acute and chronic haemorrhage/blood loss.

A

Acute= 20% of blood volume lost (1L)
Chronic= blood loss over longer period, eg. peptic ulcer, menstrual bleeding

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9
Q

What are examples of haemorrhage in body cavity?

A

Hemothorax, hemopericardium, hemoperitoneum, hemarthrosis

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10
Q

What is hemarthrosis and what causes it?

A

Bleeding into joint spaces, caused by injury or Haemophilia A

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11
Q

What are examples of haemorrhage in tissue?

A

Petechia, purpura, ecchymoses, hematoma

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12
Q

What is petechia and what causes it?

A

1-2 mm haemorrhages in skin or mucous membranes, as a result of capillary defects - anomalies in platelets, bacterial sepsis

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13
Q

What is purpura and what causes it?

A

Haemorrhages in skin greater than 2mm diameter forming plate-like lesions, result from inflammation in small blood vessels (vasculitis) or platelet abnormalities

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14
Q

What is Henoch-Schonlein purpura?

A

Allergic purpura, hypersensitive vasculitis and inflammatory response in blood vessel, active IgA mediated disorder following infection

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15
Q

What is ecchymoses?

A

Larger extravasations of blood into tissue (greater than 1-2 cm in diameter) causing purple/red discolouration

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16
Q

Describe the ecchymoses cascade.

A

1. Blood vessels rupture
2. RBCs die and release haemoglobin
3. Macrophages degrade haemoglobin via phagocytosis
4. Discolouration of skin changes to gold brown due to degradation of haemoglobin by haemosiderin

17
Q

What is a haematoma?

A

Large leakage from large blood vessels due to trauma

18
Q

How is blood loss limited?

A

Platelet activation -> platelet adherence to endothelial layer & each other -> fibrinogen clot
Vasoconstriction -> epinephrine/norepinephrine, reduced blood flow

19
Q

What is thrombosis?

A

Disrupted blood flow as a result of blood clot formation in uninjured vessels, adherent to vascular endothelium

20
Q

What is Virchow's triad?

A

Three mechanisms predisposing to formation of thrombus: endothelial injury, abnormal/disrupted blood flow, hypercoagulability

21
Q

What is endothelial injury?

A

Physical loss of endothelium (activation of clotting cascade), endothelial dysfunction (atherosclerosis, trauma, surgery, hypertension, etc.)

22
Q

Describe abnormal/disrupted blood flow in thrombosis.

A

Blood flow altered through stasis or turbulence
Stasis prevents dilution of clotting factors

23
Q

What is hypercoagulability?

A

Alteration in the coagulation pathways
Primary (genetic) or secondary (acquired)

24
Q

Describe the morphology of thrombosis.

A

Size and shape depends on site of origin and cause, vocally attached to underlying vascular surface

25
Q

Describe arterial/cardiac thrombi.

A

Begin at site of injury or turbulence and grow in retrograde direction

26
Q

Describe venous thrombi.

A

Occur at site of stasis and grow in direction of blood flow, large amounts of RBCs