Vascular Disorders & Thrombosis 1

Question 1

Fluid accumulation in tissues

Answer 1

Edema

Question 2

Fluid accumulation in body cavities

Answer 2

Effusion

Question 3

Fluid accumulation within alveolar lumens

Answer 3

Pulmonary edema

Question 4

Fluid accumulation within thoracic cavity

Answer 4

Hydrothorax

Question 5

Fluid accumulation within pericardial sac

Answer 5

Hydropericardium

Question 6

Fluid accumulation within abdominal/peritoneal cavity

(2 different names)

Answer 6

Ascites or hydroperitoneum

Question 7

What are some causes of edema/effusion?

(4 possible answers)

Answer 7

• increased vascular permeability
• intravascular hydrostatic pressure
• decreased plasma colloid osmotic pressure
• decreased lymphatic drainage

Question 8

What is the pathogenesis of increased vascular permeability?

Answer 8

• Inflammatory stimuli cause local release of inflammatory mediators (histamine, bradykinin, leukotrienes, etc.)
• Endothelial cells contract, and inter-endothelial gaps widen
• Result = increased vascular permeability

Question 9

What are some clinical examples of increased vascular permeability?

Answer 9

• Infectious diseases (virus, bacteria)
• Immune-mediated (type III hypersensitivity)
• Toxins

Question 10

What is the basic pathogenesis of increased hydrostatic pressure?

Answer 10

Increased blood volume in micro-vasculature leads to hyperemia and congestion (can be localized or generalized)

Question 11

What are some clinical examples of increased intravascular hydrostatic pressure?

Answer 11

• Portal hypertension (e.g. right sided heart failure)
• Pulmonary hypertension (e.g. left-sided heart failure, high altitude diseases)

Question 12

Active increased flow of blood into the microvasculature

Answer 12

Hyperemia

Question 13

Passive accumulation of blood

Answer 13

Congestion

Question 14

What is the general pathogenesis caused by left-sided heart failure?

Answer 14

• Left-sided heart failure causes pulm. edema and congestion, and this will lead to hemorrhage
• Alveolar macrophages containing hemosiderin appear, eventually causing fibrosis then pulmonary hypertension)

Question 15

What is the general pathogenesis caused by high-altitude disease/brisket disease?

Answer 15

• High altitude causes hypoxia, which leads to pulmonary arterial vasoconstriction and pulmonary hypertension
• This causes right-sided heart failure and hepatic congestion, resulting in ascites and peripheral edema

Question 16

What is the general pathogenesis caused by right-sided heart failure?

Answer 16

• Right-sided heart failure leads to hepatic congestion, which will result in ascites

Question 17

What is the basic pathogenesis of decreased plasma colloid osmotic pressure?

Answer 17

Hypoproteinemia due to increased protein loss or decreased protein synthesis; usually generalized

Question 18

What are some clinical examples of decreased plasma colloid osmotic pressure?

Answer 18

• Increased protein loss = intestinal malabsorption, parasitism, and renal disease
• Decreased protein synthesis = liver disease

Question 19

What is the general pathogenesis caused by hepatitis?

Answer 19

• Hepatitis leads to decreased protein production, which causes hypoproteinemia in the body
• Hypoproteinemia causes a decrease in plasma colloid osmotic pressure, which leads to ascite formation

Question 20

What is the general pathogenesis caused by protein-losing enteropathy?

Answer 20

• Increased protein loss leads to hypoproteinemia in the body
• Hypoproteinemia causes a decrease in plasma colloid osmotic pressure, which leads to ascite formation

Question 21

What is the basic pathogenesis of decreased lymphatic drainage (due to lymphatic obstruction)?

Answer 21

Lymphatic vessels become compressed or blocked due to inflammation, neoplasia, fibrosis, or thrombus; usually localized