Term
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Definition
| severe edema of all tissues and organs |
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Term
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Definition
| edema in the peritoneal cavity |
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Term
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Definition
| fluid in the thoracic cavity |
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Term
| What is do you call fluid in the pericardial sac? |
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Definition
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Term
| Colloidal osmotic pressure in the vascular compartment is greater than the interstitial space by about ____mmHg. |
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Definition
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Term
| List the four major causes of edema. |
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Definition
| increased hydrostatic pressure, decreased osmotic pressure (systemic edema), increased capillary permeability (inflammatory edema), and lymphatic obstruction (lymphedema) |
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Term
| Edema caused by increased hydrostatic pressure is commonly due to... |
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Definition
| vascular occlusions/obstructions or congestive heart failure |
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Term
| CHF of the left ventricle causes _____ edema and CHF of the left and right ventricles causes ________ edema. |
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Definition
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Term
| What are some common causes of edema due to decreased osmotic pressure? |
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Definition
| decreased protein synthesis (liver disease), increased protein loss (nephropathies and enteropathies), and severe malnutrition |
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Term
| Edema caused by severe burns is due to... |
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Definition
| increased capillary permeability (inflammatory edema) |
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Term
| Edema caused by shock is due to... |
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Definition
| increased capillary permeability |
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Term
| What are some common causes of lymphedema? |
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Definition
| spread of malignancy, surgical removal of lymph nodes, and parasites/infection |
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Term
| Why does standing up for a long period of time cause edema? |
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Definition
| gravity increases venous pressure so hydrostatic pressure remains high on the venule side of capillaries |
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Term
| How does decreased renal function lead to edema? |
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Definition
| decreased renal function causes hypervolemia which increases hydrostatic pressure causing edema. Also proteinuria can cause loss of protein and decreased oncotic pressure resulting in edema. |
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Term
| How does heart failure cause edema? |
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Definition
| a decrease in cardiac output causes a decrease in arterial blood pressure and mechanisms in place raise fluid volume to increase blood pressure. Also, low CO causes build up of fluid in veins causing an increase in central venous pressure. This all leads to increased transudate and edema |
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Term
| T/F Edema due to increased permeability is solely due to fluid leaking out of the arterial side of the capillaries. |
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Definition
| False. It is due to leaakge from arterial and venous side |
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Term
| What's another name for elephatiasis? |
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Definition
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Term
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Definition
| edema due to increased hydrostatic pressure. Initally manifests in lower body parts 9feet legs) as subcutaneous edema. Aka "dependent edema" |
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Term
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Definition
| due to decreased osmotic pressure usually resulting from renal failure(proteinuria). More severe subcutaneous edema than cardiac, more generalized "facial edema" |
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Term
| Describe pulmonary edema. |
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Definition
| involves lower lobes, secondary to increased hydrostatic pressure. Frothy fluid on cut surface |
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Term
| Describe edema of the brain. |
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Definition
| can be localized (neoplasm or abscess) or generalized (encephalitis, hypertensive crisis). Look for narrowed sulci and swollen gyri |
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Term
| What's the difference between active and passive hyperemia? |
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Definition
| active hyperemia results from arteriolar diolation, looks bright red. passive hyperemia results from impaired venous drainage (called congestion). Blue-red color is main feature |
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Term
| What can cause passive hyperemia? |
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Definition
| heart failure (systemic), liver cirrhosis (local), and venous obstruction (local) |
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Term
| On a gross pathology study of an organ, how can you tell if there is hyperemia? |
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Definition
| excessively blood surface when you cut the organ |
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Term
| Things that cause hemorrhage usually fall into one of four categories; these categories are? |
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Definition
| trauma, artherosclerosis, inflammatory, or neotplastic erosion |
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Term
| What do you call a localized accumulation of blood in several layers of tissue? |
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Definition
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Term
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Definition
| a small (1-2mm) blled on skin or mucosal/serosal membranes dut to increased vascular pressure, lwo platelet counts or defective platelet function |
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Term
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Definition
| small surface bleeding (<1 cm). Same causes as petechia plus trauma, vasculitis, or vascular fragility |
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Term
| What do you call a largish (>1-2cm) subcutaneous hematoma? |
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Definition
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Term
| What is blood in the pleural cavity called? |
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Definition
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Term
| What do you call joint deformities due to hematoma? |
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Definition
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Term
| Iron-deficiency anemia can be due to what kinds of hemorrhage? |
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Definition
| small repeated bleeds like menstrual bleeding or peptic ulcer |
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Term
| What is the definition of shock? |
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Definition
| widespread hypoperfusion of tissues due to reduction in the blood volume, cardiac output or erdistribution of blood, resulting in an inadquate effective circulatory volume. |
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Term
| What are the inital defenses the body has to protect against shock? |
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Definition
| intense vasoconstriction, resdistribution of blood flow, fluid mobilization, and retention. |
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Term
| T/F Septic shock is a common form of shock |
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Definition
| True: 200,000 deaths/year in the US are due to septic shock |
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Term
| What organisms cause septic shock? |
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Definition
endotoxins (LPS consiting of toxic lipid A core and complex polysaccharide coat) from gram negative bacilli (e. coli, klebsiella penumoniae, proteus sp, psudomonas aeruginosa, serratia sp. and bacteriodes sp)
gram positive cocci (pneumonococci and streptococci)
some fungi and super antigens (TSS) |
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Term
| How do bacteria/toxins cause shock? |
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Definition
| activation/injury to endothelium results in cascade of inflammatory mediates such as IL-1, IFN-gamma, and TNF-alpha. This activates endothelium (a procoagulant state), more cytokines, complement system, and cogaulation cascade. This causes thrombosis, peripheral vasodilation/pooling of blood, endothelial injury (leaky capillaries), and leukocyte induced damage as well as insulin resistance, relative immune suppression/renal insufficiency and DAC |
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Term
| What can cause cardiogenic shock? |
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Definition
| mechanical dysfunction (MI, pericadial tamponade, massive PE, tension pneumothroax, acute mitral or aortic regurg) OR electrical dysfunciton (tachy or bradycardia) |
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Term
| What cause hypovolemic shock? |
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Definition
| fluid loss (vomiting, diarrhea, polyuria, burns, trauma) and blood loss (GI bleed, ruptured aortic aneurysm, massive bleed) |
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Term
| What is the mechanism behind anaphylactic shock? |
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Definition
| IgE hypersensitivity leading to release of histamine and serotonin leading to widespread vascular permeability |
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Term
| What is the mechanism behind neurogenic shock? |
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Definition
| loss of tone in vasculature causes decreased blood pressure |
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Term
| How is the liver affected by CHF? |
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Definition
| CHF results in passive hyperemia of the liver causing heptomegally and a nutmeg appearance grossly |
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Term
| Why are heart failure cells redish brown? |
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Definition
| hemosiderin granules from phagocytosing RBCs |
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Term
| What is the mortality rate of septic shock? |
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Definition
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Term
| What percentage of septic shock results in DAC? |
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Definition
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Term
| What are the stages of shock? |
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Definition
| early or compensated shock (aka nonprogressive), decompensated but reversible shock (progressive), and irreversible shock |
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Term
| Compensated shock is characterized by.. |
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Definition
| tachycardia, vasoconstriction of arterioles, and reduced urine output |
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Term
| Decompensated reversible shock is characterized by... |
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Definition
| hypotensions, tachypnea and hsortness of breath, oliguria, worsening circulatory and metabolic imbalances (acidosis) |
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Term
| Irreversible shock is characterized by... |
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Definition
| circulatory collapse, marked hypoperfusion of vital organs and loss of vital functions leading to death |
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