| A | B |
|---|
| Edema | Accumulation of fluid in the interstitial spaces |
| Hyperemia | Increased blood in a part of the body |
| Active acute hyperemia | Increased arterial blood to the area as seen in inflammation |
| Types of hyperemia | Active or passive, acute or chronic passive |
| Passive acute hyperemia | Reduction of venous flow in patients with varicose veins |
| Passive chronic hyperemia | Long standing congestion in the lung, liver, and skin; brown induration |
| Brown induration | Caused by chronic passive venous congestion in the lungs and legs |
| Hemosiderin | Pigment in macrophages in brown induration of the lung and legs |
| Nutmeg liver | Chronic passive centrilobular venous congestion in the liver |
| Transudate | Caused by ↑pressure hydrostatic or ↓oncotic pressure or inflammation |
| Features of a transudate | Low protein content, specific gravity < 1.01 and few cells |
| Exudate | All exudates are inflammatory in nature |
| Features of an exudate | High protein content, specific gravity >1.01and many inflammatory cells |
| Effusion | Collection of fluid in cavities: pleural, pericardial |
| Ascites | Collection of fluid in the abdomen |
| Hemorrhage | Escape of blood from the circulatory system; internal or external |
| Causes of internal hemorrhage | Erosion [bleeding peptic ulcer], rupture [aneurysm], DIC or neoplasia |
| Bleeding into the skin | Petechiae [pinpoint], ecchymosis [large bruises]; purpura [in between] |
| Hematoma | Localized collection of blood in the tissue; usually in the clotted form |
| Hemothorax | Bleeding into a pleural cavity in the thorax |
| Hemopericardium | Bleeding into the pericardial sac |
| Hemarthrosis | Bleeding into a joint |
| Hemoperitoneum | Bleeding into the peritoneal cavity in the abdomen |
| Thrombus | Formation of a clot within the vascular system |
| Virchow’s triad | Hypercoagulability, venous stasis or vessel wall damage |
| Hypercoagulability | Increased clotting; oral contraception and certain cancers |
| Fate of a thrombus | Lysis, propagation, recanalization, organization, infection or embolism |
| Thrombus lysis | Breakdown of the clot by plasmin in fibrinolysis |
| Thrombus propagation | Extension of the clot due to continuing stasis or inflammation |
| Thrombus Organization | Infiltration with granulation tissue to make the clot more solid |
| Thrombus Recanalization | Ingrowth of new blood vessels in an attempt to reestablish a channel |
| Embolus | Obstruction of a distant vessel due to thrombus: venous or arterial |
| Thromboembolism | Most common cause of pulmonary embolism; DVT, air, fat, amniotic fluid |
| Arterial embolism | Atherosclerotic plaques in arteries, damaged mitral or aortic valves |
| Fat embolism | Fat from the bone marrow in long bone fractures like the femur |
| Paradoxical embolus | Venous embolus appearing in the arterial circulation; via VSD |
| Air embolism | Air sucked into the vein with open chest and neck wounds |
| Amniotic fluid embolism | Amniotic fluid arising during or shortly after delivery, may cause DIC |
| Shock | Syndrome characterized by low blood pressure and tachycardia |
| Classification of shock | Non-progressive, progressive and irreversible |
| Types of shock | Hypovolemic, cardiogenic, anaphylactic, neurogenic or septic |
| Hypovolemic shock | Bleeding, vomiting, diarrhea, burns: ↓BP, ↑heart rate, cold clammy skin |
| Cardiogenic shock | Myocardial infarction results in acute heart failure: cold clammy skin, ↑HR |
| Anaphylactic shock | Histamine release → massive vasodilation → ↓PR; warm skin and ↑HR |
| Neurogenic shock | Spinal cord trauma; vagal stimulation →↓BP, ↓HR [bradycardia], warm dry skin |
| Septic shock | Low blood pressure, tachycardia, hot dry skin due to cytokines and endotoxins |
| Endotoxins | Poisons released from dead Gam-negative enteric [gut related] organisms |
| Effects of shock on the brain | Edema of the brain due to a breakdown of the blood brain barrier |
| Effects of shock on the lungs | Acute Respiratory Distress Syndrome due to proteinaceous material |
| Effects of shock on the liver | Centrilobular necrosis as these zones are furthest away from oxygen |
| Effects of shock on the kidney | Acute tubular necrosis as the tubules are most sensitive to ischemia |
| Effects of shock on the heart | Subendocardial infarction due to under perfusion of the heart |
| Arterial embolism | From arterial plaque – painful, pulseless, pale, paresthesia, poikilothermic limb |
| Lines of Zhan | Alternating layers of platelets, fibrin, and RBCs in an antemortem thrombus |
| Postmortem clot | Formed after death, chicken fat appearance, made up of WBCs and fibrin |
| Varicose veins | Dilated enlarged superficial veins-pregnancy, obesity, genetics, standing long |
| Deep Vein Thrombosis | Clot formed in a deep vein in the leg or pelvis causes a painful swollen leg |
| Pulmonary embolism clinical triad | Pleuritic pain, dyspnea, and hemoptysis |
| Thromboembolism | Most common cause of pulmonary embolism is deep vein thrombosis |
| d-dimer test | Test for a clot fragment; exclude pulmonary embolism caused by a clot |
