Notes in PTH.S1.L09.Hemodynamic Disorders, Thromboembolic Disease, and Shock

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Published	10/21/2024	Under normal conditions, what helps retain proteins in the plasma and prevent a net movement of water and electrolytes into tissues?A) Capillary hydro…
Published	10/21/2024	Which of the following can lead to edema by disturbing the balance of fluid movement across capillary walls?A) Increased plasma protein contentB) Incr…
Published	10/21/2024	What term describes the accumulation of fluid in tissues due to the net movement of water into extravascular spaces?A) EffusionB) EdemaC) InfarctionD)…
Published	10/21/2024	Hemostasis refers to which of the following processes?A) Migration of clots in the bloodstreamB) The process of blood clotting to prevent excessive bl…
Published	10/21/2024	Which of the following may lead to ischemic cell death (infarction)?A) Trauma to blood vesselsB) Decreased plasma protein contentC) Thrombosis or embo…
Published	10/21/2024	Disorders that affect cardiovascular, renal, or hepatic function often result in which of the following?A) Increased plasma colloid osmotic pressureB)…
Published	10/21/2024	What disrupts the balance between hydrostatic pressure and colloid osmotic pressure, leading to fluid accumulation in tissues?A) Elevated hydrostatic …
Published	10/21/2024	If lymphatic drainage capacity is exceeded, what is the result?A) Increased plasma protein contentB) Tissue edemaC) Increased colloid osmotic pressure…
Published	10/21/2024	Trauma, fibrosis, invasive tumors, and infectious agents can all disrupt lymphatic vessels and impair the clearance of interstitial fluid, leading to …
Published	10/21/2024	Filariasis induces obstructive fibrosis of lymphatic channels and lymph nodes, contributing to {{c1::lymphedema}}.
Published	10/21/2024	Severe lymphedema caused by filariasis is commonly known as {{c1::elephantiasis}}.
Published	10/21/2024	Hyperemia is an active process involving {{c1::arteriolar dilation}}, leading to increased blood flow.
Published	10/21/2024	In hyperemia, affected tissues turn red ({{c1::erythema}}) because of the increased delivery of oxygenated blood.
Published	10/21/2024	Congestion is a passive process resulting from {{c1::reduced venous outflow}} of blood from a tissue.
Published	10/21/2024	In congestion, affected tissues have a blue-red color ({{c1::cyanosis}}) due to the accumulation of deoxygenated hemoglobin.
Published	10/21/2024	Hemostasis is the process by which blood clots form at {{c1::sites of vascular injury}} to prevent excessive bleeding.
Published	10/21/2024	Hemorrhagic disorders are characterized by excessive bleeding because the hemostatic mechanisms are either {{c1::blunted or insufficient}}.
Published	10/21/2024	Thrombotic disorders involve the formation of blood clots ({{c1::thrombi}}) within intact blood vessels or heart chambers.
Published	10/21/2024	Reflex {{c1::vasoconstriction}} occurs immediately and reduces blood flow to the injured area.
Published	10/21/2024	The local secretion of {{c1::endothelin}} augments vasoconstriction as part of the initial response in hemostasis.
Published	10/21/2024	Primary hemostasis involves the formation of a {{c1::platelet plug}}.
Published	10/21/2024	The exposure of {{c1::von Willebrand factor (vWF)}} and collagen promotes platelet adhesion and activation.
Published	10/21/2024	Activated platelets undergo a shape change from small rounded discs to {{c1::flat plates with spiky protrusions}} to increase surface area.
