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Pathology Exam 3 > Fluids and Hemodynamics > Flashcards

Fluids and Hemodynamics Flashcards

1
Q

Distribution of water in the body?

A

36 liters
24 in cells
12 extracellularly

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2
Q

Percentage of body weight distributions?

A

Intracellular fluid is 40% body weight
Extracellular fluid is 16% body weight
Blood serum is 4% of body weight

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3
Q

How much blood do you have?

A

5 Liters

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4
Q

Of the 5 liters that make up your blood how much is plasma and how much are cells?

A

3 liters plasma

2 liters cells (hematocrit 40%)

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5
Q

What determines the flow of water from the intravascular space to the extravascular space?

A

Protein concentration within the vascular space

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6
Q

Where is sodium excluded from?

A

Intracellular space, but is freely exchanged between intravascular space and extravascular space

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7
Q

What are two isotonic solutions important to know?

A

0.9% Sodium chloride

5% Dextrose

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8
Q

How much of serum is made up of albumin protein?

A

60%

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9
Q

What influences albumin in the serum? (2)

A

Degree of hydration

Synthesis by liver

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10
Q

How much of serum is immunoglobulins?

A

16%

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11
Q

Albumin:Immunoglobulin ratio is what? And how do you measure this?

A

3-4:1

Serum Electrophoresis

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12
Q

What effect will decrease in albumin cause in a tissues?

A

Edema due to shift of water from blood to interstitium

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13
Q

Main intracellular ion?

A

Potassium

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14
Q

Changes in sodium concentration function to do what?

A

Change volume of the cell.

They don’t influence shifting of water into or out of the interstitial space

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15
Q

What causes edema in renal failure?

A

Increased hydrostatic pressure

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16
Q

Acidosis results in what involving potassium?

A

Hyperkalemia

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17
Q

Two types of edema?

A

Inflammatory (Exudate)

Non-inflammatory (Transudate)

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18
Q

What’s Anasarca?

A

Widespread extreme generalized edema

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19
Q

Three examples of effusions?

A

Pleural effusion
Pericardial effusion
Hemorrhagic effusion

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20
Q

What should you associate hemorrhagic TB with?

A

TB

21
Q

Anything that can cause Edema can cause what?

A

Effusion

22
Q

How do you determine composition of effusion?

A

Aspiration

23
Q

Mechanisms that can cause edema? (4)

A

Increased vascular permeability
Increased hydrostatic pressure (Decreased venous outflow)
Decreased protein in the blood
Decreased lymphatic flow

24
Q

What can cause increased hydrostatic pressure?

A

Obstruction of normal blood flow on venous side of capillaries

25
Q

Example of localized obstruction of venous blood flow?

A

Venous thrombosis in extremities

Pulmonary edema

26
Q

What is left sided congestive heart failure?

A

Increased pressures in venous pulmonary system causes edema in alveoli

27
Q

What is right sided congestive heart failure?

A

Increased pressure in the vena cava/liver resulting in liver congestion and peripheral edema

28
Q

Which type of congestive heart failure results in peripheral edema?

A

Right sided

29
Q

Sodium and Water retention results in what?

A

Acute reduction of renal function

30
Q

Inadequate perfusion of kidneys results in what?

A

Activation of renin/angiotensin

31
Q

Loss of albumin is indicative of what? (2)

A

Nephrotic syndrome

Protein-losing enteropathies

32
Q

Decreased synthesis of albumin is indicative of what? (2)

A

Hepatic cirrhosis

Liver failure

33
Q

Malnutrition is indicative of what?

A

Kwashiorkor

34
Q

Decreased Oncotic Pressure caused by what? (3)

A

Loss of albumin
Decreased synthesis of albumin
Malnutrition

35
Q

Three causes of lymphatic obstruction?

A

Filariasis
Neoplasia
Scarring

36
Q

What does nephrotic syndrome cause?

A

Too much protein to be secreted in urine, which in turn causes anasarca due to loss of oncotic pressure

37
Q

Nutmeg liver is also referred to as what?

A

Liver congestion

38
Q

What is hyperemia?

A

Increased blood flow into capillary beds due to arteriolar or arterial dilation

39
Q

What causes hyperemia? (2)

A

Sympathetic neurogenic mechanisms

Release of vasoactive substances such as histamine or serotonin

40
Q

Congestion is due to what?

A

Accumulation of blood within capillaries due to impaired venous drainage

41
Q

What causes Nutmeg liver (Right heart failure)?

A

Obstruction of vena cava or hepatic vein

42
Q

Features of Nutmeg Liver?

A

Alternating areas of light (pale hepatocytes) and dark (distended sinusoids) in a pattern resembling a nutmeg

43
Q

What microscopic features may you see in Nutmeg Liver? (3)

A

Congestion of central vein with increased blood in sinusoids
+/- atrophy or necrosis centrilobular hepatocytes
+/- fatty change in perilobular hepatocytes

44
Q

Gross features of lungs suffering from pulmonary edema?

A

Wet, heavy, boggy lungs

45
Q

Microscopic pulmonary edema features? (3)

A

Congestion of pulmonary veins
Transudate and red cells within alveoli
“Heart failure cells” alveolar macrophages containing hemoglobin

46
Q

Consequence of hemorrhage?

A

Shock

47
Q

When is a hematoma benign and when is it lethal/

A

Benign as bruise

Lethal as brain

48
Q

Cardiac tamponade causes what?

A

Decreased venous return due to increased fluid volume in pericardium

Pathology Exam 3 (10 decks)

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