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1
Q

Define Hemostasis

A

Process of stopping blood loss

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2
Q

What is the principle mechanism of hemostasis?

A

Blood Coagulation

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3
Q

Aka for Tissue Factor

A

Tissue Thromboplastin

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4
Q

Fibrinogen represents what percent of blood proteins?

A

5-10%

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5
Q

What Vitamin is needed to help produce clotting factors in the liver?

A

Vitamin K

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6
Q

Clotting Factor I = ?

A

Fibrinogen

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7
Q

Clotting Factor II = ?

A

Prothrombin

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8
Q

Clotting Factor V = ?

A

Preacceleran

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9
Q

Clotting Factor VII = ?

A

Proconvention

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10
Q

Anti Hemophilic Factor = Clotthing Factor ??

A

VIII

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11
Q

Christmas Factor = Clotting Factor ??

A

IX

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12
Q

Clotting Factor X = ?

A

Stuart- Prower Factor

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13
Q

Name the blood factor that is released with injury and that activates Clotting Factor VII which then activates CF X

A

Tissue Thromboplastin

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14
Q

What is the name of the coagulation pathway that can happen outside and inside the blood vessel

A

Extrinsic Pathway

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15
Q

Name the steps in the Extrinsic Pathway

A

Tissue Cut ——> Tissue Thromboplastin —–> VII (proconvertin) ——-> X (Stuart-prower factor) ——> CF II (prothrombin) ——> CF 1 (Fibrinogen) ——-> Fibrin

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16
Q

What is a big difference between the Extrinsic Pathway of Coagulation and the Intrinsic Pathway

A

With Intrinsic there has to be exposure of the collagen fibres of the basement membrane to blood flow.

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17
Q

What ions help to speed the process of coagulation?

A

Calcium ions

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18
Q

What is the CF cascade for Intrinsic Coagulation

A 
Exposure of Collagen to blood flow
Hageman Factor (CF XII) 
CF XI
CF IX
CF X
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19
Q

T or F

To help with coagulation calcium bromate is injected intravenously to a pt who is hemorrhaging

A

False

Calcium Chlorate

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20
Q

Exposure of collagen fibres to blood flow can activate a special factor that will bind them. What is the name of this factor?

A

von Willebrand factor (vWF)

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21
Q

What is the outcome of vWF and the bound platelets to this factor? What is made??

A

Platelet Plug

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22
Q

T or F

Platelet plugs result in complete closure of damaged endothelium

A

False

Only partial

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23
Q

When platelets bind to vWF they become activated. What is the name of this process?

A

Platelet Degranulation

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24
Q

Platelet Degranulation results in the release of certain substances. Please name them

