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RUSVM Pathology I JB1 > Circulatory Disturbances > Flashcards

Circulatory Disturbances Flashcards

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1
Q

Ground substance of ECM consists of

A

Glycoproteins (Fibronectin and Laminin), Glycosaminoglycans, Proteoglycans, etc

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2
Q

Edema can be classified as

A

Inflammatory

Non-Inflammatory

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3
Q

Water distribution between plasma and interstitium is primarily determined by

A

Hydrostatic and Osmotic pressure differences between the two compartments

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4
Q

Thrombosis

A

Clot (thrombus) forms within a vessel which is not injured or only mildly injured

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5
Q

Endothelin released from vascular endothelium has what effect

A

Vasoconstriction

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6
Q

Coagulation Factors

A

Plasma proteins produced by the liver

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7
Q

Interstitial fluid accounts for ________% of total water weight

A

15%

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8
Q

Starling Equation

A

Illustrates the role of hydrostatic and osmotic forces in the movement of fluid across capillary membranes

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9
Q

Common name for this disease

A

“Mulberry Heart Disease”

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10
Q

Nutmeg Liver

A

Appearance of the parenchyma with animal suffering from chronic hepatic congestion

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11
Q

Coagulation Cascade

A

Amplifying series of enzymatic conversions; each step proteolytically cleaves an inactive proenzyme into an activated enzyme, culminating in thrombin formation

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12
Q

Histological appearance of what circulatory disorder

A

Edema

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13
Q

Interstitium is composed of

A

Extracellular Matrix (ECM)

Supporting Cells

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14
Q

Condition

A

Submandibular edema

_______________________

“Bottle Jaw”

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15
Q

Fat Embolsim can be the result of

A

long bone fractures

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16
Q

Pericardial Effusion

A

“Mulberry Heart Disease”

Inflammatory edema

Fibrin strands and cloudy appearance of pericardial fluid

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17
Q

Cardinal signs of inflammation

A

Reddening - Rubor

Edema - Tumor

Heat - Calor

Pain

Loss of Function

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18
Q

Example of what circulatory disturbance

A

Edema

________________

Inflammatory Edema

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19
Q

Pathogenesis of septic shock

A
  1. Endotoxin - producing gram negative bacilli
  2. LPS and other microbial substances induce injury and activation of the vascular endothelium
  3. Stimulate WBCs to release cytokines
  4. Vasodilation and prothrombotic diathesis
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20
Q

Describe what happens during the primary hemostasis step of normal hemostasis

A
  • Endothelial injury exposes highly thrombogenic subendothelial ECM allowing platetlets to adhere and be activated
  • Activation of platelets results in a dramatic shape change and release of secretory granules lead to further platelet aggregation to form the primary hemostatic plug
  • Secreted products recruit additional platelets
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21
Q

Hemostasis

A

Arrest bleeding by physiological properties of vasoconstriction and coagulation or by surgical means

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22
Q

Anti-coagulation factors secreted by endothelium

A

Prostacylin

Nitric Oxide

Tissue Plasminogen Activator (tPA)

