Section 3: Hemodynamic Disorders Flashcards
1
Q
Hemostasis
A
Process which causes bleeding to stop
Keeps blood in a damaged blood vessel
2
Q
Increased blood volume can be due to ___ or ___
A
Hyperemia
Congestion
3
Q
Congestion is a ___ process
A
Passive
4
Q
Venous obstruction can lead to ___ (bluish color)
A
Cyanosis
5
Q
Congestion can be caused by
A
Congestive Heart Failure
Deep Vein Thrombosis
6
Q
Chronic pulmonary congestion causes fibrotic
A
Alveolar septa
7
Q
Heart failure cells are composted of
A
Macrophages
Hemosiderin
8
Q
Heart failure cells are found in
A
Chronic pulmonary congestion
In lungs after heart failure
9
Q
Congestive hepatopathy can be caused by anything that obstructs
A
Hepatic venous drainage
10
Q
Necrosis caused by congestive hepatopathy can cause
A
Nutmeg liver
11
Q
Centrilobular necrosis
A
Central lobule of liver dying due to congestive hepatopathy
12
Q
Edema
A
Abnormal accumulation of interstitial fluid
13
Q
2/3 of body’s H2O is
A
Intracellular fluid
14
Q
1/3 of body’s H2O is
A
Interstitial fluid
15
Q
Interstitial fluid is drained by
A
Lymphatics
16
Q
2 types of edema
A
- Localized (MC)
2. Generalized (rare)
17
Q
Types of localized edema
A
- Lower extremities
- Peritoneal cavity
- Pleural cavity
18
Q
Edema in peritoneal cavity can be called
A
Ascites
19
Q
Ascites occurs due to occlusion of hepatic veins, which can occur due to
A
Cirrhosis
Cancer
Blood clots
20
Q
Edema in pleural cavity can be called
A
Hydrothorax (fluid around lungs)
21
Q
Generalized edema occurring in subcutaneous tissues can be called
A
Anasarca
22
Q
Anasarca is bodywide edema due to
A
Low dietary protein
23
Q
Edema can be caused by
A
- inflammation
- too much hydrostatic pressure
- too little osmotic pressure
- lymphatic obstruction
- retention of sodium or H2O
24
Q
Increased hydrostatic pressure is from
A
Impaired venous return
25
Localized impaired venous return
Deep vein thrombosis
26
Generalized impaired venous return
Congestive heart failure
27
Reduced osmotic pressure can be from
Too few plasma proteins
| Hypoalbuminemia
28
Most common plasma protein
Albumin
29
Too few plasma proteins can be due to
Reduced production of proteins
Increased loss of proteins
30
Increased loss of plasma proteins can be due to
Nephrotic syndrome
31
Nephrotic Syndrome
Peripheral edema
Proteinuria
Hyperlipidemia
Hypoalbuminemia
32
Lymphatic obstruction can occur due to
Inflammation / fibrosis
Tumors
Inactivity
33
Damage to which organs are most likely to be involved with edema
Liver
Heart
Kidney
34
Filariasis aka
Elephantiasis
35
Filariasis caused by
Extreme lymphatic obstruction due to bacterial infection
36
A mastectomy can cause ___ due to scar tissue obstructing lymph drainage
Lymphedema
37
Peau d’orange
Tethering of sweat glands of the breast due to edema pushing upward
Due to severe lymphatic obstruction
38
Causes of sodium and water retention
A. High salt diet
B. Hypoperfusion to kidneys
C. Acute renal failure
D. Poststreptococcal glomerulonephritis
39
Increased water volume causes increased
Pressure
40
Exudate
Protein rich edema
41
Dependent edema
Ankles or sacrum (pressure ulceration)
42
Cerebral edema
Increased intracranial pressure
43
Cerebral edema can be caused by
Abnormal BBB (tumors, infection, trauma)
Cell membrane injury (toxins, hypoxia)
44
Pitting edema
Transudate accumulates
Protein poor
No osmosis
Non-inflammatory
Ex. Heart Failure
45
Non-Pitting Edema
Exudate accumulates
Protein rich
Osmosis
Inflammatory
46
Hemorrhage
Extravasation of blood from vessels
47
Hypovolemic shock
Rapid loss of greater or equal 20% of blood volume
48
Hematoma
Large accumulation of blood within tissue
49
Contusion
Trauma causing bruise (hematoma)
50
Ecchymosis
Minor trauma
Hematoma from unlikely trauma
51
Petechiae
Small area of hemorrhage (1-2mm)
52
Common cause of petechiae
Low platelets
Vit K deficiency
Vit C deficiency causing vessel fragility
53
Purpura
Slightly larger hemorrhage (3-5 mm)
54
Common causes of purpura
Mechanical trauma
Vasculitis
Vessel fragility from Vit C deficiency
55
Progressive change of color in contusions
Red/blue —green— yellow
56
Transition of color in contusions is due to hemoglobin broken down to ___ and ____
