Term
| How do you know if someone has had a previous thrombosis (histologically)? |
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Definition
| Can see reorganization of the thrombus and recanalization such that there are more lumens. |
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Term
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Definition
| 1) ADHESION to ECM mediated by vWF which bridges surface receptors of platelets and exposed collagen. vWF (and gpIb) are strong enough to overcome shear forces of flowing blood. |
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Term
| Describe secretion in platelet aggregation? |
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Definition
| Platelets secretion thromboxine A2 and ADP. TxA2 is a stimulus and ADP is important mediator of aggregation. Agonists bind to platelet surface R and intracellular phosphorylation cascade leads to these 2 things being secreted. |
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Term
| Describe platelet aggregation. |
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Definition
| Creates a hemostatic plug. Activation of the casc ade leads to generation of thrombin: binds to platelet R, cascade, more ADP and TxA2, further aggregation of platelets, which is then followed by platelet contraction, creating irreversibly fused mass of platelets. At the same time, thrombin converts fibrinogen to fibrin within and about the platelet plug, cemeting platelets in place. |
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Term
| What 3 factors are prothrombotic? |
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Definition
| 1) vascular damage 2) platelet activation 3) activation of coag cascade. |
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Term
| what factors are antithrombotic (4 things ) |
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Definition
| normal blood flow, anticoags, fibrinolytic system, endothelium. |
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Term
| tan to white areas of myocardial scarring indicate what? |
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Definition
| remote healed myocardial infarction |
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Term
| patients with WHICH TYPE OF EMBOLUS have a high mortality rate? |
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Definition
| saddle pulmonary thromboembolus.A pulmonary thromboembolus travels from a large vein in the leg up the inferior vena cava to the main pulmonary arteries as they branch. Such thrombi embolize most often from large veins in the legs and pelvis where thrombi form with stasis. |
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Term
| the difference between thrombus and thromboembolus is.... ? |
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Definition
| thromboembolus is a thrombus that breaks loose and is carried by blood stream to clog another vessel (lung=pulmonary, but can be brain, GI, kidneys, etc). |
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Term
| A true thrombus has alternating lines of fibrin/platelets and red blood cells (more red)--what are these alternating structures called? |
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Definition
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Term
What is the following describing: increased fluid in the interstitial tissue splaces as a result form inflammation or hydrodynamic derangements (increased hydrostatic pressure for example or sodium retention).
WHAT ARE THE INFLAMMATORY AND HYDROSTATIC FORMS OF THE ABOVE. |
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Definition
| EDEMA. Either increased capillary pressure or decreased colloid osomotic pressure can result in interstitial fluid increase. Inflammatory edema is a protein-rich exudate;; hydrostatic edema is a protein-poor transudate. |
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Term
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Definition
1) increased hydrostatic pressure
2) reduced plasma osmotic pressure by too little plasma protein
3) lymphatic obstruction
4) sodium retention |
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Term
| what are specific causes of pulmonary edema? what would the sectioned lung look like? |
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Definition
1) left ventricular failure
2)renal failure
3) acute respiratory distress
4) infections.
***sectioned lung will contain frothy, blood-tinged fluid that is a mix of air, edema fluid, and extravasated RBCs. FLUID IS TRANSUDATE (more gross than histological). |
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Term
| passive congestion results from impaired _________ to/fro (pick) from a tissue. |
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Definition
| Passive is impaired outflow from a tissue (venous). capillary rupture and hemorrhage can occur. tissue is CYANOTIC. hemosiderin fills the macrophages--these are known as HEART FAILURE CELLS. |
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Term
| T/F. Nutmeg liver is due to active congestion. |
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Definition
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Term
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Definition
| active congestion: augmented tissue flow due to arteriolar dilation, engorgement of vessels with oxygenated blood. |
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Term
| hemorrhage occurs under what conditions? |
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Definition
1) chronic congestion
2) hemorrhagic diatheses disorders cause an INCREASED TENDENCY |
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Term
| why is it called a "saddle" embolus? |
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Definition
| it straddles the arterial bifurcation and thus block BOTH branches. can be found in pulmonary artery. |
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Term
| Thrombi that form on heart valves are called... _______ ? |
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Definition
| VEGETATIONS. can be a result of infection (infective endocarditis), or in noninfected with hypercoagulable states. |
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Term
| what should you look for histologically to determine coronary atherosclerosis? |
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Definition
1) fibrous cap--indication of a plaque, with raised focal lesion within the intima that consists of soft, lipid-filled core with firm, white, fibrous cap (smooth muscle, MP, foam cells, lymphocytes, collagen, elastin. Lipid core or necrotic center is mostly foamy macrophages, Chol crystals, cell debris, calcium.)
2) calcification |
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Term
| What is found between the fibrous cap and the intima layer in an athersclerotic patient? (histologically) |
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Definition
| necrotic center: cell debris, cholesterol crystals, foam cells, calcium |
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Term
| After ABO incompatible transfusion, there is an activation of the ________ system. |
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Definition
| COAGULATION. antigen-antibody complex--> complement system--> platelets--> platelet factor 3 (plus activation of intrinsinc clotting system from Hageman factor)-->prothrombin-->thrombin--> fibrin laid down. |
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Term
Virchow's triangle encomapsses the 3 major causes of thrombosis: hypercoagulability, endothelial injury, and ______ ?
What genetic factor causes hypercoagulability? |
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Definition
1) also alterations in blood flow! turbulence is the main contributor. IT causes endothelial injury and leads to formations of pockets of stasis.
2) hypercoagulability: factor V Gene and prothrombin genes are most common but hypercoag can be acquired via cardiac failure, trauma, oral contraceptives, cancer, obesity, etc. |
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Term
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Definition
| 1) cardiogenic; hypovolemic (blood loss or plasma volume loss); septic (microbial infection-->dilatation of vessels). |
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Term
| Fill in the blanks: In normal hemostasis, there is a brief period of arteriolar _______; platlets then adhere and becocome activated forming a _________ _____; tissue factor is made by the endothelium which activates thrombin, converting ______ to _______, causing deposition of this same material; Permanent plugs can be formed by the polymerized form of this same material. |
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Definition
1) vasoconstrition (briefly occurs)
2) hemostatic plug forms from activated platelets.
3) thrombin converts fibrinogen to fibrin, causing local fibrin deposition.
4) POLYMERIZED fibrin and platelets form a solid permanent plug. |
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Term
| What the difference between pre-mortem and post-mortem thrombus? |
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Definition
| pre mortem thrombi have LINES OF ZAHN and are adherent to endothelium. post-mortem thrombi have dark red portion where RBCs settled by gravity resembling "RED CURRANT JELLY" and a yellow "CHICKEN FAT" supernatant. They are NOT attached to vessel wall. |
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Term
| Aneurysm is a _______ of a vessel wall th at causes it to bulge out. It may eventually rupture causing hemorrhage. can also be a site of stasis and thereby thrombus. |
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Definition
| WEAKENING OF VESSEL WALL. |
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Term
| What is the characteristic type of cell in fatty streaks? |
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Definition
| fatty streaks are the earliest lesoin of atherosclerosis, and are composed of lipid-filled FOAM CELLS. They don't interfere with blood flow ..YET. |
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