HEMODYNAMICS and THROMBOEMBOLIC DISEASES Flashcards
(129 cards)
1
Q
also termed as phlebothrombosis
A
Venous thrombosis
1
Q
Factor III is known as what?
A
Tissue Factor/ Thromboplastin
1
Q
A chronic form of decompression sickness
A
Caisson Disease
2
Q
when do the counter-regulatory mechanisms of hemostasis take place?
A
Thrombus and antithrombotic events
2
Q
Coumarin is an anticoagulant. How does it mediate its actions?
A
by inhibiting vitamin K
3
Q
finger pressure over substantially edematous subcutaneous tissue displaces the interstitial fluid and leaves a depression
A
Pitting edema
3
Q
most physiologically relevant pathway for coagulation occuring when vascular damage has occurred
A
Extrinsic Pathway
4
Q
severe generalized edema with widespread subcutaneous tissue spreading
A
Anasarca
4
Q
What is obstructed in Parasitic filariasis which causes elephantiasis?
A
Lymphatics/ Lymph nodes
4
Q
sudden or insidious onset of widespread fibrin thrombi in the microcirculation
A
(DIC) Disseminated Intravascular Coagulation
4
Q
What are the 3 main etiologies of decreased plasma protein (albumin) concentrations that ultimately lead to Edema?
A
Nephrotic Syndrome Chronic Liver Disease Malnutrition
5
Q
a membrane bound procoagulant glycoprotein that is synthesized by endothelium
A
Tissue factor/Factor 3/Thromboplastin
5
Q
What is a secondary hemostatic plug?
A
irreversibly fused mass of platelets
6
Q
sequence of hemostasis where thrombin cleaves fibrinogen to insolube fibrin
A
Secondary Hemostasis
7
Q
Hyperemia typically results to Erythema while Congestion results to?
A
Cyanosis
8
Q
Hydrostatic pressure in the arteriolar segment of the capillary
A
32 mmHg
8
Q
Patterns of Tissue Hemorrhage
A
Hematoma Petechiae Purpura Ecchymoses
9
Q
A form of cerebral edema that preferentially affects gray matter
A
Cytotoxic Cerebral Edema
9
Q
what can be found inside the alpha granules of platelets?
A
Fibrinogen Fibronectin Factors 5 and 8 platelet factor 4 platelet-derived growth factor transforming growth factor-Beta
10
Q
Subcutaneous Edema is Important. TRUE or FALSE.
A
TRUE
11
Q
What are the Calcium-dependent factors?
A
1 2 10 13
12
Q
Abnormal increase in interstitial fluid within tissues
A
Edema
12
Q
Discharge of blood out of the vascular space
A
Hemmorhage
13
Q
Differentiate Prostacyclin and Thromboxane as to: 1. Where is it derived 2. VC or VD 3. platelet Activator or Inhibitor
A
Prostacylin: VD, platelet inhibitor and endothelial derived Thromboxne VC, platelet activator and platelet derived
14
2 types of platelet cytoplasmic granules
Alpha and Sigma
14
most common primary genetic disorder of coagulability
Leiden Mutation
14
True or False. Salt & Water retention corrects the primary volume deficit caused by low serum protein
False.
15
accumulation of fluid in peritoneal space
Ascites
16
TRUE or FALSE. After exposure of Subendothelial surface from injury, Platelets adhere to a single factor in the ECM which is called the Von Willebrand Factor.
FALSE. it can also adhere to other factors such as Fibronectin
17
Microscopic morphology of Edema
Clearing Separation of ECM Subtle cell swelling
18
the Vitamin K dependent factors
9 10 7 2
20
An edema caused by increased hydrostatic pressure or decreased plasma preotein; protein poor fluid
Transudate
21
Gamna-Gandy bodies are seen in what organ as a result of congestion
Spleen
21
The initial wave of platelet aggregation is? (reversible or irreversible)
Reversible
22
accumulation of blood in the joint spaces
Hemarthrosis
23
a protease that cleaves plasminogen to form plasmin
t-PA (Tissue Plasminogen Activator)
23
Prothrombic properties
Platelet Procoagulant Antifibrinolytic
24
What are the color changes in Ecchymoses and their significance?
Red=RBC rupture Blue-green=bilirubin oxidation Gold/yellow-brown=Hemosiderin
24
components of Virchow's triad
Endothelial injury Hypercoagulability Abnormal blood flow
24
Subcutaneous Hemorrhage is Important. TRUE or FALSE
FALSE
25
what are the fates of thrombus?
