Hemodynamics

Question 1

What does exudate contain that transudate does not

Answer 1

Inflammatory cells

Question 2

Examples of Localized Increased hydrostatic pressure

Answer 2

Venous stasis

Ascites

Question 3

Examples of Generalized Increased hydrostatic pressure

Answer 3

Cardiac Failure

Renal Failure

Question 4

What infiltrate is indicative of liquefactive necrosis

Answer 4

Neutrophils

Question 5

What are the reasons a transudate can form?

Answer 5

Increased Hydrostatic Pressure
Loss of Plasma Colloid
Increased Vascular Permeability
Impaired Lymphatic Drainage
Salt and Water Retention

Question 6

What is the difference b/w hyperemia and congestion?

Answer 6

Hyperemia = Active process due to increased blood inflow

Congestion = Passive process due to impaired venous outflow

Question 7

Why would Renal Failure patients have non-gravity dependent edema?

Answer 7

Because their edema is due to a loss of colloid pressure, not hydrostatic pressure

Question 8

Why is ventricular hypertrophy such a threat to induce heart failure?

Answer 8

Because there is no angiogenesis in the heart tissue. The heart muscle gets bigger without a corresponding increase in bloodflow to support it

Question 9

Clinical symptom of left ventricular failure

Answer 9

Pulmonary Edema

Question 10

Clinical symptom of right ventricular failure

Answer 10

Pitting edema. Blood accumulates in lower extremities because it cannot return to heart effectively

Question 11

Clinical symptom of congested liver

Answer 11

Ascites

Question 12

what happens to the architecture of the lungs after long-term heart failure?

Answer 12

Septa become very thickened.

Macrophages ingest RBC and form HFC’s to retain iron

Question 13

What is amyloidosis

Answer 13

Amyloid is a misfolded protein that can accumulate in blood vessels

Question 14

What can pericardial hemorrhage lead to

Answer 14

Tamponade

Question 15

What is the state of normal hemostasis?

Answer 15

Conditions that allow for the fluidity of the blood to be maintained as well as allow for the formation of a solid plug to close a vascular defect

Question 16

What are the three factors that determine hemostasis and thrombosis

Answer 16

Vascular endothelium
Platelets
Coag System

Question 17

Endothelial cell anti-thrombotic properties

Answer 17

Antiplatelet effects
Anticoag properties
Fibrinolytic properties

Question 18

Endothelial cell

PRO-thrombotic properties

Answer 18

Adhesion of platelets
Make vWF
Make TF

Question 19

What is the first thing that happens after a vascular injury?

Answer 19

Transient arteriorlar vasoconstriction (reflex pathway)

Question 20

What is exposed after a vascular injury that facilitates platelet adherence and activation?

Answer 20

Highly pro-throbotic subendothelial ECM

Question 21

What is factor 3?

Answer 21

Tissue factor, made by endothelial cells

Question 22

What factor does factor 3/TF mix with to help start the coag cascade?

Answer 22

Factor 7

Question 23

What is the main goal of the cascade?

Answer 23

Activate Thrombin

Question 24

What does activated Thrombin do?

Answer 24

It cleaves fibrinogen to create the insoluble fibrin

It also recruits more platelets to the clot

Question 25

What happens after the clot has controlled the bleeding?

Answer 25

Fibrinolysis occurs to help smooth out the clot and limit its size so it doesn't disrupt laminar blood flow

Question 26

What is the fibrinolysis molecule released by Endo Cells?

Answer 26

t-PA

Question 27

What does thrombomodulin do?

Answer 27

Blocks additional coagulation cascade activity

Question 28

What can "trick" endothelial cells into forming clots without injury to the vessels?

Answer 28

Microbes Inflammatory mediators hemodynamic forces

Question 29

What does heparin do?

Answer 29

It binds to thrombin and causes a modification so that it cleaves Protein C instead of Fibrinogen Protein C is an anticoagulant

Question 30

What factors does Protein C cleave?

Answer 30

5a and 8a

Question 31

What does t-PA stand for?

Answer 31

Tissue type plasminogen activator, which cleaves plasminogen into plasmin

Question 32

What does plasmin do

Answer 32

Cleaves insoluble fibrin to bust up clots

Question 33

What makes vWF?

Answer 33

EC's

Question 34

What does vWF do?

Answer 34

It binds to both platelets and sub-endothelial ECM

Question 35

What secretes PAI? (Plasminogen activator inhibitors)

Answer 35

EC's

Question 36

What do PAIs do?

Answer 36

Favor thrombosis by limiting plasminogen activity

Question 37

What makes platelets

Answer 37

Megakaryocytes in bone marrow

Question 38

What 2 things do platelets need to do to work?

Answer 38

Have a contractile cytoskeleton Secrete 2 Cytoplasmic granules

Question 39

What are the 2 Granules

Answer 39

Alpha granules Dense bodies

Question 40

What do Alpha granules have inside?

Answer 40

P-selectin (adhesion) Fibrinogen (fibrin precursor) Fibronectin Factors 5 and 8

Question 41

What do dense bodies have?

Answer 41

ADP/ATP Ca++ Histamine Epi

Question 42

What bleeding disorders are caused by missing or defective vWF

Answer 42

Von Willebrands' Bernard Soulier

Question 43

What happens when a Platelet has adhered (via vWF and ECM Collagen)

Answer 43

It changes shape and releases its granules and expresses binding sites for fibrinogen

Question 44

In normal vessels what two mediators are constantly keeping hemostasis in balance

Answer 44

EC: PGI2 (vasodilator) Platelet: TxA2 (Thromboxane) Promotes platelet aggregation

Question 45

What does Aspirin do?

Answer 45

Permanently blocks TxA2. It also blocks PGI2 but the ECs can remake their own Cyclooxygenase to make more PGI2

Question 46

What works in a similar manner to Aspirin?

Answer 46

NO Nitric Oxide

Question 47

What factor does heparin inhibit?

Answer 47

10a

Question 48

What is virchow's triad

Answer 48

Edothelial Injury Changes to normal blood flow Blood Stasis

Question 49

What are lines of zahn

Answer 49

Show there is still laminar blood flow and the RBC and platelets are forming in layers

Question 50

What organs will have Red Infarcts instead of Pale?

Answer 50

Those with dual blood supply like the lungs or the GI tract