Published	10/21/2024	Deposition of fibrin; This event consolidates the initial platelet plugVasoconstrictionPrimary HemostasisSecondary HemostasisThrombus & Antithromb…
Published	10/21/2024	Secondary HemostasisVascular injury exposes {{c1::tissue factor}} at the site of injuryA membrane-bound procoagulant glycoprotein that is normally exp…
Published	10/21/2024	Secondary HemostasisTissue factor binds and activates {{c1::factor VII}}, setting in motion a cascade of reactions that culminates in thrombin generat…
Published	10/21/2024	{{c1::::}}
Published	10/21/2024	{{c1::Clot stabilization and resorption::Stage of Hemostasis?}}Polymerized fibrin and platelet aggregates undergo contraction to form a solid, perma…
Published	10/21/2024	Clot stabilization and resorptioncounterregulatory mechanisms (e.g., {{c1::tissue plasminogen activator [t-PA]}} made by endothelial cells) are set …
Published	10/21/2024	TRUE or FALSEEndothelial cells are central regulators of hemostasis
Published	10/21/2024	{{c1:: ::}}
Published	10/21/2024	{{c1::Platelets::What cells}}Play a critical role in hemostasis by forming the primary plug
Published	10/21/2024	PlateletsCytoplasmic granules{{c1::a-granules::a-granules/Dense (or o) granules}}Have the adhesion molecule {{c2::P-selectin}} on their membranesConta…
Published	10/21/2024	PlateletsCytoplasmic granules{{c1::a-granules::a-granules/Dense (or o) granules}}Protein factors involved in wound healing (e.g., fibronectin, platele…
Published	10/21/2024	PlateletsCytoplasmic granules{{c1::Dense (or o) granules::a-granules/Dense (or o) granules}}Contain adenosine diphosphate (ADP), adenosine triphosphat…
Published	10/21/2024	PlateletsAfter a traumatic vascular injury platelets encounter constituents of the subendothelial connective tissue, such as {{c1::vWF}} and {{c1::col…
Published	10/21/2024	{{c1::Platelet adhesion::Platelet Function?}}Mediated largely via interactions between the platelet surface receptor glycoprotein Ib (Gplb) and vW…
Published	10/21/2024	{{c1::Platelet activation}}When secretion (release reaction) of granule contents occurs + changes in shapeTriggered by several factors including the c…
Published	10/21/2024	{{c1::Platelet aggregation::Platelet function?}}The conformational change in {{c2::glycoprotein Ilb/Illa}} that occurs with platelet activation allow…
Published	10/21/2024	{{c1:: ::}}
Published	10/21/2024	It is a series of amplifying enzymatic reactions that lead to the deposition of an insoluble fibrin clot
Published	10/21/2024	Coagulation cascadeCascade of reactions involves:An {{c1::enzyme}} (an activated coagulation factor)A {{c1::substrate}} (an inactive proenzyme f…
Published	10/21/2024	Assembly of reaction complexes also depends on {{c1::calcium}}, which binds to γ-carboxylated glutamic acid residues that are present in factors …
Published	10/21/2024	The coagulation cascade can be divided into the extrinsic and intrinsic pathwaysThe {{c1::prothrombin time (PT)}} assay assesses the function of the p…
Published	10/21/2024	Clotting of plasma is initiated by the addition of negatively charged particles (e.g., ground glass) that activate {{c1::factor XII (Hageman factor)}}…
Published	10/21/2024	{{c1::::}}
Published	10/21/2024	What factor, in vivo, is the most important activator of factor IX?
Published	10/21/2024	What factor does factor IXa/VIIIa complex activates?
Published	10/21/2024	Among the coagulation factors, {{c1::thrombin}} is the most important
Published	10/21/2024	Thrombin is involved in the conversion of {{c1::fibrinogen}} into cross-linked {{c1::fibrin}}
Published	10/21/2024	Thrombin activates {{c1::platelets}} through a special {{c2::G-protein-coupled}} receptor referred to as {{c3::protease-activated receptor-1 (PAR-1)}}…
Published	10/21/2024	Thrombin directly {{c1::induces}} {{c2::platelet aggregation}} and {{c3::TxA2}} production, and activates endothelial cells, which respond by expressi…
Published	10/21/2024	Once initiated, coagulation must be restricted to the site of {{c1::vascular injury}} to prevent deleterious consequences
Published	10/21/2024	Activation of the coagulation cascade also sets into motion a {{c1::fibrinolytic}} cascade that {{c2::limits}} the size of the clot and contributes to…
Published	10/21/2024	What is the enzymatic activity of plasmin?
