Term
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Definition
| sever generalized edema with profound subcutaneous tissue swelling |
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Term
| What happens to the kidneys in conjestive heart failure? |
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Definition
reduced blood flow
triggers renin-angiotensin-aldosterone
sodium and water retained
venous pressure increased leading to systemic edema |
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Term
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Definition
| extreme edema of the external genitalia and lower limbs usually caused by filariasis (roundworm) |
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Term
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Definition
| obstruction of superficial lymphatics in patients with breast cancer leading to edema of the overlying skin |
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Term
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Definition
| influenced by gravity, characteristic of congestive heart failure |
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Term
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Definition
more evenly distributed throughout the body
characteristic of renal dysfunction |
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Term
| What is periorobital edema characteristic of? |
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Definition
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Term
| Why would cerebral edema be rapidly fatal? |
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Definition
herniation of the brain/brainstem
compression of brainstem vascular supply |
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Term
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Definition
an active process
arteriolar dilation with increased blood flow to the tissue |
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Term
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Definition
a passive process
impaired outflow of blood from tissue
cyanotic tissue (vessels full of deoxygenated blood) |
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Term
| Chronic pulmonary congestion will have... |
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Definition
| heart failure cells (hemosiderin-laden macrophages) |
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Term
| Chronic hepatic congestion will have... |
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Definition
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Term
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Definition
| distal end, first to be affected |
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Term
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Definition
| better-off, may still have fatty change due to congestion |
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Term
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Definition
1-2mm bleed
locally increased intravascular pressure, thrombocytopenia or defective platelet function, clotting factor deficiences |
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Term
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Definition
>3 same conditions as petechiae as well as:
trauma, vasculitis, increased vascular fragility (i.e. amyloidosis) |
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Term
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Definition
| >1-2cm subq hematoma (usually from trauma) |
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Term
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Definition
| an inappropriate activation of the hemostatic process |
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Term
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Definition
temporary hemostatic plug that is reversible
brief period of arteriolar vasoconstriction (endothelin)
thrombogeneic subendothelial ECM is exposed
platelets adhere, release ADP TxA2 |
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Term
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Definition
| a potent endothelial-derived vasoconstrictor (in primary hemostasis) |
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Term
| What does an injured endothelium release to begin coagulation cascade? |
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Definition
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Term
| What does the endothelium release to allow platelet adherence? |
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Definition
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Term
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Definition
| aka PgI2 (inhibits platelet aggregation) |
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Term
| What effect does nitrous oxide have on platelet aggregation? |
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Definition
|
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Term
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Definition
| interact with antithrombin 3 to inactivate thrombin (by blocking factor 10 and 9) |
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Term
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Definition
| binds to thrombin and converts it into an anticoagulant that is able to activate protein C |
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Term
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Definition
| necessary for platelets to bind to collagen in the ECM |
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Term
| inhibitors of plasminogen activator are released from where? |
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Definition
| released from endothelium, block T-pa from binding to fibrin |
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Term
| What are in the alpha granules of platelets? |
|
Definition
fibrinogen
fibronectin
factors 5 and 8
PDGF
TGF-B |
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Term
| What are in platelet dense body granules |
|
Definition
ADP and ATP
calcium
histamine
serotonin
epinephrine |
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Term
| What receptor on the platelet binds vWF |
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Definition
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|
Term
| Why is calcium released from dense granules of platelets? |
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Definition
| Calcium is necessary for parts of the coagulation cascade. |
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Term
| What does ADP do for platelets? |
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Definition
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Term
| What receptor does fibrinogen bind to on the surface of a platelet? |
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Definition
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Term
|
Definition
| bleeding disorder caused by deficient or inactive GIIb-IIIa receptors (found on platelets that bind fibrinogen) |
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Term
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Definition
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Term
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Definition
| inhibit the activity of thrombin and other factors |
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Term
|
Definition
| inactivate factors Va and 8a |
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Term
| tissue factor pathway inhibitor |
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Definition
| inactivates factor 10a and 7a |
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Term
| d-dimer elevation seen in blood is a sign of... |
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Definition
| a fibrin split product, elevated d-dimer suggests an abnormal thrombotic state |
