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Pathology -- Cardiology > Fluid and Hemodynamic Alterations I > Flashcards

Fluid and Hemodynamic Alterations I Flashcards

(62 cards)

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1
Q

Total volume of water in the body =

How much intracellular? Extracellular?

A

36L

Intra – 24. Extra – 12.

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2
Q

Blood volume is approximately…

A

5L

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3
Q

of the 5L of blood, apprximately ___ is plasma and ____ is cells.

A

3L Plasma

2L Cells

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4
Q

Hematocrit is approximately ______%

A

40%

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5
Q

What is an osmole?

A

One mole of nonpermeant and non-ionizable

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6
Q

4/5 of the osmolarity of the interstitial fluid is caused by ___________

A

Sodium and Chloride

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7
Q

Half the osmolarity of the intracellular fluid is caused by…

A

Potassium

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8
Q

Examples of isotonic solutions

A

0.9% Sodium Chloride

5% Dextrose

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9
Q

60% of serum protein is _______

A

Albumin

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10
Q

16% of serum protein is ______

A

Immunoglobulin/Gamma Globulin

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11
Q

Other than Albumin and Gamma Globulins, what other proteins are running around?

A

Transport Proteins
Enzymes
Coagulation Proteins (Fibrinogen)

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12
Q

Normal Albumin:Immunoglobulin Ration

A

3-4:1

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13
Q

Loss of serum protein causes….

A

Shift of water from the blood into the interstititium (edema)

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14
Q

Changes in sodium act primarily to….

A

Change the volume of cells, not to move water in or out of interstitial space

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15
Q

What causes edema in renal failure?

A

Increased hydrostatic pressure

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16
Q

How does acidosis alter blood chemistry?

A

It will shift Hydrogens from outside the cell and replace them with potassium which leaves the cell. Resulting in hyperkalemia.

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17
Q

What is the definition of Edema

A

Accumulation of abnormal amounts of fluid in the intercellular tissue spaces or within body cavities

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18
Q

Two types of edema and the types of fluid.

A

Inflammatory Edema – Exudate

Non-inflammatory Edema – Transudate

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19
Q

Inflammatory edema is caused by…

A

Increased vascular permeability

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20
Q

Non-inflammatory edema is caused by…

A

a change in hemodynamic forces across a capillary wall

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21
Q

What is Anasarca?

A

Severe generalized subcutaneous edema

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22
Q

What is ascites?

A

edema within the pleural cavity

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23
Q

What is hydrothorax?

A

Edema within the pleural cavity

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24
Q

What is pitting edema?

A

Subcutaneous edema in which digital pressure leaves indentations

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25
What is an effusion?
An outpouring of fluid
26
Causes of increased hydrostatic pressure?
- Obstruction of normal BF on venous side of capillaries - Localized causes (Venous thrombus, pulmonary edema) - Generalized (Fluid Retention)
27
Causes of fluid retention
Renal Failure, Inadequate Renal Perfusion
28
Explain the mechanism of congestive heart failure
1. Heart Failure 2. Decreased renal perfusion 3. Renin (JGA) 4. Angiotensinogen --> Ang I and II 5. Aldosterone 6. Retained Na + H2O 7. Increased Intravascular Volume 8. Increased Hydrostatic Pressure 9. Edema
29
Causes of loss of albumin?
Nephrotic Syndrome -- Leakage across glomerular BM | Protein Losing Gastroenteropathy
30
Causes of decreased albumin synthesis?
Hepatic Cirrhosis Liver Failure Malnutrition (Kwashiorkor, Marasmus)
31
Pathological features of cirrhosis
Diffuse destruction of hepatic parenchyma | Fibrosis, Nodular regeneration
32
What is kwashikor?
Protein caloric under nutrition
33
What is marasmus?
Loss of calories (starvation)
34
Causes of lymphatic obstruction?
Filariasis, Neoplasia, Scarring
35
Pathology of filariasis?
Fibrosis of lymphatics in inguinal area
36
Where is the fluid in pulmonary edema?
Initially in lower lung lobes | Initially in alveolar septa around capillaries, but eventually collects in the alveoli
37
Three causes of pulmonary edema
Increased Hydrostatic Pressure Decreased Oncotic Pressure Microvascular Injury
38
Causes of increased hydrostatic pressure in pulmonary edema?
left CHF Mitral Valve/Aortic Valve Stenosis Obstruction of Pulmonary Vein
39
Cause of decreased oncotic pressure in pulmonary edema?
hypoalbuminemia
40
Causes of microvascular injury leading to pulmonary edema?
Infection, Inhaled Gasses, liquid aspiration, drugs, shock/sepsis/radiation
41
Clinical pathology of CHF?
Vascular congestion, Alveolar Transudate, Few red cells
42
Clinical pathology of microvascular injury?
Exudate with high protein (fibrin)
43
In edema of the brain, swelling in an enclosed space?
Narrowed Sulci Flattened gyri Necrosis Herniation
44
Symptoms common to right congestive heart failure?
``` Subcutaneous edema (esp. in lower extremities) caused by higher hydrostatic pressure. Stays low because its dependent edema (influenced by gravity). Nutmeg liver. ```
45
Causes of hyperemia (active hyperemia)?
Sympathetic neurogenic mechanisms | Release of vasoactive substances (histamine, serotonin)
46
What is congestion (passive hyperemia)?
Accumulation of blood in the capillaries caused by impaired venous drainage. It shows up as blue-red discoloration. T
47
Two primary examples of congestion?
Nutmeg Liver | Pulmonary Edema
48
What is nutmeg liver all about?
Rt. Heart Failure. Causes obstruction of vena cava/hepatic vein Liver gets alternating light/dark pattern that resemble a nutmeg.
49
What are in the light and dark regions of a nutmeg liver?
Light -- Pale hepatocytes | Dark -- Distended sinusoids
50
Microscopic features of nutmeg liver?
- Congestion of central vein increasing blood in sinusoids - +/- atrophy or necrosis of centrilobar hepatocytes - +/- fatty change in the perilobular hepatocytes (chronic ishemia)
51
What's the story with pulmonary edema?
left heart failure | Wet, heavy boggy lungs
52
Microscopic features pulmonary edema?
Congestion of Pulmonary Veins Transudate and red cells within alveoli "Heart Failure Cells" (alveolar macrophages full of hemoglobin)
53
What is hemorrhage?
Release of blood outside of the cardiovascular system
54
Define hematoma
accumulation of blood in a tissue
55
Define hemothorax
accumulation of blood within the pleural cavity
56
Define hemopericardium
accumulation of blood within the pericardial cavity
57
Define hemoperitoneum
Accumulation of blood within the peritoneal cavity
58
Define hemarthrosis
Accumulation of blood within a joint space
59
Define petechial hemorrhages
Minute (mm) hemorrhages of the skin, mucous membranes, and serosal surfaces
60
Define purpura
Hemorrhages slightly larger than petechia
61
Example of a benign hematoma? Lethal hematoma?
Benign -- Bruise | Lethal -- brain
62
What is cardiac tamponade?
Decreased venous return due to increased fluid volume in the pericardium

Pathology -- Cardiology (13 decks)

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