Published	10/21/2024	An elevated level of breakdown products of {{c1::fibrinogen}} (often called {{c2::fibrin split products}}), most notably fibrin-derived {{c3::D-dimers…
Published	10/21/2024	Plasmin is generated by enzymatic catabolism of the inactive circulating precursor {{c1::plasminogen}}, either by a {{c2::factor XII-dependent pathway…
Published	10/21/2024	The most important plasminogen activator is {{c1::t-PA}}
Published	10/21/2024	What determines if clot formation, propagation, or dissolution occurs?
Published	10/21/2024	These are the antithrombotic properties of the endothelium except:A. Platelet inhibitory effectB. Anticoagulant effectC. Fibrinolytic effectD. NOTA
Published	10/21/2024	Diseases that are characterized by platelet defect, exceptA) Bertholdt-Soulier SyndromeB) Von Willebrand DiseaseC) Glanzmann’s ThrombastheniaD) NOTA
Published	10/21/2024	Defects of secondary hemostasis often present with:A) Small bleeds in skin or mucosal membranesB) Bleeds into soft tissues or jointsC) Small blood ves…
Published	10/21/2024	Virchow triad{{c1::Endothelial injury}}{{c1::Abnormal blood flow}}{{c1::Hypercoagulability of blood}}
Published	10/21/2024	Virchow triadAbnormal blood flowNormal blood flow is {{c1::laminar}}{{c2::Turbulence}} contributes to arterial and cardiac thrombosis by causing endot…
Published	10/21/2024	Virchow triadEndothelial injury{{c1::Endothelial integrity}} is the most important factor
Published	10/21/2024	Virchow triadHypercoagulability of bloodAn abnormally high tendency of the blood to clot, and is typically caused by {{c1::alterations in coagulation …
Published	10/21/2024	What are the two most common inheritable point mutation genes that cause hypercoagulation?
Published	10/21/2024	A serious, potentially life-threatening disorder that occurs following the administration of unfractionated heparin
Published	10/21/2024	Heparin-induced thrombocytopenia syndrome (HIT) involves formation of antibodies that recognize complexes of {{c1::heparin}} and {{c1::PF4}} on the su…
Published	10/21/2024	Diagnosis of Heparin-induced thrombocytopenia syndrome (HIT):: presence of {{c1::anti-PF4-heparin antibodies}}
Published	10/21/2024	Heparin-induced thrombocytopenia syndrome (HIT)Binding of HIT antibodies to platelets results in their removal by {{c1::macrophages}} → {{c2::thromboc…
Published	10/21/2024	An autoimmune disorder characterized by:Presence of one or more antiphospholipid (aPL) autoantibodiesVenous or arterial thrombosis, or pregnancy compl…
Published	10/21/2024	TRUE OR FALSEArterial or cardiac thrombi usually begin at sites of turbulence or endothelial injury while venous thrombi usually occur at sites of sta…
Published	10/21/2024	Thrombosis: morphologyLines of {{c1::Zahn}}Grossly and microscopically apparent laminationsPale platelet and fibrin deposits alternate with darker red…
Published	10/21/2024	THROMBOSISThrombi occurring in {{c2::heart chambers}} or in the {{c2::aortic lumen}} are designated {{c1::mural}} thrombi
Published	10/21/2024	Thrombi that are frequently occlusive
Published	10/21/2024	Arterial ThrombiWhat are the most common sites in decreasing order of frequency?
Published	10/21/2024	{{c1::Venous::Arterial or Venous}} thrombosis ({{c1::Phlebothrombosis}})Almost invariably occlusive, with the thrombus forming a long luminal cast
Published	10/21/2024	Clots that form after death
Published	10/21/2024	Postmortem clotClots that form after death are {{c1::gelatinous}}Have a {{c2::dark-red dependent}} portion where red cells have settled by gravityYell…
Published	10/21/2024	EMBOLISMIs a detached intravascular solid, liquid, or gaseous mass
Published	10/21/2024	Majority of emboli are {{c1::dislodged thrombi}}, hence the term {{c2::thromboembolism}}
Published	10/21/2024	What are the other types of emboli?
Published	10/21/2024	Where do Pulmonary Emboli originate?