Thrombomodulin

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23
Q

Condition

A

Hydrothorax

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24
Q

Gingivitis and blood shot eyes are an example of what circulatory disturbance

A

Hyperemia

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25
Pro-coagulation factors secreted by endothelium
Thromboplastin Platelet Activation Factor (PAF) Von Willebrand Factor
26
Describe what happens during the secondary hemostasis step of normal hemostasis
* Tissue factor is exposed at the site of injury * Thrombin cleaves circulating fibrinogen into soluble fibrin creating a fibrin meshwork deposition * Thrombin also induces further platelet recruitment and granule release
27
Venous Infarcts
Intensely hemorrhagic as blood backs up into the affected tissue behind the obstruction
28
In which direction does hydrostatic pressure move fluid?
Moves fluid out of vasculature
29
Classification of hemorrhage
Paintbrush hemorrhage
30
Describe the basic mechanism of normal hemostasis
1. Vasoconstriction 2. Primary hemostasis 3. Secondary hemostasis 4. Thrombus and antithrombotic events
31
Example of what circulatory distrubance
Edema
32
Hemothorax
Blood in the thoracic cavity
33
Condition
Colonic Torsion
34
Increased blood hydrostatic pressure can be the result of
Generalized - Right sided CHF Localized - Tightly bandaged limb resulting in venous occlusion
35
Role of vascular endothelium in hemostasis
* Anti-thrombotic and pro-fibrinolytic in normal state * Pro-thrombotic and anti-fibrinolytic during injury
36
Hemorrhage by Rhexis
Due to a substantial rent or tear in the vascular wall (or heart)
37
Example of what circulatory disturbance?
Hemorrhage
38
Iron (Perl's) Stain
Highlights hemosiderin - laden macrophages within alveoli \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Stains blue
39
Pathological hyperemia is usually caused by
Inflammation
40
Substances released from vascular endothelium that modulate perfusion
NO Endothelin
41
Types of hyperemia
Physiological Pathological
42
Condition - Fibrin thrombi within glomerular capillaries
Disseminated Intravascular Coagulation (DIC)
43
Describe the histologic appearance of edema
* Clear or pale eosinophilic staining * Dependent on inflammatory vs non-inflammatory * Spaces distended * Blood vessels filled with RBC * Lymphatics dilated * Collagen bundles separated
44
Difference betwen hemorrhage and hyperemia/congestion
Hemorrhage the blood is outside the vessel wall Hyperemia/Congestion the blood is within the blood vessels
45
Tissue Factor - Factor III-Thromboplastin
Membrane bound procoagulant glycoprotein synthesized by endothelium. Acts in conjunction with Factor VII as the major in vivo pathway to activate the coagulation cascade, eventually culminating in thrombin
46
Nitric Oxide when released from vascular endothelium has what effect
Relaxation and vasodilation
47
Hemoptysis
Coughing up of blood or blood-stained sputum from the lungs or airways
48
End results of shock
Hypotension Impaired tissue perfusion Cellular hypoxia DIC and multi-organ system failure
49
Thrombosis
Formation or presence of a solid mass within the cardiovascular system
50
Secretory granules secreted during primary hemostasis
ADP and TXA2
51
Thrombomodulin
Has anticoagulent activity
52
Structural molecules of the ECM include
Collagen, Reticulin and Elastic Fibers
53
Edema
Abnormal accumulation of excess extracellular water in interstitial spaces or in body cavities \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Fluid is outside both vascular fluid compartment and cellular fluid compartment
54
Thromboplastin
Promotes blood coagulation
55
Disseminated Intravascular Coagulation (DIC)
Systemic reaction in which there is generalized activation of the blood coagulation system
56
Etiology
Histophilus somni infection
57
Pathological form of hemostasis is
Thrombosis
58
Example of what circulatory disturbance
Thrombosis \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Saddle Thrombosis
59
Acute Respiratory Distress Syndrome (ARDS)
Sudden, diffuse and direct - increase in vascular permeability. High fatality rate Pneumonia if animal survives
60
Clinical significance of hemorrhage is determined by
location and severity
61
Hydrothorax
Fluid in the thoracic cavity
62
Condition
Chronic Hepatic Congestion \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Nutmeg Liver
63
Example of what circulatory disturbance
Congestion \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Pulmonary congestion
64
Tissue Plasminogen Activator (tPA)
Regulates fibrinolysis
65
Describe what happens during the vasoconstriction step of normal hemostasis
* Brief period of arteriolar vasoconstriction occurs mostly as a result of reflex neurogenic mechanism * Augmented by local secretions of factors such as endothelin
66
Example of circulatory disturbence
Edema \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Pitting Edema
67
Example of what circulatory disturbance
Thrombosis
68
Condition
Pulmonary Edema
69
Extracellular Matrix is composed of
Structural molecules Ground substance
70
Decreased plasma colloid osmotic pressure can be the result of
* Proteins not absorbed from diet * Proteins not produced * Protein loss
71
Congestion
Passive venous engorgement - blood is not oxygenated
72
Embolus
