Term
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Definition
-Transudates are caused by disturbances of hydrostatic or colloid osmotic pressure, not by inflammation. They have a low protein content in comparison to exudates
-An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation. Has a high protein/cell content
-The specific gravity breaking point is greater or less that 1.015 (less than for transudate) |
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Term
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Definition
| -Generalized subcutaneous accumulation of fluid, usually due to marked hypoalbuminemia (often from cirrhosis) |
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Term
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Definition
| -Pits on pressure (over shin) |
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Term
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Definition
-Parasitic disease where the lymphatics can become obstructed from fibrosis (formation of excess fibrous connective tissue) causing lymphedema
-May cause elephantiasis |
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Term
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Definition
-When we get a drop in blood volume renin kicks in
-It stimulates aldosterone (mineralocorticoid) which in turn stimulates retention of Na+ and water leading to increased plasma volume leading to edema
-Also gives us more angiotensin, which acts to raise BP through water and salt retention |
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Term
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Definition
-Passive process where there is decreased venous outflow and organs become engorged with venous blood
-Like in congestive heart failure |
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Term
| What cells are characteristic of congestion in the lungs? |
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Definition
-Hemosiderin-laden macrophages (AKA heart failure cells)
-From left sided heart failure
-Causes brown color in the lungs |
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Term
| What is active hyperemia? |
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Definition
-arterial vasodilation
-normal in some cases like EXERCISE, but can be pathological in acute INFLAMMATION
-Passive hyperemia is the result of obstruction and is typically venous (i.e. congestion) |
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Term
| Passive congestion in the liver? Cause? Appearance? |
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Definition
-The congestion is the pathological result of pressure back up usually from right sided heart failure
-Causes a "nutmeg" appearance of liver |
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Term
| Hemorrhage? Petechiae vs purpura vs ecchymoses? |
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Definition
-Leaking of blood through defect in vessel wall
-Petechiae; very small dots
-Purpura; small dots from 0.2 to 1cm
-Ecchymoses; bruise |
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Term
| Define; Epistaxis, hematemesis, hemoptysis, & melena |
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Definition
-Epistaxis; nose bleed
-Hematemesis; vomiting blood
-Hemoptysis; coughing up blood
-Melena; tarry-collored, partly digested blood in stool |
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Term
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Definition
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Term
| What errors usually cause small and large bleeds? |
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Definition
-Small bleeds (petechial or purpuric) are usually from platelet errors
-Large bleeds or in deeper tissues are usually from coagulation factor deficiencies |
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Term
| What is thrombosis and what typically causes it? |
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Definition
-Process of thrombus formation; coagulated, solid fibrin-platelet mass (with entrapped RBCs)
-Often the result of atherosclerosis |
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Term
| What are the two fluid flow properties predisposed to thrombus formation? |
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Definition
-Turbulent flow, like at bifurcations
-Stasis (slow flow), like in congestive heart failure or in immobilization (deep vein thrombosis in lower limbs) |
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Term
| What is the most common coagulation cascade protein to mutate in hereditary hypercoagulable disorder? |
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Definition
-Factor V, such that protein C cannot affect it
-Deficient protein C or S and antithrombin III can also cause hypercoagulability |
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Term
| Ante mortem thrombi? How can we tell? |
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Definition
-Thrombus formed before death
-We can tell because it will have lines of Zahn (layers of platelet and fibrin)
-A post mortem clot will be jelly-like |
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Term
| How do we tell the difference between arterial and venous thrombi? What do we call venous thrombosis specifically? |
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Definition
-Venous will be redder and less laminated looking because there will be less fibrin and more RBCs trapped.
-Phlebothrombosis |
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Term
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Definition
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Term
| What do we call thrombi formed on heart valve surfaces? |
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Definition
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Term
| What is a drug that can cause thrombosis? How? |
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Definition
-Oral contraceptives
-The estrogen causes a rise in Vit K dependent factors |
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Term
| What are the four possible fates of a thrombus? |
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Definition
1. Propagation; eventual blocking off of blood vessel
2. Resolution; thrombolysis (the most common fate)
3. Embolization; lodging at another site
4. Organization; conversion to vascular tissue with obstruction (can be into wall or recanalized) |
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Term
| What does fibrinolysis and what things activate it? |
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Definition
-Plasminogen lyses clots
-It is activated by t-PA
-Can also be activated by streptokinase and urokinase
-Both t-PA and urokinase are in turn inhibited by PAI |
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Term
| What is the source of most arterial emboli? |
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Definition
| -The heart (mural thrombi) |
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Term
| What are the five signs of a lower limb embolism? |
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Definition
| -The five P's; pain, paresthesia, pallor, pulselessness, paralysis |
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Term
| What is Homan's sign? What can it result in? |
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Definition
-Calf pain when foot is dorsiflexed and knee is slightly flexed
-Sign of deep vein thrombosis
-May eventually lead to a pulmonary embolism |
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Term
| What are the signs of pulmonary embolism? What is usually the fate of a pulmonary embolism? |
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Definition
-Tachycardia, dyspnea, and tachypnea (fast heart, shortness of breath, and fast breathing)
-Most dissolve, but if 70% of blood or more is cut off, it can cause sudden death (saddle embolus in main trunk) |
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Term
| What causes a fat embolism? |
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Definition
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Term
| What is Caisson's disease? |
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Definition
-The bends, basically
-Causes air embolism |
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Term
| What is an amniotic embolism and what causes it? |
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Definition
-When the amniotic fluid gets into the uterine veins due to a tear
-Will have fetal epithelial cells and lanugo hair
-Most common with there is a tumultuous labor with deliver of a dead fetus
-Results in shock then DIC then death |
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Term
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Definition
-Disseminated intravascular coagulation
-We see this in association with septic shock (from all the LPS) and in amniotic embolism |
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Term
| What is an infarction? What are the two types? |
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Definition
-Localized area of ischemic coagulative necrosis resulting from sudden reduction of blood flow
-Can be white (hard tissue like heart) or red (soft tissue like the lungs that have dual blood supply) |
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Term
| Hypovolemic shock vs cardiogenic shock vs endotoxic shock vs anaphylactic shock vs neurogenic shock? |
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Definition
-From fluid loss (hemorrhage, dehydration, burns, etc.)
-From decreased cardiac output
-From LPS from gram negative bacteria causes widespread inflammation reaction (active hyperemia)
-From allergic reaction, also causes widespread active hyperemia
-Central nervous system/injury causes autonomic disturbance and widespread active hyperemia |
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Term
| What are the signs of shock? |
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Definition
-HAT COAT
H - hypotension
A - acidosis
T - tachycardia
C - cold and clammy skin (warm in septic)
O - oliguria
A - apprehension
T - tachypnea |
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Term
| What are the three stages of shock? |
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Definition
-Stage 1 - body compensates
-Stage 2 - decompensation (reversible damage)
-Stage 3 - irreversible damage |
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