Published	10/21/2024	PULMONARY EMBOLISMFragmented thrombi are carried through progressively larger veins and the {{c1::right::left or right}} side of the heart before slam…
Published	10/21/2024	PULMONARY EMBOLISMCan occlude the main pulmonary artery, {{c1::straddle}} the pulmonary artery bifurcation ({{c1::saddle embolus}}), or pass out into …
Published	10/21/2024	TRUE OR FALSE: PULMONARY EMBOLISMMost pulmonary emboli (60% to 80%) are clinically silent because they are small
Published	10/21/2024	What occurs when emboli obstruct 60% or more of the pulmonary circulation?
Published	10/21/2024	Embolic obstruction of {{c1::medium-sized::small-sized or medium-sized}} arteries with subsequent vascular rupture can result in pulmonary hemorrhage …
Published	10/21/2024	PULMONARY EMBOLISMEmbolic obstruction of {{c1::small end-arteriolar}} pulmonary branches often does produce hemorrhage or infarctionMultiple emboli ov…
Published	10/21/2024	Embolism that 80% arise from intracardiac mural thrombi
Published	10/21/2024	Presence of microscopic fat globules that is sometimes with associated hematopoietic bone marrow—in the vasculature
Published	10/21/2024	Clinical Features of Fat Embolism Syndrome
Published	10/21/2024	Pathogenesis of Fat Emboli
Published	10/21/2024	What is the primary mechanism by which air embolism causes vascular obstruction?A) Formation of blood clotsB) Coalescence of gas bubbles into frothy m…
Published	10/21/2024	At what volume of air is there typically a clinical effect in cases of air embolism?A) 10 to 50 mLB) 50 to 100 mLC) Greater than 100 mLD) Less than 10…
Published	10/21/2024	Which of the following complications can occur when air emboli reach the central nervous system (CNS)?A) HemiparesisB) Sudden onset of comaC) Seizures…
Published	10/21/2024	A large volume of air, generally between {{c1::300 to 500}}mL, introduced at a rate of 100 mL/sec, may be fatal in cases of air embolism.
Published	10/21/2024	In decompression sickness, how does increased atmospheric pressure during descent affect gases in the body?A) Gases become more compressed and insolub…
Published	10/21/2024	What primarily occurs during a rapid ascent that leads to decompression sickness?A) Decreased tissue pressure causes gas to dissolve furtherB) Partial…
Published	10/21/2024	In decompression sickness, how do gas bubbles affect organ tissues?A) They induce muscle spasms and joint pain exclusivelyB) They cause mechanical dis…
Published	10/21/2024	What is the outcome when bubbles enter the venous circulation in small quantities?A) They cause immediate symptoms of decompression sicknessB) They ar…
Published	10/21/2024	Which of the following is a potential consequence when gas bubbles enter the venous circulation in large quantities?A) Activation of coagulation casca…
Published	10/21/2024	Term for decompression sickness that primarily involves gas bubbles within skeletal muscles and joints, causing pain
Published	10/21/2024	What condition, resulting from gas bubbles in the lung vasculature, leads to respiratory distress due to edema, hemorrhage, and atelectasis or emphyse…
Published	10/21/2024	What is the name of the chronic form of decompression sickness that results from repeated or prolonged exposure to high-pressure environments?
Published	10/21/2024	Decompression sickness is primarily caused by which of the following?A) Gradual ascent after prolonged deep-sea divingB) Sudden decrease in atmospheri…
Published	10/21/2024	Which gas is particularly implicated in decompression sickness due to its high solubility in blood and tissues at high pressures?A) OxygenB) Carbon di…
Published	10/21/2024	5th common cause of maternal mortality worldwide
Published	10/21/2024	Which of the following are found in the autopsy findings of Amniotic fluid embolism:A) Squamous cellsB) Lanugo hairC) Fat from vernix caseosa and muci…
Published	10/21/2024	Which of the following is NOT a symptom associated with the onset of amniotic fluid embolism?A) Sudden severe dyspneaB) CyanosisC) HypertensionD) Shoc…
Published	10/21/2024	What maternal condition often follows the initial onset of amniotic fluid embolism and involves widespread coagulation?