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Term
| what are the 3 influences that predispose to thrombus formation? (Virchow's triad) |
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Definition
endothelial injury
stasis OR turbulence of blood
blood hypercoagulability |
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Term
| what is the most significant influence on thrombus formation? |
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Definition
| endothelial injury (especially in the heart and arteris-->atherosclerosis) |
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Term
| what are some of the characteristics of a DVT |
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Definition
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Term
|
Definition
mutation in factor V that is RESISTANT TO CLEAVAGE BY PROTEIN C
allows coagulation to go unchecked |
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Term
| what do elevated levels of homocysteine cause? |
|
Definition
| inhibition of antithrombin 3 and thrombomodulin |
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Term
|
Definition
| a thrombotic mass that forms on a cardiac valve |
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Term
| antiphospholipid antibody syndrome |
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Definition
patients have antibodies to phopholipids like cardiolipid (lupus anticoagulant)
risk of thrombi, thrombocytopenia |
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Term
| what is unique about patients that have antiphopholipid antibody syndrome? |
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Definition
| false-positive test for syphilis |
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Term
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Definition
| alternating pale layers of platelets and fibrin with darker layers of RBCs in thrombi |
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Term
|
Definition
thrombus adherent to a wall
mostly endocardium, aneurysm |
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Term
|
Definition
thrombus in the veous system
usually occurs in the deep leg veins (DVT) |
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Term
| how do you differentiate thrombus vs postmortem clot |
|
Definition
postmortem clot is not attached to vessel wall
gelatinous texture
dark red dependent portion composed of red cells
yellow chicken fat supernatant |
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Term
| propagation of thrombi definition |
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Definition
| thrombus accumulates mroe platelets and fibrin leading to vessel obstruction |
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|
Term
| arterial thrombi are mostly seen where |
|
Definition
| site of injury/turbulence |
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|
Term
| venous thrombi are normally seen where |
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Definition
|
|
Term
| does a thrombus induce inflammation? |
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Definition
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|
Term
|
Definition
| bacterial seeding of a degraded thrombus |
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|
Term
| superficial venous thrombi occur typical in _____ system |
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Definition
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Term
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Definition
| "migratory thrombophlebitis" seen in cancer patients caused by procaogulants that are released from tumors |
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Term
| where do mural emboli mostly affect? |
|
Definition
| brain, kidneys, and spleen |
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Term
| what is the most common type of embolus |
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Definition
|
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Term
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Definition
| an embolus that passes from the right side of the heart through a heart defect into the left side of the heart and the systemic circulation |
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|
Term
| What percent blockage of pulmonary circulation results in severe consequences? |
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Definition
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|
Term
| Where are systemic thromboembolisms derived from most commonly? |
|
Definition
| (arterial circulation) most commonly intracardiac mural thrombi |
|
|
Term
| where do systemic thromboemboli usually lodge? |
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Definition
|
|
Term
| What characterizes fat embolism syndrome? |
|
Definition
Pulmonary insufficiency
irritability restlessness, delirium, coma
anemia
thrombocytopenia |
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|
Term
| When does fat embolism syndrome present (after long bone injury) |
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Definition
|
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Term
|
Definition
| rapid formation of gas bubbles in skeletal muscle and the tissue around joints |
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Term
|
Definition
| chronic decompression sickness (bends) |
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|
Term
| What characterizes an amniotic fluid embolism? |
|
Definition
sudden and severe dyspnea, cyanosis, hypotensive shock
seizures and coma
uterine/lung/other vessels contain FETAL SQUAMOUS CELLS |
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Term
|
Definition
ischemic necrosis caused by occlusion of either arterial supply or venous drainage
mostly arterial (97%) only a venous thrombis infarct in organ of single venous outflow such as testis or ovaries |
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|
Term
| where do red (hemorrhagic infarcts) occur? |
|
Definition
venous occlusion
loose tissue (LUNG)
tissue with dual circulation
blood flow re-established to a necrotic tissue |
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|
Term
| where do white (anemic) infarcts occur |
|
Definition
solid organs with end-arterial circulation
heart spleen, kidneys
hemosiderin-laden macrophages provide long-term microscopic evidence of a previous infarct |
|
|
Term
| how long does it take for neurons to die? myocardial? fibroblasts? |
|
Definition
3-4 minutes
20-30 minutes
can live for hours |
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|
Term
| what characterizes the beginning of septic shock? (nonprogressive stage) |
|
Definition
neurohumoral mechanisms to increase BP
tachycardia
peripheral vasoconstriction
renal conservation of fluid |
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|
Term
| what characterizes progressive stage of septic shock? |
|
Definition
widespread tissue hypoxia due to worsening circulatory imbalances
arterioles dilate and blood begins to pool
vital organs begin to fail |
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|
Term
| what characterizes the end stages of septic shock? (irreversible stage) |
|
Definition
lysosomal enzyme leakage causing tissue damage
myocardial contractile function worsens (NO effect)
complete renal shutdown from tubular necrosis
DIC |
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|
Term
| what usually causes an increase in localized hydrostatic pressure? |
|
Definition
| impaired venous outflow (congestive heart failure, kidney hypoperfusion so increase in water retention making the problem worse!) |
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|
Term
| periorbital edema is characteristic of what? |
|
Definition
|
|
Term
| the brief period of arteriolar vasoconstriction is caused by what? |
|
Definition
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