IV - Hemodynamic Disorders, Thrombosis and Shock Flashcards Preview

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Mechanism of edema in severe liver disease

Reduced plasma osmotic pressure due to reduced protein synthesis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 114


Mechanism of edema caused by Wuchereria bancrofti

Lymphatic obstruction(in Filariasis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 114


A chronic alcoholic male presented with easy fatigability and orthopnea. Chest radiograph showed bilateral pleural effusion, while abdominal ultrasound showed ascites and small liver. What is the mechanism of effusion in this condition?

Reduced plasma oncotic pressure (TOPNOTCH)


Patient X presented with pitting edema of the legs, jugular vein distention, and elevated transaminases. If the liver showed a nutmeg appearance, the patient most likely have:

Chronic passive congestion of the liver secondary to congestive heart failure (TOPNOTCH)


Patient with left-sided heart failure may develop pulmonary edema because of what mechanism?

Increased hydrostatic pressure (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 114


Assay that assesses the function of proteins in the extrinsic pathway (factors VII, X, V, II, fibrinogen)

Prothrombin time (PT) (TOPNOTCH) RobbIns Basic Pathology, 9th ed., p. 119


Assay that screens the function of proteins in the intrinsic pathway (factors XII, XI, IX, VIII, X, V, II, and fibrinogen)

Partial thromboplastin time (PTT) (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 119


Most important coagulation factor, its various enzymatic activities control diverse aspects of hemostasis

Thrombin (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 119


Prostacyclin, nitric oxide and adenosine diphosphatase action: platelet activation or platelet inhibition?

Platelet inhibition(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 121


Patient presents with epistaxis and GI bleeding. Lab result showed low platelet count. The patient may have defect in _____. Primary or secondary hemostasis?

Primary hemostasis (TOPNOTCH)


Patient presented with knee joint and swelling after a soccer game. However, no physical evidence of injury was noted. He is most likely suffering from what defect in hemostasis?

Secondary hemostasis. Bleeding into joints following minor trauma is particularly characteristic of hemophilia. (TOPNOTCH) Robbins Basic Pathology, 9th ed, p. 122


Fatal and most feared complication of severe thrombocytopenia

Intracerebral hemorrhage (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 122


Patient was on anticoagulation therapy for the treatment of arterial thromboembolism. However, few days later she was noted to have blood in the urine and reddish spots on her legs. Platelet count was 20. What is the pathophysiologic mechanism for this condition?

Formation of antibodies against complexes of heparin and platelet factor 4 on platelet surface resulting to platelet activation, aggregration, and consumption. (HIT)(TOPNOTCH)


Syndrome presenting with recurrent thromboses, repeated miscarriages, cardiac valve vegetation, and thrombocytopenia.

Antiphospholipid antibody syndrome (TOPNOTCH) Robbins Basic Pathology, 9th ed., p.124


Most common site of arterial thrombi

Coronary arteries (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 125


True or False. Saphenous vein thrombosis often cause embolization.

False. Superficial vein thrombosis rarely embolize. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126


Lower extremity DVT are often associated with____. Turbulent blood flow, endothial injury or hypercoagulable state?

Hypercoagulable state (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126


Major cause of arterial thromboses

Atherosclerosis (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 126


Systemic activation of thrombin leading to widespread formation of thombi in microcirculation, and consumption of platelets and coagulation factors.(TOPNOTCH)

Disseminated Intravascular Coagulation/Consumptive coagulopathy(TOPNOTCH)


Patient X fractures his right femur after falling from a height of 10 meters. After 2 days of hospitalization, he developed sudden onset of dyspnea, tachycardia, and restlessness. Diffuse petechial rashes was noted on his trunk. What is the most likely diagnosis?

Fat emboli (TOPNOTCH)


A 60 y/o female, bed-ridden, was admitted to the hospital with shortness of breath and hemoptysis. Physical examination finds the patient to be afebrile, tachycardic, calf tenderness and widely split S2. What is the most likely diagnosis?

Pulmonary embolism (TOPNOTCH)


A 30 year old female experienced dyspnea and edema after being injected with antibiotic. She later lost consciousness and BP rapidly declined, and later went into shock. The is due to:

Anaphylactic shock (TOPNOTCH))


A bedridden elderly patient experienced sudden onset of dyspnea and hemoptysis. The underlying lesion that led to this complication was most likely located in which site?

Veins lof lower extremity. It is the most common site of DVT leading to pulmonary embolism. (TOPNOTCH)


Exudate or transudate? Inflammation



Exudate or transudate? Nephrotic syndrome



Exudate or transudate? Chronic liver disease



A stillborn baby with Turner syndrome is found to have generalized edema and a large lymphangioma around her neck at autopsy. Heart and aorta findings were unremarkable. What is the mechanism for her edema? (A) Reduced oncotic pressure (B) lymphatic obstruction (C) sodium retention (D) inflammation

Lymphatic obstruction (TOPNOTCH) Robbins Basic Pathology 8th ed. pp82-83


Which of the following will most likely produce pulmonary edema? (A) mitral valve stenosis (B) pulmonary hypertension (C) tricuspid stenosis (D) subpulmonic valve stenosis

mitral stenosis (TOPNOTCH) Robbins Basic Pathology 8th ed. P 84


In which of the following cases would cerebral edema be more generalized? (A) a meningioma on the parietal cortex (B) viral encephalitis (C) occlusion of the right cerebral artery (D) frontal abscess

viral encephalitis (TOPNOTCH) Robbins Basic Pathology 8th ed. P84


A patient with congestive heart failure dies. At autopsy, his liver appears grossly similar to nutmeg. Which describes an expected microscopic finding? (A) lymphocytic infiltrates in the portal tracts (B) hepatocyte necrosis around central veins (C) hepatocyte necrosis around hepatic arterioles (D) vacuolated hepatocytes and giant cell formation

hepatocyte necrosis around central veins (TOPNOTCH) Robbins Basic Pathology 8th ed., p. 85.