Disorders of Blood Flow
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Questions and Answers

What is the main cause of acute generalized venous congestion?

  • Chronic lung disease
  • Right-sided heart failure
  • Acute heart failure (correct)
  • Liver cirrhosis
  • What leads to the finding of cyanosis in congestion?

  • Increased levels of reduced hemoglobin (correct)
  • Acute inflammation
  • Obstruction of arterial flow
  • Increased oxygenation of blood
  • Which condition is always pathological?

  • Congestion (correct)
  • Active dilatation of arteries
  • Increased blood flow during exercise
  • Physiological hyperemia
  • Which type of hyperemia is typically observed after exercise?

    <p>Physiological hyperemia</p> Signup and view all the answers

    What is the result of right-sided heart failure in terms of venous congestion?

    <p>Chronic generalized venous congestion</p> Signup and view all the answers

    Which of the following is NOT a clinical effect of general venous congestion?

    <p>Increased arterial pressure</p> Signup and view all the answers

    What is the main cause of transudate fluid in edema?

    <p>Venous congestion</p> Signup and view all the answers

    What is a possible microscopic effect of chronic hypoxia on central hepatocytes?

    <p>Atrophy</p> Signup and view all the answers

    Which feature is exclusive to pitting edema?

    <p>Soft consistency</p> Signup and view all the answers

    Which condition is NOT a typical cause of acute local congestion?

    <p>Tumor pressure</p> Signup and view all the answers

    In cardiac edema, where does the swelling first appear?

    <p>Ankle</p> Signup and view all the answers

    Which of the following is a common outcome of acute venous congestion?

    <p>Hemorrhage</p> Signup and view all the answers

    Which condition is not associated with generalized edema?

    <p>Localized venous congestion</p> Signup and view all the answers

    Which of the following is not true about exudate fluid?

    <p>Normal glucose content</p> Signup and view all the answers

    What pathological condition is characterized by profound subcutaneous tissue swelling?

    <p>Anasarca</p> Signup and view all the answers

    What type of edema fluid typically clots on standing?

    <p>Exudate</p> Signup and view all the answers

    What is the definition of edema?

    <p>Pathological accumulation of excess fluid in tissues</p> Signup and view all the answers

    Which complication is likely in patients with portal hypertension?

    <p>Esophageal varices</p> Signup and view all the answers

    Which condition is an example of increased capillary hydrostatic pressure leading to edema?

    <p>Heart failure</p> Signup and view all the answers

    Which of the following is a cause of decreased plasma osmotic pressure?

    <p>Hypoproteinemia</p> Signup and view all the answers

    Which condition typically results in periorbital edema before generalizing?

    <p>Renal Edema</p> Signup and view all the answers

    Increased tissue osmotic pressure is commonly caused by which of the following?

    <p>Acute inflammation</p> Signup and view all the answers

    What is a common underlying mechanism of nutritional edema?

    <p>Dietary protein deficiency causing hypoproteinemia</p> Signup and view all the answers

    Which disorder is associated with impaired hepatic production of albumin and increased portal blood pressure?

    <p>Hepatic Edema</p> Signup and view all the answers

    Which factor is responsible for edema due to lymphatic obstruction?

    <p>Neoplasia</p> Signup and view all the answers

    In which type of edema are adrenal hormones such as those in Cushing disease involved?

    <p>Endocrine Edema</p> Signup and view all the answers

    What results from sodium and water retention in the context of edema?

    <p>Increased aldosterone secretion</p> Signup and view all the answers

    Which condition can increase capillary permeability and cause edema?

    <p>Acute inflammation</p> Signup and view all the answers

    Which type of edema is marked by increased capillary permeability and is often seen around the eyelid and face?

    <p>Allergic Edema</p> Signup and view all the answers

    In which conditions is renal edema commonly seen?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What kind of edema is associated with increased fluid flow from vessels to the interstitial tissue due to increased capillary hydrostatic pressure?

    <p>Edema caused by venous congestion</p> Signup and view all the answers

    Which condition is NOT a cause of edema related to increased tissue osmotic pressure?

