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Path: Hemodynamics > CH 4 part. 1 > Flashcards

CH 4 part. 1 Flashcards

1
Q

What is edema?

A

Accumulation of fluid in the interstitial (body cavities) due to increased hydrostatic and decreased oncotic pressures.

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2
Q

Anasarca

A

system malfunction (liver failure, renal failure, right side heart failure) that induces general systemic edema.

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3
Q

Types of edematous fluid collection

A

Hydro - thorax, pericardium, peritoneum (ascites)

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4
Q

parasitic filariasis

A

parasitic worm that causes fibrosis of inguinal lymphatics and lymph nodes causing elephantitis

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5
Q

complication of upper extremity edema?

A

breast cancer removal. exacerbate UE edema due to physical removal of lymphatics (decrease drainage and increase edema)

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6
Q

Increased hydrostatic pressure due to?

A

mainly impaired venous return

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7
Q

Reduced oncotic pressure due to?

A

sever liver disease and malnutrition

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8
Q

Sodium and water retention due to?

A

renal failure (which can be caused by congestive heart failure).

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9
Q

Causes of lymphedema?

A

Chronic inflammation, invasive tumors, physical removal, radiation,

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10
Q

Sub Q edema

A

dependent edema (due to gravity), and Pitting edema

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11
Q

Edema secondary to renal dysfunction

A

Periorbital edema. affects Loose CT

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12
Q

Sub Q (soft tissue) edema importance signals?

A

signals underlying cardiac, renal diseases. affects wound healing and clearance

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13
Q

Pulmonary edema

A

seen with Left ventricular failure. pink, frothy fliud (extravasated RBC)

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14
Q

Brain edema (general)

A

brain swollen with narrow sulci and distended gyri. compression against skull.

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15
Q

Brain edema (severe)

A

brain substance herniation through the foramen magnum. compression of vasculature (ischemia)

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16
Q

Hyperemia

A

active process. arteriolar dilation (increase blood flow- oxygenated blood) inflammation and exercise.

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17
Q

congestion

A

passive process. reduced outflow of blood (cardiac failure)

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18
Q

local congestion

A

venous obstruction (cyanosis, stasis)

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19
Q

chronic congestion

A

chronic hypoxia (ischemia and scar), capillary rupture (hemorrhage foci)

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20
Q

Telltale sign of chronic congestion- capillary rupture?

A

hemosiderin-laden macrophages

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21
Q

Acute pulmonary congestion

A

engorged alveolar capillaries -> alveolar septal edema -> intra-alveolar hemorrhage

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22
Q

chronic pulmonary congestion

A

septa thick and fibrotic (no edema), hemosiderin-laden macrophages (HF cells)

23
Q

Acute hepatic congestion

A

distension of central vein and sinusoids. potential centrilobar ischemia (distal end)

24
Q

chronic passive hepatic congestion

A

centrilobar are red-brown color due to cell death and located around uncongested tan liver (nutmeg liver)

25
Q

Hepatic microscopic examination- overveiw

A

Centrilobar hemorrhage, hemosiderin-laden macrophages, and variable degeneration of hepatocytes

26
Q

What is a hemorrhage?

A

extravasation of blood to extravascular space

27
Q

external hemorrhage?

A

hematoma

28
Q

Petechiae hemorrhage

A

small 1-2mm in skin, mucous, serosal. Associated with: increased intravasc pressure, low platelet (thrombocytopenia), and defective platelet function (uremia)

29
Q

Purpura

A

> 3mm hemorrhage. Associated to trauma, vasculitis, amyloidosis, and indication for petechiae

30
Q

ecchymoses

A

sub Q hematoma (bruise). change of color due to Hemoglobin (red/blue) -> bilirubin (green/blue) -> hemosiderin (yellow/brown)

31
Q

Normal Hemostasis

A

tightly regulated. form clots, keep blood fluid

32
Q

Thrombosis

A

blood clot formation

33
Q

components of hemostasis/thrombosis

A

vascular wall, platelets, coagulation cascade

34
Q

arteriolar vasoconstriction

A

immediate vasoconstriction to site of injury

35
Q

Primary hemostasis

A

formation of platelet plug. vWF and collagen promote platelet adherence and activation (shape change and degranulation)

36
Q

Secondary hemostasis

A

deposition of fibrin. Tissue factor coag cascade- thrombin generation - fibrin meshwork.

37
Q

Clot stabilization and resorption

A

tissue plasminogen activator (t-PA) to limit clotting and resorb clot.

38
Q

endothelial cells

A

anticoagulation. when activated- procoagulation.

39
Q

Endothelial antiplatelet

A

prevent platelet adherence to collagen (vWF) due to NO and PGI2

40
Q

Endothelial antiplatelet ADP

A

degrades ADP, therefore inhibits aggregation of platelets

41
Q

Endothelium anticoagulant

A

thrombomodulin binds to thrombin to convert to anticoagulant. Activating protein C to inhibit factor 5a and 8a.

42
Q

Endothelium anticoagulant heparin-like

A

endothelium surface bind and activate antithrombin 3 (indirect activation)

43
Q

endothelium anticoagulant tissue factor path

A

cell surface protein that inactivates factors: 7a and 10a

44
Q

endothelium fibrinolytic effect

A

tissue plasminogen activator (t-PA) cleaves plasminogen to plasmin which cleaves fibrin and degrades thrombi

45
Q

platelets attaché to what on endothelial surface

A

vWF (collagen)

46
Q

procoagulant effects of endothelial cells

A

synthesize tissue factor. activate factors 9 and 10

47
Q

antifibrinolytic effects

A

activated endothelial cells secrete inhibitors of plasminogen activator (PAI)

48
Q

Bernard- Soulier syndrome

A

deficiency of GpIb (no platelet binding to vWF)

49
Q

Glanzmann thrombasthenia

A

deficiency of GpIIb-IIIa (no platelet-fibrinogen-platelet binding)

50
Q

von Williebrand disease

A

deficiency of vWF

51
Q

platelet alpha granules

A

P-selectin for adherence to collagen

52
Q

Platelet delta (dense) granules

A

contain ADP (platelet aggregation), ATP, calcium (for coagulation cascade), histamine.

53
Q

platelet activation

A

negatively charged phospholipids on their surface bind to calcium

Path: Hemodynamics (2 decks)

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