Hemodynamic Basis of Disease

Question 1

What is oncotic pressure?

Answer 1

The osmotic pressure that pulls fluid into the capillaries

Question 2

List the four reasons fluid accumulates in the interstitial spaces.

Answer 2

• Increase in hydrostatic capillary pressure* Decrease in plasma osmotic pressure* Increased vascular permeability* Fluid excess beyond lymphatic drainage capacity

Question 3

What is the extravasation of fluid due to increased hydrostatic pressure or reduced oncotic pressure called?

Answer 3

Transudate

Question 4

Fluid loss due to increased vascular permeability is called _______.

Answer 4

exudate

Question 5

Vascular permeability is increased by ______ or _________.

Answer 5

inflammation; direct damage to vascular endothelial cells

Question 6

______ has a higher specific gravity than _______ due to excess protein.

Answer 6

Exudates; transudate

Question 7

The ratio of protein concentration (of fluid/serum) is _____ in transudates and _____ in exudates.

Answer 7

0.5

Question 8

Glucose is typically ______ in exudates, because more metabolism occurs in exudation.

Answer 8

lower

Question 9

There are two kinds of increased blood volume: __________.

Answer 9

hyperemia (active, to fight infection, due to arteriole dilation) and congestion (passive, pathologic, due to venous impairment)

Question 10

Right heart failure leads to _________.

Answer 10

backup in the venous system, particularly accumulating in the liver (“nutmeg” liver), and thence the spleen, GI tract, and ascites

Question 11

Ascites is essentially _________.

Answer 11

abdominal effusion

Question 12

Left heart failure leads to _________.

Answer 12

pulmonary effusion, pulmonary edema, and decreased renal blood flow, which results in fluid retention

Question 13

Petechiae are _______.

Answer 13

small, pinpoint hemorrhages (1-2 mm)

Question 14

Purpura are _________.

Answer 14

hemorrhages >3 mm and

Question 15

Echymoses are ________.

Answer 15

hemorrhages 1-2 cm

Question 16

Hematomas are _______.

Answer 16

accumulations of blood within tissue

Question 17

What are the three main categories of thrombosis?

Answer 17

• endothelial injury* abnormal blood flow (stasis, turbulence)* hypercoagulability (inherited, acquired)

Question 18

A thrombus is _______, while an embolus is a ________.

Answer 18

a mass on the wall of a blood vessel; free-flowing mass

Question 19

DVT stands for _______.

Answer 19

deep vein thrombosis

Question 20

DIC is a syndrome in which ___________.

Answer 20

coagulation consumes platelet store, and then hemorrhage occurs at other sites (stands for disseminated intravascular coagulation)

Question 21

Define infarction.

Answer 21

(n) tissue necrosis caused by vessel occlusion; most often results in coagulative necrosis (exception – brain = liquefactive)

Question 22

Shock is ________.

Answer 22

insufficient blood volume or blood pressure to perfuse tissues

Question 23

Septic shock is ________.

Answer 23

a subset of shock caused by microbial infection; indicated by elevated SIRS markers

Question 24

Accumulated fluid in tissue is called ______, while accumulated tissue in a body cavity is called ______.

Answer 24

edema; effusion

Question 25

Decreased oncotic pressure can be the product of ________.

Answer 25

excessive protein loss from the GI tract or urinary excretion, or decreased plasma protein synthesis

Question 26

Most infarcts are roughly ______-shaped, due to the arborization of arterial blood vessels. Hemorrhages are not.

Answer 26

wedge