    <p>Liver failure</p> Signup and view all the answers

    What is a primary cause of turbulence in blood flow?

    <p>Atheroma</p> Signup and view all the answers

    Which of the following does stasis of blood flow prevent?

    <p>Dilution of activated clotting factors</p> Signup and view all the answers

    Which condition leads to increased platelet adhesiveness?

    <p>Post-surgical recovery</p> Signup and view all the answers

    Which is a key factor in laminar blood flow?

    <p>Clear zone of plasma</p> Signup and view all the answers

    During which condition is increased fibrinogen most commonly observed?

    <p>Pregnancy</p> Signup and view all the answers

    How does endothelial injury contribute to thrombosis?

    <p>By activating local thrombosis</p> Signup and view all the answers

    Which factor is known to increase blood viscosity?

    <p>Decreased plasma volume</p> Signup and view all the answers

    What is a common effect of stasis on blood flow?

    <p>Brings platelets into contact with endothelium</p> Signup and view all the answers

    Which type of thrombus is described as having a fibrin network entangling abundant red blood cells and fibrin?

    <p>Red thrombus</p> Signup and view all the answers

    What is a common characteristic of venous thrombosis that distinguishes it from arterial thrombosis?

    <p>Presence of eddy currents around valves</p> Signup and view all the answers

    Which type of venous thrombosis is associated with inflammation caused by septic lesions?

    <p>Septic thrombophlebitis</p> Signup and view all the answers

    A thrombus formed in the left auricle in cases of mitral stenosis with atrial fibrillation is known as?

    <p>Auricular thrombi</p> Signup and view all the answers

    Which of the following types of thrombus contains both red and pale areas?

    <p>Mixed thrombus</p> Signup and view all the answers

    What is an example of arterial conditions that can lead to thrombosis?

    <p>Vasculitis</p> Signup and view all the answers

    Which factor is directly involved in the initial step of thrombus formation by causing endothelial injury?

    <p>PAF (Platelet Activating Factor)</p> Signup and view all the answers

    Which of the following substances are released from aggregated and activated platelets and induce more platelet aggregation and vasoconstriction?

    <p>ADP and Thromboxane-A2</p> Signup and view all the answers

    In the activation of the coagulation cascade, which coagulation factor interacts with calcium on the surface of activated platelets to convert fibrinogen into insoluble fibrin?

    <p>Thrombin</p> Signup and view all the answers

    Which component plays a crucial role in the formation of the primary hemostatic plug following endothelial injury?

    <p>Aggregated platelets</p> Signup and view all the answers

    What directly activates the coagulation cascade leading to the formation of the secondary hemostatic plug?

    <p>Release of tissue factor</p> Signup and view all the answers

    Which of the following is NOT a predisposing factor of thrombosis?

    <p>Hypotension</p> Signup and view all the answers

    What is the primary cause of inflammatory edema?

    <p>Increased vascular permeability</p> Signup and view all the answers

    Which factor is NOT a cause of venous obstruction leading to pitting edema?

    <p>Inflammation as in filariasis</p> Signup and view all the answers

    Which of the following correctly describes lymphatic obstruction?

    <p>It results in non-pitting edema called lymphodema.</p> Signup and view all the answers

    What makes edema of the brain and lungs particularly dangerous?

    <p>They are the most life-threatening forms of abnormal fluid retention.</p> Signup and view all the answers

    Which condition is most likely to cause endothelial injury leading to thrombosis?

    <p>Hypertension</p> Signup and view all the answers

    Which of the following is incorrect regarding the formation of a thrombus?

    <p>It can be formed outside the cardiovascular system.</p> Signup and view all the answers

    Which condition is primarily associated with the development of brown induration of the lungs?

    <p>Mitral stenosis</p> Signup and view all the answers

    What microscopic feature is NOT typically observed in brown induration of the lungs?

    <p>Smooth outer surface of the lung</p> Signup and view all the answers

    Which of these features is characteristic of the liver in right-sided heart failure?