Any detacehed intravascular mass which is carried by the blood to a site distal to the point of origin
73
Most water leakage occurs in capillaries or post-capillary venues because they have
Semi-permeable membrane wall that allows water to move more freely than proteins
74
Non inflammatory pulmonary edema can be the result of
Left Sided Congestive Heart Failure (CHF)
75
Pathogenesis of thrombosis
1. Endothelial injury 2. Alteration in blood flow - turbulence or stasis 3. Hypercoagulability 1. Increase coagulation factors 2. Decrease coagulation inhibitors
76
Transcellular Fluid accounts for \_\_\_\_\_\_\_% of total water weight
5%
77
Hemarthrosis
Blood within a joint space
78
Classification of hemorrhage
Ecchymosis
79
This condition is caused by
Copper deficiency
80
Describe the fluid in non-inflammatory edema
"Protein Poor" Low protein content ( \<30g/L) Low specific gravity ( \< 1.025) Low cellularity ( \< 1.5x109L) Less than 1500 cells per uL
81
Epistaxis
82
Classification of hemorrhage
Suffusive Hemorrhage
83
Example of what circulatory disturbance?
Congestion
84
Hemorrhage by Diapedesis
Hemorrhage due to a small defect in the vessel wall or RBCs passing through the vessel wall in cases of inflammation or congestion
85
Classification of hemorrhage
Agonal Hemorrhages
86
Example of what circulatory disturbance?
Congestion
87
Paint Brush Hemorrhage
Looks like if red paint was hastily applied with a paint brush - most common on mucosal and serosal surfaces
88
Example of what circulatory disturbance
Congestion
89
Embolism
Pieces of a thrombus break off from the original mass and sail downstream to lodge at a distant site
90
Hyperemia
Increase of arteriole mediated engorgement of the vascular bed - blood is oxygenated
91
Ascites (Hydroperitoneum)
Fluid (transudate) within the peritoneal cavity
92
Chronic pulmonary edema causes
Alveolar walls to become thickened - fibrosis Congestion, micro-hemorrhages and accumulation of heart failure cells
93
Nitric Oxide
Causes vasodilation, inhibits platelet adhesion and aggregation
94
Prostacylin
Causes vasodilation, inhibits platelet aggregation
95
Condition
Dissecting aneurysm
96
Tissue Edema results from what in regards to starling pressures
Increased hydrostatic pressure Decreased osmotic pressure
97
Shock caused by blood maldistribution can be due to
Anaphylactic - Type I Hypersensitivity Neurogenic Septic
98
Pathomechanisms of Edema
* Increased blood hydrostatic pressure * Decreased plasma colloid osmotic pressure * Lymphatic obstruction * Increased vascular permeability
99
This condition is usually the result of what?
Heart failure and associated edema
100
Condition
Gastric Volvulus (Torsion)
101
Endothelin
Potent endothelium - derived vasoconstrictor
102
Pitting Edema
Pressure is applied to an area of edema a depression or dent results as excessive intersitial fluid is forced to adjacent areas
103
Key players in the regulation of homeostasis, as the balance between anti and prothombotic activities of endothelium determines whether thrombus formation propagation or dissolution occurs
Endothelial Cells
104
In which direction does osmotic pressure (of plasma protein) move fluid?
Moves fluid into the vasculature
105
Condition
Pericardial Effusion
106
Hemopericardium leads to
Fatal Cardiac tamponade
107
Epistaxis
Bleeding from the nose
108
Pulmonary congestion is usually the result of
Heart failure - associated with edema
109
What happens at the conclusion of the coagulation cascade
Thrombin converts the soluble plasma protein fibrinogen into fibrin
110
Hemoperitoneum
Blood in the peritoneal cavity
111
Cardiogenic Shock
Failure of the heart to maintain normal cardiac output
112
Example of what circulatory disturbance
Thrombus \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Mural thrombus
113
Example of what kind of embolism
Fat Embolism
114
Describe the gross appearance of edema
Wet Gelatinous and heavy Swollen organs Fluid weeps from cut surfaces May be yellow
115
Example of what circulatory disturbance
Edema
116
Inflammatory Edema
Increased vascular permeability - refers to as an exudate
117
Total body water is \_\_\_\_\_\_\_% of total body weight
65%
118
Submandibular Edema
"Bottle Jaw" Commonly associated with sever GI parasitism and hypoproteinemia in sheep
119
Suffusive Hemorrhage
Larger than ecchymosis and contiguous.
120
Example of what circulatory disturbance?
Thrombosis
121
Describe what happens in the thrombus and antithrombotic event step of normal hemostasis
* Polymerized fibrin and platelet aggregates form a solid permanent plug to prevent any additional hemorrhage * Counter regulatory mechanisms and thrombomodulin are set into motion to limit the hemostatic plug to the site of injury
122
Thrombus
Aggregate of platelets, fibrin and entrapped blood cells. Can result in occlusion of the vascular lumen and embolism. It is adhered to the vascular wall as opposite to blood clot
123
Hypovolemic Shock
Fluid loss due to hemorrhage, vomiting, diarrhea
124
Causes of physical hyperemia
* Digestion * Exercise * Dissipation of heat * Neurovascular - facial hyperemia (blushing)
125
Agonal Hemorrhages
Petechiae and ecchymoses associated with terminal hypoxia
126
Hemorrhage
Escape of blood from the blood vessels
127
Components necessary for normal hemostasis or thrombosis
Vascular wall Platelets Coagulation cascade