A

ADP
Thromboxane A2
Growth Factors
Serotonin

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25
What is the function of Thromboxane A2?
To promote further platelet activation, vasoconstriction and mediates inflammation
26
Thromboplastin Antecedent = what clotting factor?
XI
27
Hageman Factor = CF?
XII
28
CF XIII = ?
Fibrin Stabilizing Factor
29
What does hemodynamics mean?
the movement of blood with different velocities. Blood flows faster in larger and middle sized arteries and flows slow in veins.
30
What is the approx time blood takes to coagulate?
10 mins
31
Endothelial mediation of the anticoagulation system is carried out by what molecule in the body?
PGI2 = prostacyclin
32
T or F Larger hemorrhages but still less than 2cm are known as petechiae
False Purpura
33
What are pinpoint hemorrhages called?
Petechiae
34
T or F Hemorrhagic Vasculitis is an example of an ecchymoses
False Purpura - larger hemorrhages but still less than 2 cm Ecchymoses = when hemorrhage are larger than 2cm
35
T or F Petechiae can be caused by hypovitaminosis C
True
36
Brain Petechiae can be a result of?
Fat embolism
37
What is a hemorrhage called when it is in the cavities of big tissue masses?
Hematoma
38
What is Thrombocytopenia
"Penia" means lack, lack of platelets (thrombocytes) = increase bleeding - usually doesn't result in large bleeding but more Petechia & Purpura
39
Where are clotting factors produced in the body?
Liver
40
Genetic Diseases associated with non-production of some clotting factors is known as? Name the 3 discusses in class
Hemophilias 1. von willebrand disease 2. hemophilia A - Classic Hemophilia 3. hemophilia B - Christmas disease
41
T or F | Classic hemophilia is a genetic non-production of Clotting Factor IX
False Clotting Facotr VIII - antihemophilic clotting factor
42
Menorrhagia is associated with what Hemophilic disease
von willebrand disease
43
What Hemophilic disease are characterized by hemarthrosis? (hematoma in the joint)
Hemophilia A & B
44
T or F Hemophilias only develop in women
False Males
45
Are hemophilias linked to the X or Y chromosome
X
46
T or F A thrombus can be formed outside and inside
False Blood clot can be formed outside and inside Thrombus only formed WITHIN a blood vessel.
47
T or F A thrombus is more organized than a blood clot
True
48
The process of formation of a Thrombus is called?
Thrombosis
49
What makes up a Thrombus?
Fibrin Platelets WBC RBC
50
Why is a thrombus more difficult to form in the arteries compared to the veins
Hemodynamics! Blood flows quicker through the arteries and therefore there is washing away of components of blood coagulation
51
What are lines of Zahn?
Represent special types of thrombi characterized by visible & microscopic laminations produced by alternating pale layers of platelets mixed with fibrin and a darker layer containing red blood cells.
52
50% of deaths in the USA are caused by?
Atherosclerotic plaques formed in arterial walls which causes additional resistance to blood flow and causes turbulent blood flow which promotes platelet activation
53
Normal wear and tear in vessels is termed?
Hemodynamic Stress
54
Name some constitutional risk factors associated with atherosclerosis
1. Age - 40-60 years = 5- fold increase risk 2. Gender - men = 5x more vulnerable than women of same age. (70 years chances are =) 3. Familial Disposition - genes from parents
55
What is the normal blood cholesterol level
160-200 mg/dL
56
What can happen if we have less than 160 mg/dL of cholesterol in our blood?
You need cholesterol to build hormones - if you have less the liver will produce too much and it can cause hypercholesterolemia
57
The ratio of LDL:HDL should not be more than?
4:1
58
What can lead to blood flow abnormalities in the arteries?
1. Cardiac Damage reducing the heart's pumping ability 2. Increased viscosity of blood = blood flows slower 3. Turbulence of blood flow - could be caused by aneurysm
59
A bulbous thrombosis can be formed where in the body can be a result of what condition?
Heart | Mitral Valve Stenosis
60
What is polycythemia
Blood Cancer | Overproduction of RBC which increases the friction against the vascular wall.
61
Erythremia aka ?
Polycythemia
62
What are the risk factors for Thrombosis
Physical Inactivity Varicose Veins Blood hyper coagulation
63
95% of thrombi are formed where?
Deep veins of the legs
64
This condition is characterized by distention of the width of veins where the valves will no longer be able to close. It is more commonly seen in women than men
Varicose Veins
65
What type of things can cause Turbulence in blood flow
