Edema/Congestion/Hemostasis

Question 1

what is Edema

Answer 1

increase fluid within interstitial tissue

Question 2

generally, what causes an edema

Answer 2

Increased Hydrostatic pressure

Decreased venous return

Question 3

in the body what causes an edema

Answer 3

Reduced plasma osmotic pressure
Lymphatic obstructure
Sodium and water retention
Inflammation

Question 4

what is a generalized edema

Answer 4

Anasarca

Hydrops

Question 5

how does Inflammatio lead to an edema

Answer 5

Vasodilation and increased permiability due to more blood being present

Question 6

what causes vasodilation

Answer 6

NO
Protoglycans
Histamine

Question 7

what would causes an increase in hydrostatic pressure to cause an edema

Answer 7

Impaired venous return for mechanical obstruction or congestive heart pressure

Question 8

what would cause reduced plasma osmotic pressure to lead to an edema

Answer 8

reduced protein (albumin) synth
Increased loss of protein (nephrotic syndrome, gastroenteropathy)

Question 9

what would cause lymphatic obstrucutre to lead to a edema

Answer 9

Fibrosis
Parasites
cancer
Compression

Question 10

what would cause a Na and Water retension to lead to an edema

Answer 10

Acute impairment of renal function

decreased renal perfusion with release of renin

Question 11

what would lead to inflammation to cause an edema

Answer 11

Increased vascular permeability
necrosis
angiogensis

Question 12

Pulmonary edema does what to gas exchage

Answer 12

Impairs gas exchange

Question 13

what causes pulpmonary edema

Answer 13

Acute congestive heart failure

Question 14

what does a cerebral edema leads to

Answer 14

Causes compression and herniation of critical areas

decreases blood flow

Question 15

what is plasma osmotic pressure

Answer 15

The pulling of water into the blood vessels due to solutes being present

Question 16

where is balance normally found to stop edema

Answer 16

Between hydrostatic and osmotic presssure

- prefers to leave capillary slowly and taken up by lymph

Question 17

what is effusion

Answer 17

Collection of fluid in body cavity or other space

Question 18

where might effusion occure

Answer 18

Pleural
Pericardial
Peritoneal (ascites)
Joint space (synovial)

Question 19

a buldge in the abdominal cavity due to effusion

Answer 19

Ascites

Question 20

what does effusion in the joint space lead to

Answer 20

Limited movement

Question 21

what is transudate effusion

Answer 21

Transudate is fluid pushed through the capillary due to high pressure within the capillary

Question 22

what is exudate effusion

Answer 22

Exudate is fluid that leaks around the cells of the capillaries caused by inflammation.

Question 23

what is Hyperemia

Answer 23

increased tissue blood volume secondary to neurogenic mechanisms or inflammation

Question 24

is hyperemia active or passive

Answer 24

active

Question 25

what is congestion

Answer 25

Increased tissue blood volume secondary to impaired venous return

Question 26

is Congestion active or passive

Answer 26

Passive

Question 27

is Hyperemia and congestion both associated with increase in blood flow

Answer 27

No, only hyperemia is an increase blood flow | Congestion is due to increased volume from a blockage(less outflow)

Question 28

color of congestion and hyperemia

Answer 28

Hyperemia: red Congestion: blue (low O2)

Question 29

what often accompanies congestion

Answer 29

Edema

Question 30

examples of congestion

Answer 30

Acute pulmonary congestion Chronic pulmonary congestion with hemosiderin Chronic hepatic congestion Acute hepatic congestion

Question 31

what causes chronic pulmonary congesion with meosiderin

Answer 31

Laden Macrophages

Question 32

what does chronic hepatic congestion lead to

Answer 32

Gross appearance of nutmeg pattern due to blood in the centrizonal sinusoids

Question 33

what does Acute peatic congestion lead to

Answer 33

Ischemic necrosis of centrizonal hepatocytes (centrizonal necrosis)

Question 34

what is a hemorrhage

Answer 34

Loss of blood secondary to vessel injury or physical disruption - blood no longer in the vessel

