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Gen Path > Exam 2 Chapter 3 > Flashcards

Exam 2 Chapter 3 Flashcards

1
Q

What is required for survival?

A

circulation

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2
Q

What are the 2 most important compounds in circulation? What does circulation remove?

A

oxygen and glucose, removes metabolic waste

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3
Q

Pressures and endothelial function are regulated by what?

A

circulation

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4
Q

Clotting and hemorrhage are balanced by what?

A

homeostasis

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5
Q

The process of blood clotting is called?

A

hemostasis

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6
Q

What occurs if there is too little blood clotting?

A

hemorrhage (stroke)

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7
Q

What occurs if there is too much blood clotting?

A

thromboembolism

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8
Q

___________ can cause MI, stroke or pulmonary embolism (PE)

A

thromboembolism

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9
Q

What 2 things increase blood volume within tissue?

A

hyperemia and congestion

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10
Q

Hyperemia is _________, whereas congestion is ___________.

A

active, inactive

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11
Q

What causes arteriolar dilation and an increase in inflow?

A

hyperemia

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12
Q

Hyperemia causes tissue ___________.

A

erythema (redness)

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13
Q

This type of increased blood volume occurs due to inflammation and exercise.

A

hyperemia

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14
Q

Congestion causes decreased _________ outflow.

A

venous

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15
Q

Congestion causes tissue ___________.

A

cyanosis (blue)

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16
Q

_______ occurs from venous obstruction and is a potential cause of congestive heart failure, DVT, and testicular torsion

A

congestion

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17
Q

This type of increased blood volume can either be physiological or pathological.

A

hyperemia

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18
Q

This type of increased blood volume can only be pathological.

A

congestion

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19
Q

This hyperemic condition is characterized by alveolar capillary engorgement, edema and hemorrhage.

A

acute pulmonary congestion

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20
Q

This condition is characterized by fibrosis of alveolar septa.

A

chronic pulmonary congestion

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21
Q

This is an example of acute pulmonary congestion.

A

Acute Respiratory Distress Syndrome (ARDS)

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22
Q

Alveolar macrophages and _________ are characteristic of chronic pulmonary congestion. Called “heart failure cells”.

A

hemosiderin

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23
Q

This is an example of chronic pulmonary congestion.

A

congestive heart failure (CHF)

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24
Q

This type of congestion is nicknamed “nutmeg liver”. It is characterized by steatosis, fibrosis, hemorrhage and necrosis.

A

congestive hepatopathy

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25
Q

What is the most common cause of hepatic congestion?

A

congestive heart failure (CHF)

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26
Q

2/3 of the body’s interstitial fluid is ____________.

A

intracellular

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27
Q

This is the abnormal accumulation of interstitial fluid.

A

edema

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28
Q

Edema can occur within _______ or ____ ______

A

tissues, body cavities

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29
Q

What type of edema is common in the lower extremities? It is also characterized by ascites and hydrothorax.

A

localized

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30
Q

What type of edema is usually subcutaneous and within cavities? Anasarca can also occur.

A

generalized

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31
Q

This is generalized edema due to malnutrition.

A

anasarca

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32
Q

What are the two opposing forces of fluid balance?

A

hydrostatic pressure and osmotic pressure

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33
Q

Hydrostatic pressure is related to _____ ______. It pushes H2O ____.

A

blood pressure, out

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34
Q

Osmotic pressure is related to _______ ________. It pulls water ___.

A

plasma proteins, in

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35
Q

Increased hydrostatic pressure also causes increased ____________ pressure.

A

intravascular

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36
Q

Increased hydrostatic pressure also impairs what?

A

venous return

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37
Q

This is an example of localized impaired venous return.

A

blood clot (DVT)

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38
Q

This is an example of generalized impaired venous return.

A

congestive heart failure (CHF)

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39
Q

Examples of treatment for increased hydrostatic pressure? (4)

A

1) Restoration of cardiac output
2) Thrombolysis
3) Reduction of sodium intake
4) Diuretics

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40
Q

Colloid osmotic pressure and oncomic pressure are additional names for what?

A

plasma osmotic pressure

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41
Q

Plasma protein osmotic pressure is determined by the plasma protein _______

A

albumin

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42
Q

What is the term for decreased serum albumin?

A

hypoalbuminemia

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43
Q

A decrease in osmotic pressure causes what?

