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28 Cards in this Set

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1. Review the triad of Virchow.
1. Virchow: a) Endothelial injury, b) Abnormal blood flow, c) Hypercoagulability
2. DVT in the leg are most likely to embolize if they are formed where?
2. Above the knee
3. Review the 4 fates of a thrombus.
3. Thrombus: a) Resolve b) Embolize c) Organize d) Organize and recanalize
4. Which organ receives most emboli?
4. Lungs
5. What is an embolus that is lodged across a bifurcation in pulmonary arteries?
5. Saddle embolism
6. Slides of pulmonary embolisms are likely to include what other structures?
6. Alveoli.
7. What are the lines of Zahn?
7. Alternating lines of fibrin and formed elements (red blood cells, platelets). Formed more distinctively cardiac or arterial thrombi, but also in venous thrombi.
8. How does a deep vein thrombus differ from a cardiac or arterial thrombus?
8. Venous thrombi are more gelatinous, and propagate with the direction of flow?
9. How do arterial emboli propagate? Then generally, how do all emboli propagate?
9. Against the flow of blood. Thus both arterial and venous emboli propagate towards the heart.
10. Long bone fractures can cause what types of emboli? What are the microscopic characteristics?
10. Bone marrow emboli. Smaller fat globules and bone marrow cellular elements are found in the embolus. Also can cause simple fat emboli.
11. What groups are most affected by fat embolization? What is the biochemical mechanism for damage? How is this discovered in dark skinned individuals?
11. Trauma victims are most affected by fat embolisation (up to 90%). Fatty acid damage, and prothrombic activity. The skin is cut, exposing underlying fat, which can be assessed for damage.
12. What are the miscroscopic trademarks of fat embolization, especially versus bone marrow embolization? What 2 dyes are used to mark fat? Which one is more common?
12. Fat embolism will dye with “oil red O” or “osmium tetrachloride,” which is radioactive and less commonly used. Fat embolisms will present larger fat globules and no exogenous formed elements (which are found in bone marrow embolism).
13. What are the hallmarks of fat embolization syndrome (FES)? What are the descriptors of the hallmarks?
13. FES: a) Respiratory distress (Leaky vasculature causes pulmonary edema, and heavy lungs.) b) Diffuse petechiae (Diffuse coagulation) c) Cerebral/mental status change (Diffuse white matter petechiae, CNS damage: mental status change, Oil red o stained brain tissue)
14. Gunshot wounds to the head can cause what to embolize, especially to the lungs? What is the after effect of this? What is the histological appearance?
14. Brain tissue can embolize to the lungs. This will cause diffuse intravascular coagulation (DIC). Lung sections will show CNS tissue in the blood vessels, which will stain positive with CNS tissue immunohistochemical staining.
15. During the 3rd trimester of pregnancy, air introduced into the vagina (intercourse, blowing cocaine smoke, insufflation!!) can cause what type of embolism?
15. Air embolisms, which enter via the uterine veins.
16. What divers ascending too quickly suffer what embolisms?
16. Air, especially nitrogen, embolisms. Decompression sickness: caisson disease.
17. Another late pregnancy threat to the mother is embolism of what from the uterus?
17. Amniotic fluid embolism (AFE), which carries cells, hairs, and other material from the fetus. Fetal trauma, or distress, can cause meconium release, which might be found in AFEs.
18. What is an infarction? What is the difference in blood flow between hypoxic and ischemic injury?
18. Infarction is tissue death, usually due to an interruption of the blood supply, or congestion. Pure hypoxic infarct may be due to inadequately oxygenated blood, which will still carry away dangerous metabolites. Ischemic infarct is due to both hypoxia and toxic metabolite build up.
19. What type of necrosis is seen in infarction? What tissue is different? What is seen there
19. Coagulation necrosis is seen with infarcts, except for CNS tissue, which liquefies after infarct.
20. What are the 2 types of infarct, and how do their causes differ.
20. White/pale, due to arterial occlusion. Red infarct, due to venous occlusion, or blood diffusion in non-solid organs.
21. What type of infarct is usually seen in the lung? In the spleen, heart, and kidney, and other solid organs?
21. Red infarct, because of the dual blood supply. White infarct.
22. What 2 words describe shock? What are the 3 types of shock?
22. Shock: cardiovascular collapse: a) Hypovolemic b) Cardiogenic c)Septic
23. A gun shot wound (GSW) that does not hit the heart, is most likely to lead to what kind of shock? How will organs appear?
23. Hypovolemic. Organs will be pale, because of blood loss.
24. Burns lead to what type of shock?
24. Hypovolemic, because of fluid loss via exposed surface.
25. During cardiogenic shock, which organ is kept functional by compensating mechanisms? What is the general consequence of cardiogenic shock, especially in areas closer to the end of the systemic circulation, such as the liver?
25. The CNS. Other organs suffer congestion, especially the liver, with a “nutmeg” appearance, empty triads, and centrilobular hyperemia leading to necrosis.
26. What can cause cardiogenic shock?
26. MI, heart trauma, heart failure, pulmonary embolism obstructing outflow.
27. Septic shock is associated with what kind of bacteria? What bacterial component is often involved?
27. G- bacteria, especially the LPS component, can cause septic shock.
28. What kind of shock will lead to diffuse edema, which may obstruct the air way?
28. Anaphylactic shock.