Question 35

is a hemorrhage internal or external

Answer 35

Can be both

Question 36

what is an external hemorrhgae

Answer 36

Bleeding

Question 37

what is an internal hemorrhage

Answer 37

Bleeding inside of connective tissue

Question 38

types of Internal hemorrhages based on size

Answer 38

Hematoma Petechiae Purpura Ecchymoses

Question 39

what is a hematoma

Answer 39

large | blood in tissue as a tumor of blood

Question 40

what is petechiae

Answer 40

Skin or muscous membrane hemorrhage that are 1-2mm in size

Question 41

size of petechiae

Answer 41

1-2mm in size

Question 42

what is purpura

Answer 42

Skin or muccous membrane hemorrhages larger than 3-9mm

Question 43

what is Ecchymoses

Answer 43

Focal skin and subcutaneous hemorrhages larger than 1 cm

Question 44

what are the types of hemmorhages into body spaces

Answer 44

Hemothorax Hemopericardium Hemarthrosis hemoperitoneum

Question 45

When does a hemorrhage cause shock

Answer 45

A loss of blood graeter than 20%

Question 46

what type of hemorrhage causes shock

Answer 46

Acute hemorrhages

Question 47

what does Chronic hemorrhages cause

Answer 47

Anemia

Question 48

what is hemostasis

Answer 48

The rapid arrest of blood loss at the site of an injury

Question 49

is the problem with hemmorhages into body spaces the loss of blood alone

Answer 49

No, can compress other organs

Question 50

what are the 3 componenets of Hemostasis

Answer 50

Endothelium Platelets Coagulation cascade

Question 51

what aspects of the endothelium is used for hemostasis

Answer 51

Antithrombotic properties Anticoagulent properties Prothrombotic properties

Question 52

what are the antithrombotic properties of Endothelium to cause Hemostasis

Answer 52

- Barrier from the extracellular matrix ECM | - prostacyclin (PGI2) inhibiting platelet aggregation

Question 53

action of heparin-like molecules from the endothelium to serve as an anticoagulant

Answer 53

Heparin-like molecules allow antithrombin III (AT III) to inactivate thrombin, Xa and other factors

Question 54

action of thrombomodulin in endothelium

Answer 54

serves as an anticoagulant to bind to thrombin and activate protein C

Question 55

roll of PRotein S in ANticoagulant in endothelium

Answer 55

Protein S is synth by Endothelium | - serves as a cofactor needed for full protein C function, inactivation of Va and VIIIa)

Question 56

what synthesizes Tissue Plasminogen activator

Answer 56

Endothelium

Question 57

What does the endothelium do to encourange anticoagulation in hemostasis

Answer 57

creates Heparin-like molecules Thrombomodulin Synth Protein S Synth tissue plasminogen activator

Question 58

what are the parts of the prothrombotic properties of endothelium

Answer 58

Von Wellebrand factor Tissue Factor inhibitors of plasminogen activity

Question 59

what is the Von Wilebrand factor from endothelium roll

Answer 59

A cofactor for binding platelets to collagen

Question 60

when is tissue factor secreted by endothelium

Answer 60

After exposure to cytokines(aka endothelial activation)

Question 61

what does tissue factor initiate

Answer 61

The extrinsic clotting pathway

Question 62

what are the phases to forming a platelet plug

Answer 62

Adhesion Secretion Aggregation

Question 63

how does adhesion of platelets occur

Answer 63

Von Willebrand factor bridges between collagen and a surface platelet receptor (glycoprotein Ib)

Question 64

What is secretion in platelet plug formation

Answer 64

Release of contents from both types of granules - ADP and Ca surface expression of a phospholipid complex

Question 65

What mediates platelet aggregation

Answer 65

ADP

Question 66

what is the roll of Ca in platelet plug formation

Answer 66

coagulation cascade

Question 67

why do phospholipid complexes express themeslves during platelet plug formation

Answer 67

serves as a binding site for Ca and Coagulation factors

Question 68

what is the Coagulation cascade biochemically

Answer 68

a series of enzymait conversions of inactive proenzymes to activated enzymes

Question 69

what occures at the phospholipid complex on platlet membrane during the coagulation cascade

Answer 69

Binding of Ca | Active enzyme cofactor and substrate (proenzyme)

Question 70

what is the roll of tissue factor (Thromboplastin) in the coagulation cascade

Answer 70

activates the extrinsic system

Question 71

what is the roll of Factor XII (hageman factor) in the coagulation cascade

Answer 71

Activates the intrinsic system

Question 72

what are the final products of the extrinsic and intrinsic systems

Answer 72

Thrombin (extrinsic) | Fibrin (Intrinsic)

Question 73

what controlls excesss coagulation

Answer 73

Antithrombins (Including AT III) | and protein C and S

Question 74

what is the action of antithrombins

Answer 74

Inhibit activity of thrombin and other coagulation factor

Question 75

what is the action of protein C and S

Answer 75

inactivate Factors Va and VIIIa

Question 76

why does Fibrinolysis occures

Answer 76

By the activation of plasmin from plasminogen by tissue plasminogen activator (t-PA)

Question 77

what does plasmin do when activated

Answer 77

breaks down fibrin, resulting in fibrin split/degradation products

Question 78

what is responsible for inhibiting clots

Answer 78

Antithrombin | Thrombomodulin