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basic haem > Pathology of circulatory disorders > Flashcards

Pathology of circulatory disorders Flashcards

1
Q

What are the terms used to describe an increase in blood volume within organs and tissues caused by dilation of blood vessels?

A
  • Hyperaemia: active process; increase arterial flow
  • Congestion: passive process; decrease venous outflow
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2
Q

What is oedema?

A
  • an increase in interstitial fluid in tissues
  • occurs when hydrostatic pressure is higher that the plasma colloid osmotic pressure (PCOP)
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3
Q

Generalized oedema?

A

anarsarca (swelling throughout the body; can occur in various parts of the body including the skin, subcutaneous tissue, and internal organs)

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4
Q

Localized oedema?

A
  • hydrothorax (buildup in pleural cavities)
  • hydropericardium (build up in pericardial cavity)
  • ascites (abnormal buildup of fluid in the abdominal cavity)
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5
Q

what are some egs of small bleeds?

A
  • petechiae: 1-2 mm
  • purpura: 3-5 mm
  • ecchymoses (bruise): 1-2 cm
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6
Q

What are the classes of large bleeds?

A
  • Class I Haemorrhage: up to 15% loss of circulating blood volume
  • Class II Haemorrhage: 15-30%
  • Class III Haemorrhage: 30-40%
  • Class IV Haemorrhage: >40%
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7
Q

whats menorrhagia?

A

menstrual bleeding longer than 7 days

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8
Q

Thrombus location, appearance and mechanism?

A
  • intravascular
  • granular, firm but friable (macro); lines of zahn (micro)
  • vascular injury, platelets involved
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9
Q

Clot location, appearance and mechanism?

A
  • extravascular (except at postmortem-chicken fat appearance)
  • shiny, smooth, moist
  • stasis, extravasation, no platelets involved
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10
Q

Predisposing factors to thrombosis?

A
  • vessel wall
  • blood flow
  • constituents of blood
    note: think of virchow’s triad
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11
Q

Give some causes of hypercoagulability. hint: 9

A
  • pregnancy postpartum
  • major surgery
  • malignancy
  • infection/sepsis
  • autoimmune disease
  • oestrogen therapy
  • inflammation
  • dehydration
  • inherited thrombophilia (form clots easily)
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12
Q

Give some causes of vascular damage. hint: 3

A
  • physical trauma, strain or injury
  • microtrauma to vessel wall
  • atherosclerosis
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13
Q

Give some causes of circulatory stasis. hint: 4

A
  • immobility
  • venous obstruction
  • congenital abnormalities affecting venous anatomy (may-thurner and paget-schroetter syndrome)
  • low heart rate and low BP
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14
Q

What are the components of Virchow’s triad?

A
  • endothelial injury
  • abnormal blood flow
  • hypercoagulability
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15
Q

What causes arterial thrombosis?

A
  • high flow issues
  • mainly due to vessel wall damage: atherosclerosis, neoplasia, inflammation (arthritis, trauma)
  • constituents: neoplasia, thrombophilia (thrombocytosis),
  • flow: negligible except in aneurysms
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16
Q

What causes venous thrombosis?

A
  • slow blood issues
  • mainly due to blood flow problems: systemic- congestive cardiac failure, shock; local- mass effect/ immobility
  • constituents: thrombophilia
  • vessel wall: direct trauma, pressure
17
Q

What causes thrombus in the heart?

A
  • mainly due to blood flow and vessel wall factors
  • atria: mitral stenosis, mitral regurgitation- abnormal blood flow
  • ventricle: myocardial infarction- vessel wall changes; congestive cardiac failure- abnormal blood flow
  • valves- infective endocarditis, rheumatic heart disease- abnormal blood flow
18
Q

What is the fate of the thrombus?

A
  • attached: lysis/resolve, organize/recanalize, propagate
  • detached: embolize
19
Q

What are the complications of thrombosis?

A
  • can obstruct blood vessel and lead to infarction (ischaemic injury)
  • it can dislodge/fragment and become and embolus
20
Q

Whats an embolus?

A
  • an abnormal undissolved mass that is transported from one part of the circulation to another remote from its site of origin (enters blood stream)
  • inevitably lodge in the vessels (occlusion)
21
Q

what are the types of emboli?

A
  • solid: thrombus, atherosclerotic plaque, fat droplets, tumour tissue, bone marrow fragments, shrapnel
  • liquid: amniotic fluid
  • gas: nitrogen gas, air
22
Q

whats the most common form of thromboembolism?

A

pulmonary embolism

23
Q

How do pulmonary emboli arise?

A

95% from deep leg veins proximal to popliteal fossa

24
Q

what are the different sizes of emboli and what can they cause?

A
  • large emboli can lead to death
  • medium sized emboli can lead to mild SOB
  • small emboli can lead to infarction and haemoptysis/asymptomatic
    note: repeated small emboli can lead to pulmonary hypertension
25
Q

repeated small emboli can lead to what?

A

pulmonary hypertension

26
Q

Where are the sources of systemic embolism?

A
  • > 80% cardiac: LV-myocardial infarction, LA-atrial fibrillation, mitral stenosis, valves-infective endocarditis
  • 5-10% intravascular: aortic aneurysm, paradoxical emboli
  • lower extremity (>75%), brain, spleen, kidneys- infarction
27
Q

what are the classification types of infarction (morphology)?

A
  • anaemic (white): occur in solid organs with end arterial circulation- heart, spleen, kidney
  • haemorrhagic (red): occur in loose tissues with dual circulation- lung, small intestine.
28
Q

whats infarction?

A

An infarct is a localized area of ischaemic necrosis in an organ or tissue resulting from occlusion of either its arterial supply or venous drainage.

basic haem (9 decks)

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