    <p>Enlarged, heavy liver with a smooth outer surface</p> Signup and view all the answers

    What is the appearance of the cut surface of a liver affected by nutmeg liver?

    <p>Firm with alternating areas of brown and yellow coloration</p> Signup and view all the answers

    What gross morphological change is NOT associated with brown induration of the lungs?

    <p>Liver has a smooth outer surface</p> Signup and view all the answers

    Which of the following statements is true regarding the alveolar spaces in brown induration of the lungs?

    <p>They frequently have hemosiderin-laden macrophages.</p> Signup and view all the answers

    Study Notes

    Disorders of Blood Flow

    Hyperemia

    • Definition: Increased amount of blood in an organ due to active dilatation of arteries, arterioles, and capillaries.
    • Types:
      • Physiological (e.g., skin and muscles after exercise)
      • Pathological (e.g., acute inflammation)

    Congestion

    • Definition: Increased amount of blood in an organ or tissue due to obstruction of venous flow, leading to passive dilation of veins, venules, and capillaries.
    • Always pathologic
    • Causes and types:
      • General venous congestion (systemic):
        • Acute (e.g., acute heart failure)
        • Chronic (e.g., right-sided heart failure)
      • Local venous congestion (e.g., isolated right ventricular failure)

    Effects of Congestion

    • Cyanosis: Increase in reduced hemoglobin, leading to blue coloration of lips, buccal mucosa, and nail beds
    • Cardiac edema

    Organs Affected

    • Lung (brown induration):
      • Causes: Mitral stenosis and left-sided heart failure
      • Morphology:
        • Grossly: Enlarged, heavy, firm lungs with brown color due to hemosiderin
        • Microscopically: Engorged alveolar capillaries, thickened alveolar septa, and hemosiderin-laden macrophages
    • Liver (nutmeg liver):
      • Causes: Right-sided heart failure and inferior vena cava obstruction
      • Gross: Enlarged, heavy liver with smooth outer surface and tense capsule
      • Microscopically: Distended centrilobular veins and sinusoids, atrophied central hepatocytes, and fatty changes in peripheral hepatocytes

    Edema

    • Definition: Pathological accumulation of excess fluid in interstitial tissue spaces and serous sacs
    • Types:
      • Transudate (protein-poor): Venous congestion, heart failure
      • Exudate (protein-rich): Inflammation, hypersensitivity reactions
    • Classification:
      • Pitting edema: Fluid is displaced upon pressure
      • Non-pitting edema: Fluid is not displaced upon pressure
    • Pathogenesis:
      • Increased capillary hydrostatic pressure
      • Decreased plasma osmotic pressure
      • Increased tissue osmotic pressure
      • Lymphatic obstruction
      • Sodium and water retention
      • Increased capillary permeability

    Thrombosis

    • Definition: Formation of an insoluble compact mass from circulating blood elements inside the cardiovascular system during life
    • Predisposing factors (Virchow's triad):
      • Endothelial injury
      • Alteration in blood flow (turbulence, stasis)
      • Changes in blood components (increased platelets, white cells, red cells, fibrinogen)
    • Mechanism of thrombus formation:
      • Endothelial injury releases thrombotic factors
      • Activated platelets liberate ADP and thromboxane-A2
      • Clotting factors interact with Ca to form fibrin
    • Types of thrombus:
      • Pale thrombus (platelets and fibrin)
      • Red thrombus (fibrin network with RBCs)
      • Mixed thrombus (contains red and pale areas)

    Localized Edema

    • Restricted to one part of the body (e.g., limb, organ)
    • Types:
      • Inflammatory edema (non-pitting)
      • Venous obstruction (pitting)
      • Lymphatic obstruction (non-pitting)

    Other

    • Anasarca: Severe and generalized edema with profound subcutaneous tissue swelling
    • Cardiac edema: Pitting edema due to a problem in the heart
    • Renal edema: Occurs in cases of SLE, diabetes mellitus, and amyloidosis

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    Description

    Learn about hyperemia and congestion, including their definitions, types, and causes. Understand the differences between physiological and pathological conditions.

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