A

generalized edema

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44
Q

Cirrhosis, hepatitis, liver failure, and malnutrition are results of this mechanism of reduced plasma osmotic pressure.

A

decreased production

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45
Q

This is caused by the increased loss mechanism of reduced plasma osmotic pressure.

A

nephrotic syndrome (proteinuria)

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46
Q

Lymphadema, retention of sodium (H2O), and inflammation are all additional causes of what?

A

edema

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47
Q

What causes Peau d’orange?

A

Lymphadema

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48
Q

Retention of sodium (H2O) causes increased __________ ______. This is turn causes an increase in hydrostatic pressure

A

blood volume

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49
Q

Inflammation causes increased ______ _________.

A

vessel permeability (exudate)

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50
Q

Edema impairs what?

A

wound healing

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51
Q

What are the two types of dependent edema?

A

standing and recumbent

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52
Q

On what part of the body is standing dependent edema usually seen?

A

ankles/legs

53
Q

On what part of the body is recumbent dependent edema usually seen?

A

sacrum

54
Q

Edema could be a symptom of what severe conditions? (2)

A

CHF and renal failure

55
Q

What type of edema is inflammatory?

A

non-pitting

56
Q

What type of edema is non-inflammatory?

A

pitting

57
Q

What type of edema is transudate or protein poor? There is no osmosis associated with it.

A

pitting

58
Q

What type of edema is exudate or protein rich?

A

non-pitting

59
Q

______ occurs with non-pitting edema (but not pitting edema)

A

osmosis

60
Q

This is the extravasation of blood from vessels.

A

hemorrhage

61
Q

Hemorrhage is a sign of what?

A

internal or external bleeding

62
Q

This is the accumulation of blood within tissue.

A

hematoma

63
Q

Contusions and ecchymosis are two potential causes of what?

A

hematoma

64
Q

What is the smallest type of mild hematoma?

A

petechiae

65
Q

This is the middle size of mild hematoma

A

purpura

66
Q

This is the largest size of hematoma

A

ecchymosis

67
Q

What normally inhibits thrombosis?

A

endothelium

68
Q

This is the activation of thrombin:

A

coagulation cascade

69
Q

The coagulation cascade involves the activation of ___________.

A

thrombin

70
Q

What forms the primary platelet plug?

A

clotting

71
Q

What forms the secondary platelet plug?

A

fibrin

72
Q

Platelets that are exposed to ___ form a clot (primary plug)

A

vWF

73
Q

The fibrin (secondary) plug is located at the site of injury and is composed of _________.

A

fibrinogen

74
Q

This is the clot formation inside a vessel. It can happen anywhere in the cardiovascular system.

A

thrombosis

75
Q

What are two main causes of thrombosis?

A

acquired or inherited mutations

76
Q

Smoking, pregnancy, oral contraceptives, obesity, cancer, m.i., atheromas, arrhythmia, irregular heart valves, sickle-cell anemia, immobilization, trauma/surgery or varicosities are all causes of:

A

acquired thrombosis

77
Q

This acquired mutation decreases thrombosis (anti-thrombotic).

A

factor V

78
Q

This acquired mutation increases thrombosis (thrombotic).

A

prothrombin

79
Q

What are the three components or Virchow’s triad?

A

1) endothelial injury
2) abnormal flow
3) hypercoagulability

80
Q

An arterial thrombosis occurs at the site of _______ and grows _______ blood flow.

A

injury, against

81
Q

What type of thrombosis occurs at the site of stasis and grows in the direction blood flow?

A

venous

82
Q

A venous thrombosis occurs at the site of ________ and grows ________ the direction of blood flow.

A

stasis, with

83
Q

What are thrombi on heart valves?

A

vegetations

84
Q

Vegetations can either be ______ or ________.

A

sterile or infective (bacterial, fungal)

85
Q

What is a thrombotic embolism?

A

thromboembolism

86
Q

A thrombosis is an ________ and can either be _____ or _______

A

obstruction/embolism, acute or chronic

87
Q

Congestion, tenderness, and pitting edema are symptoms of what type of thrombosis?

A

venous (DVT, CHF, trauma, immobility, pregnancy)

88
Q

Infarctions (m.i. Or stroke) are symptoms of what type of thrombosis?

A

arterial

89
Q

What is the fate of a thrombosis?

