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Clinical Medicine > Hemodynamic Disorders, Thrombosis, and Shock > Flashcards

Hemodynamic Disorders, Thrombosis, and Shock Flashcards

1
Q

an increase in interstitial fluid (within the tissues) is called

A

edema

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2
Q

severe generalized edema is called

A

anasarca

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3
Q

when fluid collects in body cavities

A

effusion

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4
Q

fluid collection in the peritoneal cavity

A

ascites

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5
Q

protein poor edema or effusion with a specific gravity of less than 1.012

A

transudate

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6
Q

protein rich edema or effusion fluid with a specific gravity of more than 1.020

A

exudate

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7
Q

approximately _____ % of lean body weight is water

A

60%

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8
Q

____ of the body water resides inside the cells and ____ is extracellular

A

2/3 inside the cells

1/3 extracellular

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9
Q

only about ___ % of total body water is in the blood plasma

A

5%

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10
Q

fluid balance is maintained by what 2 things

A
  • vascular hydrostatic pressure

- plasma colloid osmotic pressure

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11
Q

increased intravascular pressure typically comes from:

A

impaired venous return

obstruction of venous flow, congestive heart failure

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12
Q

reduced plasma osmotic pressure is most commonly due to a:

A

decrease in serum albumin

liver failure, nephrotic syndrome

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13
Q

other causes of edema include

A
  • increased vascular permeability as in inflammation or trauma
  • renal sodium (and water) retention
  • lymphatic obstruction
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14
Q

hyperemia’s cause and effects (coloration)

A
  • comes from arteriolar dilation and increased blood flow

- tissue tends to be pink or red

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15
Q

congestion cause and effects (coloration)

A
  • comes from impaired venous return

- tissue tends to have a blue or purplish color due to cyanosis

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16
Q

blood leaking out of blood vessels is called a

A

hemorrhage

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17
Q

accumulation of blood in the tissues is called a

A

hematoma

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18
Q

1-2mm hemorrhages into skin are called

A

petechiae

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19
Q

slightly larger (3-5mm) areas of skin hemorrhage

A

purpura

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20
Q

medical term for a bruise (typically less than 1 inch)

A

ecchymosis

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21
Q

a healthy individual can lose ____ % of their blood volume before there is much impact on normal homeostasis

A

20

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22
Q

3 key elements in the development of the final clot

A
  1. endothelium and vascular wall
  2. platlets
  3. the coagulation cascade
23
Q

damage of the endothelial lining can result in

A

promotion of a cascade of events that leads to formation of a hemostatic plug at the site of injury

24
Q

the prothrombin (PT) clinical lab test monitors the impact of the ____ pathway of the coagulation cascade

A

extrinsic

25
Q

the partial thrombosis (PTT) test monitors the impacts of the _____ pathway of the coagulation cascade

A

intrinsic

26
Q

the anticoagulant medication Heparin is monitored with the ____ test

A

PTT

27
Q

the anticoagulant medication Coumadin (or warfarin) with the ____ test

A

PT

28
Q

two important enzymes that limit the size of the clot and stop it from progressing to the rest o the vasculature

A

antithrombin and plasmin

29
Q

three important factors that contribute to the formation of a thrombus

A
  • endothelial injury
  • abnormal blood flow
  • hypercoagulable states
30
Q

how does stasis and turbulence of blood flow contribute to thrombus formation

A

it allows platelets to come in greater contact with the endothelium, and allows the build up of activated clotting factors that would normally be washed away with the steady, rapid flow of blood

31
Q

an embolism occurs when

A

a substance other than liquid blood (solid, semisolid, liquid or even gas) is transported in the vascular system

32
Q

the vast majority of emboli are portions of a

A

thrombus

thus, they are called thromboembolism

33
Q

most pulmonary emboli (PE) are from:

A

thrombi in the deeps veins of the leg and pelvis

34
Q

when a large embolus blocks the bifurcation of the pulmonary arteries we call it:

A

saddle embolus

35
Q

systemic thromboemboli usually arise in the ______

A

heart chambers

36
Q

systemic thromboemboli can lead to

A

tissue damage and infarction in whichever arterial supply becomes occluded

37
Q

an infarction is

A

an area of tissue death due to lack of arterial supply, but can be due to inhibited venous drainage

38
Q

the extent of damage to tissue in an infarction depends on what factors?

A
  • sie of artery occluded
  • sensitivity of the particular tissue to hypoxia
  • rate of development of the occlusion
39
Q

if there is a lot of hemorrhage at the site of infarction it is called a

A

red infarct

40
Q

if there is a little hemorrhage at the site of infarction it is called a

A

white infarct

41
Q

the definition of shock is

A

system wide inadequate blood supply (hypo perfusion) to meet the metabolic demands of the tissues

42
Q

results of shock can be

A
  • hypotension
  • impaired tissue perfusion
  • cellular hypoxia
43
Q

the 3 main categories of shock are

A
  • cardiogenic
  • hypovolemic
  • septic
44
Q

cardiac shock develops from failure of

A

the heart to pump sufficient blood to the tissues

45
Q

hypovolumetric shock is the result of

A

massive blood or fluid loss

46
Q

cardiac shock can be due to a

A
  • massive heart attack (infarction)
  • arrhythmia
  • cardiac compression (tamponade)
  • outflow obstruction
47
Q

how can septic shock develop?

A

due to a severe infection

48
Q

in septic shock, the response to microbial elements results in

A
  1. release of multiple inflammatory mediators and activation of the complement system
  2. endothelial cell activation and injury which in turn causes increased vascular permeability, vasodilation, and thrombosis
49
Q

what is DIC (disseminated intravascular coagulation) ?

A

where there are widespread tiny clots in the microcirculation that clog up the blood flow and use up the clotting factors and actually provoke bleeding problems because the clotting factors are all used up

50
Q

neurogenic shock results from:

A

the loss of vascular tone (such as seen after a spinal cord injury)

51
Q

anaphylactic shock develops from:

A

massive vasodilation and increased vascular permeability after an IgE based reaction to an antigen

52
Q

clinical signs of cariogenic or hypovolemic shock

A
  • hypotension
  • rapid weak pulse
  • increased respiratory rate
  • ashen grey color
  • cool, clammy skin
53
Q

clinical sign difference for septic shock

A

-skin may be warm and flushed due to vasodilation

Clinical Medicine (10 decks)

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