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38 Cards in this Set

  • Front
  • Back
Accumulation of abnormal amount of fluid in intercellular space or body cavities
Generalized severe edema
Main reasons for edema
-Increase in intravascular hydrostatic pressure
-Fall in colloid osmotic pressure
-Impairment of lymph flow
-Renal retention of salt and water
Edema secondary to increased hydrostatic pressure is most often seen secondary to _
DVT in legs or CHF
Edema secondary to reduced plasma osmotic pressure is most often seen in _
Reduced synthesis of albumin - nephrotic syndrome or disorders of liver such as cirrhosis
Edema from impaired lymphatic flow usually occurs due to _
-Filariasis - causes elephantiasis
-Radical mastectomy
Sodium and water retention can cause edema and occurs due to _
acute renal failure
Subcutaneous edema of lower parts of the body usually occurs because of _
CHF, particularly right heart failure
Both hyperemia and congestion are _
Increased volume of blood in affected tissue or portion of body
Active, due to increased arterial blood flow in tissue
Passive, due to impaired venous drainage
Minute hemorrhages of blood into skin, mucous membranes or serosal surfaces
Common bruise is known medically as _
Normal process, process of maintaining blood in normal vascular system free from blood clots and with the rapid formation of solid plug of blood to close injuries to blood vessels
Pathologic process - formation of clotted mass of blood within vascular system
Both hemostasis and thrombosis depend on
1 - vascular wall
2- platelets
3- coagulation system
Describe sequence of events in hemostasis
-Brief period of vasoconstriction
-Injury to endothelial cell exposes subendothelial collagen to which platelets adhere and undergo activation and release ADP, serotonin, thromboxane which recruits additional platelets and forms primary hemostatic plug
3) Tissue factors and platelet factors activate plasma coagulation cascade which results in formation of thrombin that converts fibrinogen to fibrin - secondary hemostatic plug
4 - permanent plug - polymerized fibrin and platelet aggregates
Antiplatelet effect of endothelium
Intact endothelium insulates platelets from highly thrombogenic subendothelial collagen. Platelets normally do not adhere to endothelium. Prostacyclin and nitric oxide inhibit platelet aggregation
Anticoagulant properties of endothelium
Heparin like molecules increase actions of anticoagulant protein - antithrombin III which inactivates thrombin and other factors including factor Xa. Thrombomodulin binds thrombin and turns it from procoagulant to anticoagulant. This activated protein C - natural anticoagulant.
Activated protein C does what?
It inhibits clotting by proteolytic cleavage of factors Va and VIIIa
Protein S
Cofactor for protein C - anticoagulant
Fibrinolytic properties of endothelium
Endothelial cells synthesize tissue type plasminogen activators (t-PA) which promotes fibrinolytic and helps to clear fibrin deposits from endothelial surfaces
What is necessary for platelet adhesion
vWF - von-Willebrands factor
_ necessary ion in coagulation cascade
3 stimuli for platelet aggregation
Thromboxane A2
Main function of thrombin
COnversion of fibrinogen to fibrin which stabilizes secondary hemostatic plug and anchors it to the site of origin
Platelet aggregation is inhibited by _
Endothelial derived PGI2 and nitric oxide
Three major influences predisposing to thrombosis
-Injury to endothelium
-Alterations in blood flow
-Alteration in blood - hypercoagulability
Thrombi at site of acute MI are called
Mural thrombi
Fate of thrombus
Dissolution - removed by fibrinolytic process
Organization and recanalizaiton - can induce inflammation and fibrosis and later become recanalized
disseminated intravascular coagulation - sudden development of fibrin thrombi in microcirculation. Followed by rapid consumption of platelets and coagulation factors followed by profuse bleeding. Not a primary disease, but complication of some disease such as obstetrical complication or advanced tumor
Dislodged solid, liquid or gas which is carried by the blood to some other site
99 % of all emboli are _
Almost 95 % of pulmonary emboli arise from _
thrombi in deep veins of legs (popliteal, femoral)
Saddle embolism
Embolus that is impacting bifurcation of main pulmonary artery
Paradoxical embolism
Embolus that passes through interatrial or interventricular defect and gains access to systemic site of the circulation
Clinical consequences of pulmonary embolism
1) Most are silent
2) Sudden death, acute right heart failure (cor pulmonale) or cardiovascular collapse if 60 % or more is occluded
3) pulmonary infarction
Amniotic fluid embolism
1 per 50000, 86 % mortality rate