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Flashcards in Chapter 4 Deck (145)
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1

What is cor pulmonale and what causes it

Right side heart failure, and occurs when an emboli obstructs 60% or more of the pulmonary circulation

2

What is the result of the parasite filariasis

Induces fibrosis of lymphatic channels and nodes leading to lymphatic obstruction

3

What is the general steps that decreased oncotic pressure leads to edema

1) Reduced intravascular volume
2) Renal hypoperfustion
3) Increased aldosterone secretion (secondary hyperaldosteronism)
4) Water and salt retention leads to further edema

4

What are the three main factors that limit blood clotting

1) Dilution of blood taking factors away
2) Requirement of negative charge phospholipids only seen on activated platelets
3) Factors expressed by healthy epithelium to restrict activation

5

What are the factors that are expressed by endothelial cells to prevent coagulation

1) Thrombomodulin
2) Endothelial protein C receptor
3) Heparin like molecules
4) tissue factor pathway inhibitor

6

What occurs following a loss of blood >20% of blood volume

Hemorrhagic (hypovolemic) shock

7

Which condition is the usual cause of pulmonary edema

Most commonly with left ventricular failure, but can also be with renal failure, or acute respiratory distress syndrome

8

What occurs immediately following injury to a blood vessel

Vasoconstriction in order to reduce blood flow to injured area

9

Septic shock is most commonly triggered by which pathogen

Gram positive bacteria

10

What will acute pulmonary congestion present with morphologically

Enlarged alveolar capillaries, alveolar septal edema, and focal intraalveolar hemorrhage

11

What are the most common inherited causes of hypercoagulability

1) Point mutations in factor 5 gene
2) Point mutations in Prothrombin gene

12

Where is the process of clotting occurring

On the negatively charged phospholipid surface of platelets

13

What is the role of endothelial protein C receptor

Hold protein C, so bound thrombin to thrombomodulin, can inactivated factors 5a and 8a

14

Of people with DVTs, what percent are associated with factor 5 Leiden mutation

60%

15

During platelet aggragation, what is the significance in the changes to complex 2B/3a

Allows the binding of fibrinogen, and subsequent bridging of adjacent platelets

16

How is the level of plasmin regulated

Alpha2-plasmin inhibitor (PAI) which bind to and inactivate free plasmin

17

What are the conditions that can lead to impaired venous return and subsequent increases in hydrostatic pressure

CHF, constrictive pericarditis, ascites (liver failure), venous obstruction or compression, arterial dilation

18

What condition with patients regularly receive a false positive for during antiphospholipid antibody Syndrome

Syphilis, due to binding to cardiolipin

19

What is the main enzyme responsible of for fibrinolysis

Plasmin

20

What is the most important activator of factor 10

9a/8a

21

For the PTT test, what are the materials added

Negative charged particles (beads)
Phospholipids
Calcium

22

What is the cause of congestion

Reduction in the outflow of blood from a tissue as in cardiac failure or venous obstruction

23

How will cardiac and hypovolemic shock present in clinic

Hypotension, weak but rapid pulse, tachypnea, cool but clammy skin

24

What is the general order of events in primary hemostasis

1) von Willebrand factor and collagen are exposed
2) Platelets adhere and activate, become spiky balls
3) Platelets degranulate and release factors
4) Platelets aggregate

25

What are the three general mechanisms that disruption in laminar flow can lead to thrombin activation

1) Promotes endothelial activation and adhesion of proinflamatory factors
2) Brings platelets in contact with the epithelium
3) prevents washout and dilution of Activated Factors

26

Rapid loss up to which percent of blood volume can normally occur without effects

20%

27

What are the characteristics of subcutaneous edema

Accumulate in the areas with high hydrostatic pressure, which is usually determined by areas influenced by gravity (legs when standing) aka dependent edema

28

What is trousseau syndrome, aka migratory thrombophlebitis

Increased risk of thromboembolism due to tumor associated inflammation and coagulation factors released from tumors

29

What is the result of increased salt retention

1) increased hydrostatic pressure due to increased intravascular fluid volume
2) Decreased vascular oncotic pressure due to dilution

30

What is the condition of thrombophilia

Hypercoagulability and predisposes patient to thrombi