Published	10/21/2024	What is the primary cause of morbidity and mortality in amniotic fluid embolism?A) Mechanical obstruction of blood vessels by amniotic fluidB) Infecti…
Published	10/21/2024	Through what pathway does amniotic fluid typically enter the maternal circulation in amniotic fluid embolism?A) Tears in the fetal membranesB) Umbilic…
Published	10/21/2024	Following the onset of amniotic fluid embolism, neurological impairment can manifest as all of the following EXCEPT:A) SeizuresB) HeadacheC) ComaD) Tr…
Published	10/21/2024	This causes the vast majority of infarction cases.A) Venous embolismB) Arterial thrombosis or arterial embolismC) Traumatic injuryD) Infection
Published	10/21/2024	Infarction is defined as an area of ischemic necrosis caused by occlusion of either the {{c1::arterial}} supply or {{c2::venous}} drainage
Published	10/21/2024	Uncommon causes of infarction includes all of the following, exceptA) torsion of a vessel such as testicular torsion and bowel volvulusB) traumatic va…
Published	10/21/2024	Which uncommon cause of infarction involves compromised venous drainage due to a portion of the bowel or other tissue becoming trapped?A) Arterial emb…
Published	10/21/2024	Red infarcts are most likely to occur in which type of tissue?A) Solid, dense tissues like the liverB) Loose, spongy tissues like the lungC) Avascular…
Published	10/21/2024	In which of the following situations is a red infarct most likely to occur?A) In tissues previously congested due to sluggish venous outflowB) Followi…
Published	10/21/2024	Which organs contain tissues that are prone to red infarcts due to their dual blood supply, allowing blood to flow from unobstructed parallel supply i…
Published	10/21/2024	Which of the following describes a situation where a red infarct might develop?A) Rapid arterial obstruction without any blood reflowB) Reestablishmen…
Published	10/21/2024	This type of infarct occur with arterial occlusions in solid organs with end-arterial circulation (e.g., heart, spleen, kidney)
Published	10/21/2024	In white infarct, infarcts tend to be {{c1::wedge-}}shaped, with the occluded vessel at the apex and the periphery of the organ forming the base
Published	10/21/2024	The dominant histologic characteristic of infarction in White Infarcts
Published	10/21/2024	Histologic characteristic of white infarct in the brain
Published	10/21/2024	Most white infarcts are ultimately replaced by {{c1::scar}} formation
Published	10/21/2024	This type of infarct occurs when infected cardiac valve vegetations embolize or when microbes seed necrotic tissue
Published	10/21/2024	In a septic infarct, the infarct is converted to an {{c1::abscess}}
Published	10/21/2024	A state of circulatory failure that impairs tissue perfusion and leads to cellular hypoxia
Published	10/21/2024	{{c1::Cardiogenic::What type of}} shock results from low cardiac output due to myocardial pump failure
Published	10/21/2024	{{c1::Hypovolemic:: What type of}} shock results from low cardiac output due to low blood volume
Published	10/21/2024	A life-threatening organ dysfunction caused by a dysregulated host response to infection
Published	10/21/2024	A subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality t…
Published	10/21/2024	Sepsis-like condition associated with systemic inflammation that may be triggered by a variety of non-microbial causes (e.g., burns, trauma, pancreati…
Published	10/21/2024	Identify the type of shockFluid loss - {{c1::Hypovolemic}} shockSuperantigens - {{c1::Shock associated with systemic inflammation}}Hemorrhage - {{c1::…
Published	10/21/2024	Septic ShockMost frequently triggered by gram-{{c1::positive}} bacterial infections, followed by gram-{{c1::negative}} bacteria and fungi{{c1::Microbi…
Published	10/21/2024	Stage of shock where reflex compensatory mechanisms are activated, and vital organ perfusion is maintained
Published	10/21/2024	Stage of shock where there is tissue hypoperfusion and onset of worsening circulatory and metabolic derangement, including acidosis.
Published	10/21/2024	Stage of shock characterized by cellular and tissue injury that is so severe that even if the hemodynamic defects are corrected, survival is not possi…
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