Tumor Anuerysm Varicose Veins
66
Name some conditions associated with blood hyper- coagulation
``` Extensive burns Kidney Disease - renal failure Heart failure Chronic Infections Birth Control Pills ```
67
What does Sequelae mean?
Pathological consequence. One problem creates additional problems (like a sequel)
68
Name the steps in the Sequela of Thrombosis
1. Resolution 2. Organization 3. Recanalization 4. Propogation 5. Infarction
69
In what stage of Sequela of Thrombosis does phagocytic digestions of thrombus occur?
Organization - this occurs 2 or 3 days after thrombi form
70
Where does propagation of a thrombus occur? Why?
Takes place only in veins because of hemodynamics (turbulent blood flow)
71
What stage of the Thrombus Sequela helps restore blood flow?
Recanalization
72
T or F Infarction and Ischemia mean the same thing
False Infarction is due to lack of OXYGEN compared to Ischemia which is lack of blood flow.
73
Tissue that replaces brain tissue where and infarct occurred is called?
Neuroglia
74
T or F Neuroglia undergoes shrinkage after a while, similar to when connective tissue is laid down in the heart after an infarct and the tissue dies.
False
75
What is the # 1 factor leading to an infarct?
Arteriole Thrombosis
76
An autoimmune disorder that is characterized by vascular wall inflammation is known as?
Vasculitis
77
What are 2 akas for Temporal Arteritis?
Giant Cell Arteritis | Horton's Disease
78
T or F Temporal Arteritis can occur in the Superficial Temporal arteries, Vertebral artery and the External Carotid
False The first two are correct however the External Carotid is not mentioned. The 3rd artery is Ophthalmic
79
What is a consequence of Temporal Arteritis?
Blindness
80
T or F NSAIDS are an effective means to manage Polymyalgia Rheumatic
FALSE
81
Polymyalgia Rheumatic is similar/associated with what other condition?
Temporal Arteritis
82
List some symptoms of Polymyalgia Rheumatic
Pn in shoulder Pn in muscles Pn in pelvis Blindness **can start off temporary blindness and lead to permanent
83
What is the name of the pathology that occurs when a portion of the stomach protrudes through the diaphragm
Paraesophageal Hernia
84
T or F Paraesophageal Hernia's are classified under Artery Infarction
False Venous - blood is still able to flow into herniated portion but the veins get compressed because the pressure is lower in the veins and venous outflow is stopped.
85
Postpartum Syndrome aka ?
Sheehan's Syndrome
86
Sheehan's Syndrome affects what major endocrine gland in the body?
Pituitary
87
Kazimierz Funk was accredited for the discovery of what vitamin?
B1
88
B1 =?
Thiamine
89
T or F B1 is a fat soluble vitamin
False
90
What substance is a very serious enemy of Thiamine and competes with it...and always wins?
Alcohol
91
What is the condition that results from a deficiency in B1?
Beriberi
92
Who discovered Beriberi?
Christiaan Eijkman
93
T or F Wrist drop, foot drop and 1st toe drop are associated with Wet Beriberi
False Dry
94
T or F Dry beriberi is characterized by symmetrical, non specific peripheral polyneuropathy
True
95
What are some associated symptoms of Wet Beriberi
Enlargement of heart Flabby myocardium Peripheral vasodilation Cardiac Failure - peripheral edema
96
What is a serious condition that results from Thiamine deficiency that can develop if left untreated?
Wernicke Encephalopathy
97
List some symptoms of Wernicke Encephalopathy
Global confusion Listlessness Apathy Opthalmoplegia
98
What is Ophthalmoplegia?
Results from deep brain tissue damage where eyes will go in different directions.
99
T or F | With Korsakoff's Psychosis the patient will experience only anterograde amnesia. Retrograde is not affected.
False Both
100
What is confabulation?
Inventive memory where an individual will create fantasies and constantly talks. Will not stop talking
101
B2 = ?
Riboflavin
102
Where in the body can we produce Riboflavin?
GI flora
103
What is another term for Araboflavinosis?
Cheilosis or Cheilitis
104
What is Cheilosis?
Can occur at the angle of the mouth - will begin to crack and be dry. Glossitis can occur where there is inflammation of the tongue and can lead to a loss of taste.
105
This condition consists of growth of blood vessels from conjunctiva toward the cornea and is very painful. Causes corneal ulcerations
Superficial Intersitial Keratitis
106
When there is a deficiency of Riboflavin in can lead to Dermatitis. Where in the body would this commonly be seen?
Naso-labial folds | Scrotum in males and vulva in females.
107
B3 = ?
Niacin
108
T or F B2 when deficient has a dramatic impact on the nervous system