Bilirubin
| Hemosiderin
57
3 main components of normal hemostasis
Platelets
Endothelium
Coagulation cascade
58
Primary hemostasis occurs when ___ aggregate on vessel wall following endothelial damage
Platelets
59
Endothelial Damage exposes sub-endothelial ___ and ___ to contents of blood, activating platelets to form ___
Von Willebrand factor (vWF)
Collagen
Primary plug
60
Secondary hemostasis involved formation of
Fibrin-rich clot
61
Endothelium normal ____ thrombosis
Inhibits
62
Injury to vascular endothelia exposes _____
Tissue factor
63
Thrombin cleaves ____ into ___
Fibrinogen
Fibrin
64
Coagulation cascade activates
Thrombin
65
____ (in bone marrow) produce platelets
Megakaryocytes
66
Virchow’s Triad
Endothelial injury
Hypercoagulability
Abnormal blood flow
67
Endothelial activation
Normal anti-thrombotic endothelia become pro-thrombotic
68
Stimuli that may cause endothelial injury
```
Atherosclerotic plaques
Inflammation
Abnormal blood flow
Hypercholesterolemia
Toxic exposure
```
69
Aspirin is an ___ drug
Antiplatelet
70
Warfarin and heparin are ___ drugs
Anticoagulants
71
Abnormal blood flow promotes
Endothelial activation
72
Excessively viscous blood results in stasis, which makes the blood prone to
Clotting
73
Polycythemia
Increased RBC
74
Highly viscous blood may be caused by
Polycythemia
Sickle cell disease
75
Mutations that may cause hyper-coagulability
Factor V
Prothrombin
76
4 fates of a thrombus
Dissolve
Enlarge
Embolize
Organization
77
Features of a venous thrombus
Congestion
Tenderness
Pitting edema
78
Features of arterial thrombus
Cell injury
Inflammation
Infarction
79
Venous thrombosis grows ____ venous blood flow
Along with
Anterograde
80
Venous thrombi begins at site of
Stasis
81
Common locations of venous thrombi
Popliteal or femoral
82
90% of venous thrombi occur in
Lower extremities (DVT)
83
Arterial thrombi grow ___ arterial blood flow
Against
Retrograde
84
Arterial thrombi begins at
Site of injury/ turbulence
85
Common locations of arterial thrombi
Coronary
Cerebral
Femoral
86
All thrombi roads lead to the
Heart
87
Lines of Zahn
Microscopic light and dark layers of a thrombus due to platelets and RBCs at a site of high blood pressure
88
For lines of Zahn to form, the patient must be
Alive when the clot formed
89
Disseminated Intravascular Coagulation (DIC)
Widespread thrombosis/ coagulopathy
Complication of severe trauma
Widespread organ failure
90
Embolism
When a detached intravascular mass (embolus) becomes lodged in a vessel
91
Types of emboli
Solid
Liquid
Gas
92
Ex of solid emboli
Thrombus, fat, plaque
93
Ex of liquid emboli
Amniotic fluid
94
Ex of gas emboli
Air
| Nitrogen (Caisson Disease)
95
Pulmonary embolism occurs due to
Occlusion of pulmonary artery
96
____ of PE are recurrent
30%
97
___ of PE originate from DVTs
95%
98
____ of PE are small and clinically silent
80%
99
___ of PE are massive and fatal
2%
100
Tachypnea
> 20 BPM
101
Systemic thromboembolism occurs within the
Arterial system
102
Paradoxical embolism
Crosses from venous to arterial system
103
For someone to have a paradoxical embolism, there must be either _____ or ____
Atrial septal defect
Ventricular septal defect
104
Infarction
Death of tissue, due to obstructed blood supply
105
Red (hemorrhagic) infarction occurs in lungs due to
Natural cavities and dual blood supply
106
White (pale/anemic) infarction occurs in
Solid walled organs
107
Shock
Inadequate blood supply (perfusion) to tissues, resulting in cellular injury dysfunction and possibly death
108
Types of shock with peripheral vasoconstriction and SNS activation
1. Cardiogenic
| 2. Hypovolemic
109
Cardiogenic shock occurs due to
Pump failure —decreased output
110
Hypovolemic shock occurs due to
Loss of blood/plasma volume
111
Types of sock with peripheral vasodilation
1. Septic
2. Neurogenic
3. Anaphylactic
112
Septic shock
Systemic immune reaction
113
Neurogenic shock
<60 BPM
CNS trauma
114
Anaphylactic shock
Severe allergy
115
Vasovagal syncope
Decreased HR
Decreased BP
Lightheaded
Vision problems
116
Stages of shock
1. Nonprogressive
SNS compensatory mechanisms
2. Progressive
Widespread hypoperfusion
3. Irreversible
Widespread membrane damage
