Pathology_Edema, Congestion, Hemorrhage, Shock

Front 1

Hyperemia

Back 1

increased blood flow

Front 2

Ischemia

Back 2

impaired arterial blood flow
can be caused by:
1. narrowing d/t congenital stenosis or atherosclerosis
2. arterial obstruction from a thrombus or embolism
3. functional obstruction from an arterial spasm

Front 3

Hemorrhagic

Back 3

bleeding

Front 4

thrombus

Back 4

an intravascular mass attached to a vessel wall. Can be composed of coagulation factors, RBCs and platelets.
red thrombus- venous
white thrombus - arterial

Front 5

embolism

Back 5

Detached mass (ex. clot, fat, gas) that is carried through the blood to a distant site

Front 6

stenosis

Back 6

narrowing of a vessel

Front 7

venous return

Back 7

the amount of blood that returns from venous circulation to the heart. Main determinant of preload.

Front 8

Passive Hyperemia or Passive Venous Congestion

Back 8

Venous congestion is the dilation of veins and capillaries due to impaired venous drainage which results in passive hyperaemia or venous congestion, commonly referred to as congestion.

Front 9

Systemic (general) venous congestion

Back 9

engorgement of systemic veins, eg.in left-sided and right-sided heart failure and lung diseases (such as pulmonary fibrosis) which interfere with pulmonary blood flow

Front 10

Local venous congestion

Back 10

due to obstruction and subsequent reduced venous outflow from an organ or part of body, e.g. portal venous obstruction in cirrhosis of liver

Front 11

Hematoma

Back 11

a localized collection of blood outside the blood vessels, usually in liquid form within the tissue

Front 12

Main Four Mechanisms that Cause Edema (rr)

Back 12

1. Aterations in Starling Pressure
2. Increased Vascular Permeability
3. Lymphatic Obstruction
4. Increase synthesis of ECM components like GAGs

Front 13

Examples of Things that would decrease plasma oncotic pressure (rr)

Back 13

1. kwashikor
2. cirrhosis w/ dec. albumin
3. nephrotic syndrome where you pee out ptn.
4. malabsorption w/ dec. ptn uptake

Front 14

Things that would increase vascular hydrostatic pressure (rr)

Back 14

1. Right sided heart failure --> pulmonary edema
2. Right sided heart failure--> peripheral pitting edema
3. Portal hypertension in cirrhosis --> ascites

Front 15

Ex. of how renal retention of Na and Water can lead to edema

Back 15

1. Inc. hydrostatis pressure ( causes inc. plasma volume)
2. Dec. oncotic pressure (dilutes albumin)

ex. acute renal failure or glomerulonephritis or Renin Ang. Aldosterone System

Front 16

Edema in Renal Disease

Back 16

Dec. GFR causes Fluid and Na retention
1) this increases hydrostatic pressure
2) this decreases oncotic pressure

Front 17

Edema in Liver Disease

Back 17

1. cirrhosis --> hypoalbumenia--> dec. oncotic pressure
2. inc portal hypertension causes increased vascular hydrostatic pressure
3. Lymphatic system gets compressed
4. GFR decreases, increases aldosterone

Front 18

Portal Hypertension

Back 18

1. splanchnic congestion
2. splenomegaly
3. ascites, edema

Front 19

Examples of Lymphatic Obstruction that would lead to edema (rr)

Back 19

1. Masectomy
2. Filiarsis d/t to Wucheria Bancrofti
3. Scrotal and vulvar lymphedema d/t lymphogranuloma venereum
4. Breast lymphedema d/t cancerous block of subq lymphatics.

Front 20

What are the 5 types of Shock?

Back 20

1. Hypovolemic
2. Cardiogenic
3. Septic**

4. Neurogenic
5. Anaphylactic

Front 21

Hypovolemic Shock: is caused by

Back 21

D/t excess fluid loss (over 20% of blood volume, aprox. 1000 ml) ex.:
1. Hemorrhage
2. Diarrhea
3. Burns

Front 22

Hypovolemic Shock (rr): path + symptoms

Back 22

1. Dec CO d/t dec. blood vol.
2. Dec. LVEDP
3. inc TPR d/t catecholamines, ADH, AngII, etc.Dec. Mixed venous O2 content
(indicates tissue hypoxia)

clinical signs: Cold clammy hands d/t VC, hypotension, rapid weak pulse

Front 23

Cardiogenic Shock: Is caused by

Back 23

1. Most commonly d/t acute MI ***
2. ventricular rupture
3. cardiac arrythmia
4. cardiac tamponade
5. pulmonary embolism

Front 24

Cardiogenic Shock: Path + symptoms

Back 24

1. Dec. CO d/t dec force of Left Ventricle
2. Inc. LVEDP, blood acumulates in left ventricle
3. Inc. TPR, same as hypovolemic shock
4. Inc MVO2 , "

clinical signs: chest pain w/ signs cold clammy hands, weak pulse

Front 25

Septic Shock: what is it + what can trigger it**

Back 25

systemic inflamatory response (SIRS) d/t an infection.
usually d/t gram- pathogens (endotoxins/LPS)
Also superantigens, some gram + and fungal infxns.

Front 26

Septic Shock: Path mechanism **

Back 26

1.LPS endotoxin binds macrophages.
2. Macrophages release IL-1 + TNF to get pmns.
(TNF --> Vascular Permeability)
3. neutrophils + endotoxin damage endothelial cells --> release NO + PGI1 (Vasodilators). Also activates clotting cascade.
4. endotoxin activates alternative complement pathway (C3a +C5a) stim mast cell release, histamine (VD)

Front 27

Disseminated Intravascular Coagulation **

Back 27

widespread endothelial damage
--> massive activ. of coagulation system (extr + intr) uses up all the body's clotting factors.

Front 28

Complications associated with Shock (rr)

Back 28

1. Ischemic Acute Tubular Necrosis (coag necrosis of prox tubule cells + cells in TAL)
2. Multiorgan Dysfunction***
most common cause of death
3. Lactic Acidosis d/t tissue hypoxia

Front 29

Initial Clinical Symptoms of Shock (rr)

Back 29

1. Warm skin d/t vasodilation of skin vessels
2. Bounding pulse d/t inc. CO
3. Acute Respiratory Distress Syndrome

Front 30

Septic Shock: Venk, clinical progression of symptoms

Back 30

hypotension,
tachypnea, tachycardia (compensatory response to dec. CO)

warm skin initially, then cool skin and cyanosis.

renal insuficiency, obtundance, death

Front 31

Septic Shock events: Venkt

Back 31

1.systemic vasodilation (hypotension)
2.dec dp/dt
3. diffuse endothelial activation
4. leukocyte adhesion
5. alveolar damage --> ARDS
6.DIC
7. Vascular organ failure

Front 32

How does congestive cardiac failure cause edema

Back 32

Left heart failure:
1. dec. CO
2. dec. RBF -> Na+ H20 retention
3. activates renin angiotensin axis
4. backs up all venous blood before the left ventricle --> pulmonary edema

Right Heart Failure:
increases central venous pressure, capillary filtration pressure --> pitting edema

Front 33

What is the word for generalized edema with effusion in body cavities

Back 33

anasarca