False DOESN'T AFFECT THE NERVOUS SYSTEM
109
Why is B3 popularly used in medicine?
For its vasodilation ability - nitroglycerine tx
110
What amino acid is a precursor for B3?
Tryptophan
111
How does Niacin contribute to privation of arteriosclerosis?
Leads to a decreased production of lipoproteins LDLs
112
Deficiency of Niacin can lead to what condition?
Pellagra
113
What does Pellagra mean?
"pelle agro" = dry skin
114
What are the 4 of Pellagra?
Dermatitis Diarrhea Dementia Death
115
What is the pathophysiology associated with Diarrhea and Pellagra?
Atrophy of epithelial cells of intestinal mucosa with involvement of submucosal layer
116
T or F Casal's necklace is due to a deficiency in Riboflavin
False Niacine - B3 Riboflavin is B2
117
T or F Glove-and-stocking lesions are associated with a deficiency in Niacin
True
118
What neurons are destroyed in Pellagra that can lead to dementia?
Cortical neurons
119
Pyridoxine = ?
B6
120
T or F B6 is highly resilient to heat
False Thermolabile - a small amount of heat will destroy it
121
Name 3 medications that compete with B6's biochemical reactions and can lead to deficiency
Izoniazid - antituberculosis Estrogens D-penicillamine - tx for Wilson's disease
122
T or F B6 and B2 have very similar symptoms of deficiency
True Cheilosis Glossitis
123
B12 = ?
Cobalamin
124
T or F Plants are not a source of B12
True
125
What is the name of the molecule that binds B12 and carries it to the duodenum?
R-binder
126
What cells in the GI produce the intrinsic factor required for B12 absorption?
Parietal cells of the stomach
127
T or F Extrinsic factor = B12
True
128
T or F B12 deficiency anemia is irreversible
False Nervous system pathology associated with the deficiency is irreversible.
129
List some causes of B12 deficiency
``` inadequate dietary intake surgical removal of stomach or ileum malnutrition or alcoholism Celiac Disease, Chron's Disease Vegans Intake of some medications - Ranitidine & Metformin ```
130
This auto-immune disease is considered malignant, associated with chronic gastritis and parietal canalicular antibodies.
Pernicous Anemia
131
T or F Parietal Canalicular Antibodies = Type 1 antibodies
False Type III
132
Blocking antibodies associated with Pernicious anemia are Type 1 or Type III?
Type 1
133
What are some causes of Megaloblastic Anemia?
B12 anemia | Folic Acid Deficiency
134
What is the function of B12 in Hematopoiesis?
Restoration of inactive tetrahydrofolate
135
What does pancytopenia mean?
Total decrease in the number of blood cells (RBCs, WBCs, and platelets)
136
T or F Adding B12 DOES NOT help in folic acid deficiency
True
137
T or F Adding folic acid helps in folic acid deficiency
True
138
T or F Folic acid deficiency does not affect the nervous system (except for the fetus) but vitamin B12 does
True
139
Ascorbic acid = ?
Vitamin C
140
T or F Vitamin C can be produced in the human body
False
141
What is the function of vitamin C with proline?
Vitamin C hydroxylates proline to become hydroxyproline | Hydroxyproline makes connective tissues strong and increases tensile strength
142
T or F Vitamin C plays a role in reducing oxidation of HDL and theoretically decreasing atherosclerosis
False LDL
143
T or F Retrobulbar hematoma's are associated with a deficiency in Vitamin K
False C
144
What is the condition associated with blood behind the eyeball causing an increased pressure that pushes the eye forward and can lead to loss of vision? What vitamin is associated with this condition?
Retrobulbar Hematomas Vitamin C
145
T or F Protrusion of the ribs and sternum is associated with a vitamin D deficiency
Ture
146
What is the storage and transport form of Vitamin A?
Retinol
147
What form of vitamin A is responsible for the lifespan of epithelia?
Retinoid Acid
148
What form of Vitamin A is associated with normal vision in dim light
Retinal
149
T or F Retinoids are the natural precursor for retinal
False Carotinoids
150
This form of Vitamin A is responsible for the production of visual pigments in photoreceptors
Retinal
151
T or F A deficiency in Retinol results in night blindness
False Retinal
152
Bitot's spots are a results of a deficiency in what form of Vitamin A?
Retinoid Acid
153
What two vitamins when deficient can result in the formation of a Nidus?
Retinoic Acid & Pyridoxine | vitamin A & B6
154
Pulmonary infection, Follicular & papillar dermatosis as well as formation of a Nidus results in a deficiency with Retinal, Retinol, Retinoids, or Retinoic Acid?
Retinoic Acid
155
Name the manifestations of a deficiency in Retinoic Acid
``` Xeropthalmia Xerosis Squamous Metaplasia Follicular & Papillar Dermatosis Pulmonary Infection Nidus ```