128
Pathogenesis of Gastric Volvulus (Torsion)
* Twisting of vessels obstructs gastric veins * Severe venous congestion (acute, local) * Ischemia (necrosis) * Loss of endothelial integrity * Hemorrhage * Shock * Death
129
Platelet Activating Factor (PAF)
Causes activation of platelets and neutrophils
130
Plasma accounts for \_\_\_\_\_\_% of total water weight
5%
131
Intracellular Fluid accounts for \_\_\_\_\_\_\_\_\_% of total water weight
40%
132
The Circulatory System consists of
blood, a central pump, blood distribution and collection networks, and a system for exchange of nutrient and waste products between blood and extravascular tissue.
133
Pathogenesis of Nutmeg Liver
* Low grade chronic hypoxia * Increased pressure of centralobular hepatocytes * Atrophy * Necrosis
134
Chronic pulmonary edema is most commonly associated with
Cardiac failure
135
Anasarca
Generalized edema with profuse accumulation of fluid within the subcutaneous tissue
136
Von Willebrand Factor
Promotes platelet adhesion and activation of blood coagulation
137
Hemoptysis
138
Clinical significance of edema dependent on
Extent Location Duration
139
What is the stain being used? What does it stain?
Iron (Perl's) Stain Hemosiderin-laden macrophages - "Heart Failure Cells"
140
Hemostasis
Arrest bleeding by physiological or surgical means
141
Clinical significance of edema
Tissue may become firm and distorted due to an increase in fibrous connective tissue after prolonged edema
142
Heart Failure Cells
Hemosiderin - laden macrophages Characteristic of left sided CHF
143
Example of what circulatory disturbance
Congestion and Edema
144
Condition
Intestinal volvulus
145
T/F: There are infectious causes of thromosis/ thromboembolism
True \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Bacterial valvular endocarditis Thrombotic Meningioencephalitis
146
Ecchymosis
Larger than petechia (up to 1 or 2 cm) as seen in bruise (contusion) or small hematoma
147
Homeostasis
A tendency to stability in the normal body states
148
Possible outcomes to thrombi
Lysis Propagation Embolization Organization/ recanalization
149
Classification of hemorrhage
Petechia
150
Non-inflammatory Edema
Edema of CHF or liver failure, etc - refers to as a transudate
151
This condition is usually the result of
Right sided congestive heart failure
152
Infarction
Localized area of ischemic necrosis in a tissue or organ caused by occlusion of either the arterial supply or the venous drainage
153
Describe the fluid in inflammatory edema
Protein rich ( \> 30g/L) Specific Gravity ( \> 1.025) Total nucleated cells ( \< 7x109L) Less than 7000 cells per uL
154
Example of what circulatory disturbance
Infarction
155
Types of shock
Cardiogenic Shock Hypovolemic Shock Blood Maldistribution
156
Causes of hemorrhage
Trauma Sepsis, viremia, bacteremia, toxic conditions Abdominal neoplasia may lead to hemoperitoneum Coagulation abnormalities
157
Example of what circulatory disturbance?
Hemorrhage
158
Subactue to chronic hepatic congestion is usually the result of
Right Sided Heart Failure
159
What stain is being used? What does it stain?
HE-Stain Brown pigment staining the cytoplasm of alveolar macrophages
160
Condition
Thrombotic Meningoencephalitis (TME)
161
Example of what circulatory disturbance
Edema
162
Petechia
Up to 1-2mm in size, especially found on skin, mucosal and serosal surfaces
163
Hemorrhagic Diathesis
Increased tendency to hemorrhage from usually insignificant injuries
164
Inflammatory pulmonary edema can be the result of
Damage to pulmonary capillary endothelium
165
Example of what circulatory disturbance
Infarction \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Arterial Infarct
166
Shock - Cardiovascular Collapse
Final common pathway for a number of potentially lethal clinical events. Gives rise to systemic hypoperfusion.
167
Describe the process of hematoma resolution
Hemoglobin (red/blue) enzymatically converted to bilirubin (blue/green) and eventually into hemosiderin (gold/brown)
168
Verminous Thrombosis
Thrombus formation in the cranial mesenteric artery of horses with Strongylus vulgaris infection
169
Role of vascular endothelium in inflammation
* Regulate the traffic of inflammatory cells * Produce pro-inflammatory cytokines * Control angiogenesis and tissue repair
170
Condition
Subacute Hepatic Congestion \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ "Nutmeg Liver"
171
Condition
Pulmonary Edema
172
Interstitium
Space between tissue compartments - microcirculation and the cells. Medium through which all metabolic products must pass between the micocirculation and the cells
173
Describe an arterial Infarct lesion
Initially hemorrhagic but become pale as the are of coagulation necrosis becomes eviden
174
Condition
Ascites or Hydroperitoneum
175
Example of what circulatory disturbance
Congestion
176
Condition
Hepatic Congestion
177
Pathogenesis
Twisting of vessels obstructs gastric veins → severe venous congestion (acute,local, congestion) → ischemia (necrosis → loss of endothelial integrity → hemorrhage → shock → death
178
Example of what circulatory distrubance
Thrombosis \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Verminous thrombosis
179
Example of what circulatory disturbence
Edema

RUSVM Pathology I JB1 (18 decks)

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