A

1) enlarge (propagation)
2) embolize
3) dissolve
4) organize (ingrowth of cells)
5) recanalization

90
Q

What are the main features of a thrombosis? (3)

A

cause, size, site

91
Q

Older thrombi exhibit more organization…they contain in-growths of what materials?

A

endothelia, smooth muscle, and fibroblasts

92
Q

_______ is a detached, intravascular mass that travels and can become lodged, _______ vessels.

A

embolism, occluding/blocking

93
Q

Embolisms can occur in what 3 forms?

A

solid, liquid, gaseous

94
Q

_________ _______ is an embolic occlusion of a pulmonary artery

A

pulmonary embolism

95
Q

95% of pulmonary embolisms are caused by what?

A

DVT (femoral vein, thigh)

96
Q

What percentage of pulmonary embolisms are clinically silent?

A

80%

97
Q

What percentage of pulmonary embolisms are fatal?

A

2%

98
Q

Dyspnea, tachypnea, cough, chest pain, cyanosis, hypoxia, and collapse are all symptoms of what pathology?

A

pulmonary embolism

99
Q

A pulmonary embolism can cause pulmonary hypertension. This can cause what?

A

cor pulmonale (sudden cardiac death)

100
Q

What are the risk factors for a pulmonary embolism?

A

1) previous pulmonary embolism (30% reoccur)
2) bed rest
3) burns
4) CHF
5) cancer
6) surgery (knee, hip)

101
Q

This is an embolism within the arterial system.

A

systemic thromboembolism

102
Q

What percentage of systemic thromboembolisms arise from cardiac mural thrombi?

A

80%

103
Q

What fraction of cardiac mural thrombi occur in the left ventricle?

A

2/3

104
Q

Cardiac mural thrombi occur in the left ventricle following what?

A

M.I.

105
Q

What fraction cardiac mural thrombi occur in the left atrium, causing dilation?

A

1/4

106
Q

Cardiac mural thrombi occur in the right atrium following what?

A

mitral stenosis

107
Q

These are other causes of systemic thromboembolisms (20%).

A

aortic aneurysms and atheromas

108
Q

Severity of systemic thromboembolisms depends on _________

A

location

109
Q

75% of systemic thromboembolisms arise from the _____ _______ and 10% come from the ____.

A

lower extremity, CNS

110
Q

What occurs when emboli cross from the venous system to the arterial system?

A

paradoxical embolism

111
Q

Paradoxical embolisms originate as what before crossing into the arterial system?

A

DVT

112
Q

What two defects are causes of paradoxical embolisms?

A

atrial (patent foramen ovale) or ventricular septal defects

113
Q

What is the result of a paradoxical embolism?

A

stroke

114
Q

What type of shock is caused by pump failure?

A

cardiogenic

115
Q

M.I. (MC), arrythmia, cardiac tamponade, and P.E. are all examples of causes of this what of shock?

A

cardiogenic

116
Q

What type of shock occurs due to a loss of blood/plasma?

A

hypovolemic

117
Q

Hemorrhage, severe burns and dehydration are potential causes of what type of shock?

A

hypovolemic

118
Q

What kind(s) of shock cause traditional symptoms: cyanosis (cool/clammy) and SNS stimulation?

A

cardiogenic and hypovolemic

119
Q

What type of shock is caused by infections which lead to systemic immune reactions?

A

septic

120
Q

What is involved with septic shock? It causes vasodilation and stasis

A

endothelial activation

121
Q

What type of shock occurs due to CNS trauma, spinal anesthesia, or ADR?

A

neurogenic

122
Q

Depression of medulla (vasomotor) or SNS ganglia, severe vasodilation, syncope and bradycardia are all symptoms of what type of shock?

A

neurogenic

123
Q

What type of shock causes severe vasodilation (edema) and bronchocostriction?

A

anaphylactic

124
Q

Anaphylactic shock is _____-mediated (Type I Hypersensitivity).

A

IgE

125
Q

Anaphylactic shock occurs as a response to what?

A

allergies

126
Q

What stage of shock utilizes compensatory mechanisms? The SNS accommodates to perfuse vital organs.

A

nonprogressive

127
Q

What stage of shock involves hypoperfusion and anaerobic metabolism?

A

progressive

128
Q

Progressive shock leads to what? (further impairs cardiac function)

A

acidosis

129
Q

What stage of shock is due to severe cell/tissue damage? It leads to widespread membrane damage and organ failure. It is lethal.

A

irreversible

Gen Path (4 decks)

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