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Hemodynamics I Flashcards

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1
Q

Where does edema build up?

A

in the interstitial space

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2
Q

Protein-poor fluid is referred to as what?

A

Transudate

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3
Q

What is fluid in the pleural space?

A

Hydrothorax

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4
Q

What is fluid in the space between the heart and pericardium?

A

Hydropericardium

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5
Q

What is fluid in the peritoneal space?

A

Ascites or hydroperitoneum

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6
Q

What causes reduced sodium retention-edema?

A

Reduced renin/agiotensin system

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7
Q

What are the two factors from heart failure that leads to edema?

A
  1. increased capillary hydrostatic pressure

2. Decreased renal blood flow

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8
Q

What is the most important protein for maintaining the colloid osmotic pressure?

A

Albumin

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9
Q

What is anasarca, and what is it caused by?

A

general, severe edema, usually due to the lack of oncotic pressure

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10
Q

What is the earliest sign of anasarca?

A

Periorbital edema

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11
Q

What happens to fluid balance when there is an increase in salt in the circulation? Why does this lead to edema?

A

Intracellular fluid flows out, lower [albumin]

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12
Q

What is the system that balances Na?

A

Renin-angiotensin system

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13
Q

Is inflammation transudate or exudate?

A

Exudate

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14
Q

What causes the edema seen in inflammation?

A

Increased capillary leakiness

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15
Q

What are the two common causes of lymphedema?

A

Neoplasia

Inflammation

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16
Q

What is the parasite that is transmitted by mosquitoes and causes elephantitis?

A

Wuchereria bancrofti

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17
Q

Why did some patients who had radical mastectomy cause severe lymphedema?

A

Removal of axillary lymph nodes

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18
Q

Where does the fluid loss increase in hydrostatic causes of edema?

A

From the venules

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19
Q

What determines the microscopic appearance of edema?

A

Whether there is protein in the exudate

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20
Q

How does edema appear microscopically?

A

Clearing and separation of the ECM, with pink if protein present

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21
Q

Why can severe edema compromise healing?

A

Compromise venous return

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22
Q

What are the two sites of edema that are particularly clinically important?

A

Lung

Brain

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23
Q

What are the three common causes of cardiogenic pulmonary edema?

A
  1. Left ventricular failure
  2. MI
  3. Systemic HTN
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24
Q

What are some of the causes of noncardiogenic pulmonary edema?

A
  1. ARDS
  2. Pulmonary infx
  3. Renal failure
  4. Alveolar hypoxia
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25
What are the clinical manifestations of pulmonary edema?
1. Dypsnea 2. Orthopnea 3. Cyanosis
26
What are the three characteristics of the cough associated with pulmonary edema?
1. Productive 2. Frothy 3. Hemoptysis
27
JVD = what?
Right heart failure
28
What are the two characteristics of the pulse associated with pulmonary edema?
Tachycardia | Bounding pulse
29
What are the breath sounds like in pulmonary edema?
Crackles
30
What are the gross findings of pulmonary edema on CXR?
1. Poorly defined pulmonary vessels 2. Visible lung fissures 3. Septal lines 4. Thick bronchial walls
31
What are the microscopica characterisitics of pulmonary edema?
Pink fluid with thickened alveolar septum
32
Hemosiderin laden macrophages =?
CHF
33
What is tonsillar herniation?
Brain swelling that leads to herniation of the brain out of the foramen magnum, leading to compression of the medulla
34
What are the three localized causes of cerebral edema?
1. Abscess 2. Neoplasm 3. Trauma
35
What are the four generalized causes of cerebral edema?
1. Encephalitis 2. HTN crisis 3. Obstruction of vein flow 4. Trauma
36
What is transtentorial herniation?
Brain herniates into the tentorium cerebelli
37
What is active hyperemia?
Active process in which arteriolar dilation results in **increased flow** of blood to a tissue
38
What are the clinical symptoms/signs of active hyperemia? Passive hyperemia?
``` active = Erythema Passive = bluish discoloration ```
39
What is passive hyperemia?
Congestion--Impaired **outflow** of blood from a tissue
40
What is the cause of systemic congestion?
CHF
41
What are the clinical signs of congestion?
Cyanosis Edema Congestion
42
What are the three major characteristics of acute pulmonary congestion?
1. Alveolar capillaries engorged with blood 2. Alveolar septal edema 3. Focal intra alveolar hemorrhage
43
What are microscopic characteristics of chronic pulmonary congestion?
Thickened and fibrotic septa Heart failure cells
44
What are the gross characteristics of nutmeg liver?
Central regions of hepatic lobules are grossly red/brown and depressed
45
What are the microscopic characteristics of chronic hepatic congestion?
Centrilobular necrosis
46
Long standing hepatic congestion maya result in what?
Hepatic fibrosis
47
What are the two classifications of hemorrhage?
External or internal
48
Blanching petechiae = ? | Non-palpable = ?
Blanching petechiae = vasculitis | Non-palpable= Angiomas
49
How does platelet dysfunction present?
Petechia
50
What is ecchymoses?
hematoma >1-2cm
51
What are purpura?
Hematoma greater than 3 mm, but less than 1 cm
52
What percent of blood volume loss can patients be okay with (if healthy)?
20%
53
What determines if Fe can be reused in hemorrhage?
only if it is internal bleeding
54
What is the etiology of edema in CHF?
Elevated hydrostatic pressure
55
What is the etiology of edema in Constrictive pericarditis?
Elevated hydrostatic pressure
56
What is the etiology of edema in ascites from liver cirrhosis?
Elevated hydrostatic pressure
57
What is the etiology of edema in venous obstruction/compression?
Elevated hydrostatic pressure
58
What is the etiology of edema in nephrotic syndrome?
Decreased plasma oncotic pressure
59
What is the etiology of edema in end stage liver disease?
Decreased plasma oncotic pressure
60
What is the etiology of edema in malnutrition?
Decreased plasma oncotic pressure
61
What is the etiology of edema in inflammation/ neoplasia?
Lymphatic obstruction
62
What causes edema with increased Renin/aldosterone?
Increased Na reuptake
63
How does interstitial edema appear on CXR?
Increased vascular pattern, with few densities Haziness to the overall CXR
64
What does alveolar pulmonary edema appear on CXR?
Patchiness
65
Left heart failure results in what?
pulmonary edema and trouble breathing
66
Right heart failure results in what?
Blood will back up into the veins resulting in signs such as jugular venous distension
67
What are the three systems that control plasma [Na]?
1. Renin/angiotensin 2. ANP 3. Symp nervous activity
68
What happens with increased Na uptake to the balance of fluid?
Shifts from intracellular to intravascular space
69
What happens with increased Na uptake to the capillary hydrostatic pressure?
Increases
70
What happens with increased Na uptake to the oncotic pressure?
Decreases d/t dilution of albumin
71
What are the two types of pulmonary edema?
Interstitial or alveolar
72
Left heart failure results in what? RIght heart?
``` Left = Pulmonary edema Right = JVD ```
73
Which comes first: pulmonary interstitial edema or alveolar?
Interstitial, then alveolar
74
Fragility of blood vessels is usually the result of what?
Vit C deficiency

Pathology (32 decks)

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