156
What are some problems causes by chronic Hypervitaminosis?
``` Weight loss Nausea, vomiting Dryness of mucosa of lips Bone and joint pain Heptomegaly - liver is storing excess ```
157
In what form is vitamin A stored in the liver?
Retinol Ester
158
Alpha-Tocopherol is another name for?
Vitamin E
159
Vitamin E is a collective name for? **what makes up Vitamin E essentially
4 tocopherols and 4 tocotrienols
160
Vitamin E is a good antioxidant in concert with what other vitamins?
Vitamin C | Selenium
161
What cell membranes are affected in the body with a deficiency in Vitamin E?
Neuron membranes | RBC membranes
162
Degenerative changes in the spinocerebellar tract with a Vitamin E deficiency include....
``` Absent tendon reflexes Ataxia = loss of balance Dysarthria Loss of position and vibration sense Loss of pain sensation (DRG) ```
163
T or F A deficiency in Vitamin E will usually result in anemia
False
164
T or F Hypervitaminosis E can decrease coagulative ability of the blood due to interference with vitamin K
True
165
how does hypervitaminosis E interfere with vitamin K and its clotting abilities?
Decreased production of clotting factors.
166
What vitamin stimulates the production of osteocalcin?
Vitamin K
167
T or F | B12, B3 and Vitamin K are all produced by GI flora?
True
168
Keshan's Disease is caused from a deficiency in what trace element?
Selenium
169
Hypopigmentation can be caused from a deficiency in?
Copper
170
Hypogonadism and infertility can be caused by a deficiency in?
Zinc
171
Myopathy and congestive cardiomyopathy are a result of a deficiency in what trace element?
Selenium
172
T or F | Anemia is a side effect of Marasmus
True
173
Marasamus is a conditioned associated with a deficiency in what nutrient(s)
Protein and Total Calories
174
The somatic protein compartment is located primarily where in the body?
Skeletal muscles of the body
175
T or F | Marasmus is associated with a deficiency the Visceral protein compartment
False Somatic - visceral compartment is spared.
176
Acrodermatitis enteroathica is associated with a deficiency in what trace element?
Zinc
177
The majority of the visceral protein compartment is predominantly found where in the body?
Liver
178
How can we determine the visceral compartment of protien is used?
By checking blood protein level usually albumin
179
T or f Malnourished is when you are less than 80% of normal weight
True
180
T or F Kwashikor is less than 60% of normal weight
False this is Marasmus | Kwashikor = 60-80% of normal weight
181
T or F The visceral protein compartment in Marasmus is untouched and therefore blood albumin level is close to normal
True
182
What are some symptoms of Marasmus
``` Extremities are emaciated Head is disproportionally larger Anemia - lack of nutrient Multivitamin deficiency Decreased immune function ```
183
"First-second" is associated with what nutrient deficiency disorder?
Kwashikor
184
Which condition is considered "worst" Kwashiorkor or Marasmus?
Kwashiorkor because it leads to irreversible changes
185
T or F Kwashiorkor causes depletion of the visceral protein compartment
True
186
What causes the generalized edema seen with Kwashiokor
- Depletion of visceral protein compartment = hypoalbunemia - Albumin is responsible for maintaining normal capillary oncotic pressure which normally keeps serum in the vessels (keeps blood within the blood vessels) - When low serum moves to the tissues resulting in generalized edema.
187
What happens to the hair with Kwashiorkor?
Loss of colour - turns grey, alternating band of pale and darker hair Straightening
188
Describe the affects of Kwashiorkor on the skin
Skin lesions - zones of hyper pigmentation - areas of desquamousation - Hypopigmentation - "flaky paint" appearance due to decrease in melanocytes.
189
Anorexia is particularly damaging to what endocrine organs?
Pituitary and Thyroid
190
Symptoms of Anorexia?
``` Amenorrhea Hypothyroidism Decreased immune system function Hypokalemia Low BP ```
191
T or F Anorexia does not cause fat loss in the breasts
True
192
What % of people suffering from Bulimia experience amenorrhea?
50
193
What is Aspiration pneumonia?
Inhalation of omitted particles along with digestive enzymes which causes inflammation of the lungs
194
What is Mallory Weiss Syndrome?
Destruction of the distal esophagus due to repetitive long term vomitting
195
Define neoplasia
Tissue formation, involves overgrowth of a tissue to from a neoplastic mass or neoplasm called a tumor

Pathology (6 decks)

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