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17 Cards in this Set

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1. What is edema? Anasarca?
1. Edema is excess fluid in the interstitial tissue space. Anasarca is generalized edema.
2. What is the difference between transudate and exudate?
2. transudate is a protein poor edematous fluid with a specific gravity under 1.012, resulting from non-inflammatory mechanisms. Exudate is a protein rich edematous with specific gravity over 1.012 resulting from increases in vascular permeability during inflammation
3. What is the normal net rate at which fluid flows in the interstitial space?
3. 2ml/min (14ml/min at arteriolar end of capillary balanced by 12ml/min at venous end of capillary).
4. How is hydrostatic pressure (one of the four causes of edema) increased locally? Systematically?
4. Local increases in hydrostatic pressure can be due to a blockage in venous outflow. This will cause the pressure on the arteriolar side to increase (ex. DVT). Systematic increases in hydrostatic pressure are due to cardiac failure.
5. How do the kidneys react to the decreased cardiac output in cardiac failure?
5. they release renin, causing the formation of Angiotensin II, which causes the aldosterone secretion and vasoconstriction. Aldosterone causes increased Na+ retentionà increased blood volume.
6. What is the effect of the renin-angiotensin system in heart failure?
6. Increased blood volume further stresses the failing heart.
7. What occurs in left ventricular failure? Right ventricular failure?
7. Heart failure: a) LVà blood backs up into the LA, impairing venous return from the lungs. Pulmonary edema occurs and lungs can increase in weight by 2-3x/ b) RVà this failures usually occurs after LV failure. Venous return from SVC and IVC to RA is impeded. SVC and IVC get congested. Tissue and organ edema occur with pitting.
8. What occurs when there is reduced plasma oncotic pressure?
8. osmotic pressure at the venous end of the capillary bed is not enough to retrieve the interstitial fluid. Plasma volume, therefore blood volume, decreases, and the kidneys release renin, increasing fluid retention, which further dilutes blood, further reducing plasma oncotic pressure.
9. What are causes of decreased plasma oncotic pressure?
9. Protein malnutrition: Kwarshikor, cirrhosis: alcoholic, etc.
10. What occurs when there is a lymphatic obstruction?
10. there will be edema distal to the obstruction (yeah, I you know.)
11. What is hyperemia?
11. increased blood volume due to demand
12. What is congestion? What is the effect of long standing congestion?
12. the passive back-up of blood due to venous obstruction. Causes necrosis.
13. What occurs in acute pulmonary congestion?
13. fluid in the alveolar space
14. What occurs in chronic pulmonary congestion?
14. RBC’s continue to fill the alveolar spaces, and the septa thicken due to the increase in fibrosis. Macrophages enter the alveolar space to phagocytize the RBC’s: known as heart failure cells.
15. What occurs in nutmeg liver? What can take place in the long term?
15. venous blood backs up from the central vein outward. Central areas are congested with RBC’s and hemosedrin laden macrophages and lipofuscin filled hepatocytes. Long term, leads to cardiac cirrhosis.
16. What is a petechial hemorrhage? Purpura?
16. 1-2 mm lesions on the surface of the skin. Pupura: 3-5 mm in size, occur in vasculitis and in any condition in which vessels are fragile.
17. What is ecchymosis? Hematoma?
17. Ecchymosis: lesions larger then 1cm and occur in the subcutaneous tissues. AKA bruiseà initial color is red (Hb), green (bilirubin), yellow-brown (hemosiderin). Hemoatoma: a large collection of blood