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Block 5 Material > Pathology > Flashcards

Pathology Flashcards

1
Q

Definition: edema

A

Increased interstitial fluid

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2
Q

Terms regarding other sites of increased fluid:

A
  1. Hydrothorax
  2. Hydropericardium
  3. Hydroperitoneum
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3
Q

Causes of edema

A
  1. Increased hydrostatic pressure
  2. Reduced plasma osmotic pressure
  3. Lymphatic obstruction
  4. Sodium retention
  5. Inflammation
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4
Q

Increased hydrostatic pressure causes edema through ___

A

Impaired venous return

Arteriolar dilation

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5
Q

What is hyperemia?

What kind of process? (Active or passive)

A

Arteriolar dilation leads to increased blood flow and engorgement of vessels with oxygenated blood

Active process

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6
Q

What is congestion?

What kind of process? (Active or passive)

A

Reduced outflow of blood causes increased volumes of deoxygenated blood, increased pressure, and stasis

Passive process

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7
Q

Classic sites of congestion

A

Lungs
Liver
Extremeties

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8
Q

Definition: hemorrhage

Hemorrhages in skin, mucous membranes, or serosal surfaces have specific names:

A

A release of blood into extravascular space

Petechiae 1-2 mm
Pupura >3 mm
Ecchymosis >1-2 cm

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9
Q

Clinical significance of hemorrhage depends on ___ and ___

A

Volume and rate of blood loss

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10
Q

Virchow’s Triad

A
  1. Endothelial injury
  2. Stasis or turbulent blood flow
  3. Hypercoagulability

Thrombosis: excessive clotting

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11
Q

Thrombi on heart valves are ___

A

Vegetations

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12
Q

Thrombi are usually attached __

and tend to propagate towards __

A

Attached at their site of origin

Propagate towards the heart

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13
Q

What happens to thrombi?

A 
Propagate
Embolism
Dissolve
Organize/recanalize
Microbial seeding >> mycotic aneurysm (rare)
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14
Q

Definition: emboli

A

Detached intravascular solid, semisolid, or gaseous mass carried by the blood to a site distant from the point of origin

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15
Q

Pulmonary emboli usually originate from __

A

DVT of leg above the knee

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16
Q

Fat emboli usually originate __

A

From marrow of broken long bones

17
Q

Fat emboli are sometimes accompanied by __

A

Rash

18
Q

Air emboli causes?

A

Decompression sickness from gas bubbling in tissues (esp. nitrogen)

Introduction of >100 cc of air into a vessel during a procedure

19
Q

Amniotic fluid emboli causes

A

Rupture of membranes and concurrent year of uterine vessels

High maternal mortality rate

Pathognomic: items present in amnion (fetal squames, lanugo hairs, etc) are present in embolus

20
Q

Definition: infarct

A

Coagulation necrosis corresponding to a particular vascular distribution caused by either arterial or venous occlusion

99+% are thromboembolic

21
Q

Types of infarcts:

A

Red (hemorrhagic)

  • venous
  • loose tissues
  • tissues with dual circulation (liver, lung, bowel)
  • congested tissues
  • can occur when flow is re-established to a site

White (occlusive)

  • arterial
  • more “solid” organs
22
Q

Factors that influence the development of an infarct:

A
  1. Nature of vascular supply
  2. Rate of development of the occlusion
  3. Tissue vulnerability to hypoxia
  4. Oxygen content of blood
23
Q

Definition: shock

A

Circulatory collapse with resultant hypo-perfusion and decreased oxygenation of tissue

24
Q

Causes of shock:

A

Decreased cardiac output

Widespread peripheral vasodilation

25
Q

4 major types of shock

A
  1. Hypovolemic
  2. Cardiogenic
  3. Septic
  4. Neurogenic
26
Q

Hypovolemic shock
What is it?
Causes?

A

Circulatory collapse resulting from acute reduction of circulating blood volume

Caused by:

  1. Severe hemorrhage or massive loss of fluid from the skin(injury, burns, trauma)
  2. Loss of fluid from GI tract (vomiting, diarrhea)
27
Q

Cardiogenic shock
What is it?
Cause?

A

Circulatory collapse

Resulting from:
Pump failure of the left ventricle

Most often caused by massive myocardial infarction

28
Q

Septic shock

What is it associated with?

A

Gram - infections

Cause gram - endotoxemia

  • also occurs with gram + infections
  • TSS - staph aureus
29
Q

What is MODS?

A

Multiple organ dysfunction syndrome

Can be an outcome of septic shock

Characterized by systemic shut down of vital processes

Requires major intervention

30
Q

Neurogenic shock is most often associated with ___

A

Severe trauma
and
Reactive peripheral vasodilation

31
Q

Stages of shock:

A
  1. Nonprogressive (early) stage
  2. Progressive stage
  3. Irreversible stage
32
Q 
Non progressive (early) stage of shock
Characteristics
A

Compensatory mechanisms:

  • Increased heart rate
  • increased peripheral resistance

Maintain perfusion of vital organs

33
Q

Progressive stage of shock

Characteristics

A

Tissue hypoperfusion
Circulatory and metabolic imbalance
-metabolic acidosis from lactic academia

*compensatory mechanisms are no longer adequate

34
Q

Irreversible stage of shock

Characteristics

A

Organ damage and Metabolic disturbances are so severe that survival is not possible

35
Q

Morphologic manifestations of shock

A

ACUTE TUBULAR NECROSIS OF THE KIDNEY

Others:
Brain necrosis
Liver necrosis
Fatty change in heart or liver
Patchy mucosal hemorrhages in colon
Depletion of lipid in adrenal cortex
Pulmonary edema
36
Q

What is DIC?

A

Disseminated Intravascular Coagulation

Widespread microvascular thrombi because of endothelial damage

37
Q

Causes of DIC

A
  1. Major trauma (esp crush injuries)
  2. Overwhelming infections (often gram -)
  3. Obstetric complications
  4. Mucin-secreting adenocarcinomas
  5. Prostatic surgery
  6. Venomous snake bites

Block 5 Material (17 decks)

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