Propagation Embolization Dissolution Organization
26
Chronic passive pulmonary congestion is caused by?
impeded outflow of blood from the lungs
27
TRUE/FALSE. RBC and Leukocytes can be found in a normal platelet plug.
TRUE
27
A thrombus formed in one location that detaches from a vessel wall t its point of origin and travels to a distant site
thromboembolism
28
thrombi on heart valves
Vegetations
29
Sequence of hemostasis where Hemostatic plug is formed
Primary Hemostasis
30
AGGREGATION is accomplished by binding of fibrinogen to what platelet receptor?
Glycoprotein IIb-IIIa
31
the most common cause of systemic thromboembolism
Intracardiac mural thrombi
32
Standard Assay fro coagulation pathway which specifically asess functions of factors in extrinsic pathway
Prothrombin time
34
Passive Hyperemia; reduced blood outflow from a tissue
Congestion
34
A type of Clot without the prsence of Lines of Zahn
Postmortem Clot
35
a detached intravascular solid, liquid or gaseous mass that is carried by blood to a site distant from its origin
embolism
36
What are the type of infarcts seen in the folowing: Venous occlusion Arterial Occlusion
Venous Occlusion: Red infarct Arterial Occlusion: White Infarct
38
type of edema that reflects a global disorder of fluid and Electrolyte metabolism often times associated with Heart Failure
Generalized Edema
39
general sequences of hemostasis
Vasoconstriction Primary Hemostasis Secondary hemostasis thrombus and antithrombic events
39
most important coagulation factor
Thrombin
40
cerebral edema that is a consequence of hydrocephalus
Interstitial
40
Plasminogen Activators
t-PA Urokinase-like PA (u-PA) Streptokinase
41
laminations that represent pale fibrin and platelet deposits alternating with darker red cell-rich layer
Lines of Zahn
43
Subcutaneous hematoma; RBC's in this lesion are degraded by Macrophages
Ecchymoses
43
What type of Edema is typically seen in the setting of Left Ventricular Failure?
Pulmonary Edema
45
Most common form of Cerebral edema; mainly in the white matter; BBB is disrupted
Vasogenic Cerebral Edema
45
more redblood cells are deposited in? (Arterial or Venous thrombosis)
Venous (more RBC's. less platelet)
47
other ways by which lymphatic channels may be blocked
Malignant neoplasms Fibrosis Surgical ablation
49
Protein-rich fluid; a.k.a inflammatory edema
Exudate
50
a pentasaccharide inhibitor of factor 10
Fondaparinux
51
What are "Gamna-Gandy bodies"?
iron-containing fibrotic and calcified foci of old hemorrhage
52
Px exhibits only the manifestations of a hypercoagulable state and lack evidence of other immune disorders
Primary antiphospholipid Syndrome
53
an active process that increases blood flow at a local site
Hyperemia
53
binds calcium and serve as a critical nucleation site for the assembly of complexes containing the various coagulation factors
Phosphatidylserine
55
"nutmeg" Liver is a condition of
Passive Chronic congestion of the liver
57
What glycoprotein is deficient in Bernard Soulier Syndrome
Glycoprotein Ib
59
amount of Plasma oncotic Pressure
26 mmHg
60
A condition where glomeruli become leaky due to decreased plasma protein synthesis (albumin)
Nephrotic Syndrome
62
Engorgement of alveolar capillaries, Alveolar septa edema and focal intra-alveolar hemorrhage are charactersitic of what disease?
Acute pulmonary congestion
63
amount of Air in air embolism that can elicit clinical effect
\>100ml
64
platelet derived stimulus that amplifies platelet aggregation which leads to the formation of primary hemostatic plug
Thromboxane A2
66
a.k.a. Heart-Failure cells
Hemosiderin-laden macrophages
68
consolidation of platelet plug
Secondary Hemostasis
70
Three forms of Cerebral edema
Vasogenic Cytotoxic Interstitial
71
What is more severe, Venous thrombi or Arterial Thrombi?
Arterial Thrombi (obstruction at critical sites (Cerebral and Coronary Vessels)
73
What disease characterizes a deficiency in Glycoprotein IIb-IIIa complex
Gianzmann Thrombasthenia
74
the major activator of the extrinsic clotting cascade
Tissue Factor
75
what are the classical findings in Amniotic Fluid Embolism
Fetal Squamous cells Lanugo Hair Fat from vernix caseosa Mucin in the maternal pulmonary vasculature (derived from Fetal Respiratory tract and GIT)
77
Major determinant of extracellular fluid volume (electrolyte)
Sodium or Total Body Sodium
78
the most common site of arterial thrombus are (3)
Coronary, Cerebral and Femoral Arteries
79
How does protein C mediate its action?
inhibits clotting by inactivating factors 5a and 8a
80
A detached intravascular solid, liquid or gaseous mass that is carried by the blood to a site distant from its point of origin
Embolism
81
An event when an embolus passes through an interatrial or interventricular defect and gain access to the systemic circulation
Paradoxical Embolism
82
an event that is dependent on platelet cytoskeleton that creates an irreversibly fused mass of platelets
Platelet contraction
83
an irreversible cyclooxygenase inhibitor
aspirin
84
An amplifying process of enzymatic conversions culminating in thrombin formation
Coagulation Cascade
85
Anti-coagulant effects of endothelium
Thrombomodulin Heparin-like molecule Protein S Tissue factor pathway Inhibitor
86
a form of respiratory distress in the lungs where gas bubble in the vasculature causes edema, hemorrhage, focal atelectasis or emphysema
Chokes
87
Edema of the lower extremities and thrombosis of hepatic veins
Budd-Chiari Syndrome
89
What do you call a polymerized fibrin and platelet aggregate and which sequence of hemostasis does it emerge?
Permanent Plug;Thrombus and antithrombotic events
90
infusion of amniotic fluid/ fetal tissue in the maternal circulation via a tear in the placetal membranes or rupture of uterine veins
Amniotic Fluid Embolism
92
Patients with burns are suffering from what type of edema?
Local Edema
93
Pathologic result of hemostasis; clot formation in intact vessels
Thrombosis
94
What is the function of Calcium in the Coagulation cascade?
holds components together and ensures that clotting is localized to the surface of activated platelet or endothelium
95
An area of ischemic necrosis caused by occlusion of either arterial supply or venous drainage
Infarction
96
What are the Symptoms in the Fat Embolism Syndrome?
(P-A-N-T) Pulmonary Insufficiency Anemia Neurologic Symptoms Thrombocytopenia
97
occurs when individuals experience sudden decrease in atmospheric pressure
Decompression sickness
99
Characterized by platelet adhesion, activation and aggregation
Primary Hemostasis (2nd step)
100
Accumulation of blood that may be external or contained within a tissue
Hematoma
101
sudden or insidious onset of widespread fibrin thrombi in the microcirculation
Disseminated Intravascular Coagulation (DIC)
103
pinpoint hemorrhages (1-2mm); reflects rupture of a capillary
Petechiae
105
functions as an adhesion bridge between subendothelial collagen and glycoprotein Ib platelet receptor
Von Willebrand Factor
106
painful condition from the rapid formation of gas bubbles within skeletal muscles and supporting tissues in and about the joints
Bends
108
Facilitates drainage of the interstitium
Lymphatics
109
Activates plasmin in the fluid phase
Urokinase-like PA
110
thrombus that occur in the heart chambers or in the aortic lumen
Mural thrombus
111
what can be found inside the delta granules of platelets?
ADP and ATP Ionized calcium Histamine Serotonin Epinephrine
112
the most common site of venous thrombosis (90%)
Veins of lower extremities
113
Screens for factor 12, 11, 9, 8, 10, 5 and 2
Partial Thromboplastin Time
114
Thrombus that originates at sites of turbulence or endothelial injury
Arterial/Cardiac thrombi
115
3 anti-thrombotic properties of endothelium
Antiplatelet Anticoagulant Fibrinolytic
116
Px with a well defined autoimmune dse such as SLE
Secondary antiphospholipid Syndrome
118
what 2 opposing movements control movement of water and LMW solutes between intravascular and interstitial spaces
Vascular Hydrostatic Pressure and Plasma Colloid Oncotic Pressure
119
induces a hypercoagulable state by causing endothelial injury via activation of platelets and complement directly
Antiphospholipid Antibody Syndrome
120
the most common cause of pulmonary embolism
Deep Vein Thrombosis
122
what are the characteristic features of Chronic pulmonary congestion?
thickened and fibrotic septae, hemosiderin-laden cells
123
Hydrostatic pressure in the middle segment of the capillary
20 mmHg
124
hemorrhages associated with trauma (\>3mm)
Purpura
125
Thrombus that originates at sites of stasis
Venous thrombi
126
inactivates free plasmin thus preventing excessive lysing of thrombi elsewhere in the body
Alpha-2 Plasmin inhibitor
127
Antiplatlet effects of Endothelium
Prostacyclin, NO, ADP
128
polymerizes an insoluble gel that encases platelets and other circulating cells in the secondary hemostatic plug
Fibrin
129
an edema that is caused by injury to the endothelium where vascular bed become leaky
Traumatic/Inflammatory Edema
