64 Questions
What is the main cause of acute generalized venous congestion?
Acute heart failure
What leads to the finding of cyanosis in congestion?
Increased levels of reduced hemoglobin
Which condition is always pathological?
Congestion
Which type of hyperemia is typically observed after exercise?
Physiological hyperemia
What is the result of right-sided heart failure in terms of venous congestion?
Chronic generalized venous congestion
Which of the following is NOT a clinical effect of general venous congestion?
Increased arterial pressure
What is the main cause of transudate fluid in edema?
Venous congestion
What is a possible microscopic effect of chronic hypoxia on central hepatocytes?
Atrophy
Which feature is exclusive to pitting edema?
Soft consistency
Which condition is NOT a typical cause of acute local congestion?
Tumor pressure
In cardiac edema, where does the swelling first appear?
Ankle
Which of the following is a common outcome of acute venous congestion?
Hemorrhage
Which condition is not associated with generalized edema?
Localized venous congestion
Which of the following is not true about exudate fluid?
Normal glucose content
What pathological condition is characterized by profound subcutaneous tissue swelling?
Anasarca
What type of edema fluid typically clots on standing?
Exudate
What is the definition of edema?
Pathological accumulation of excess fluid in tissues
Which complication is likely in patients with portal hypertension?
Esophageal varices
Which condition is an example of increased capillary hydrostatic pressure leading to edema?
Heart failure
Which of the following is a cause of decreased plasma osmotic pressure?
Hypoproteinemia
Which condition typically results in periorbital edema before generalizing?
Renal Edema
Increased tissue osmotic pressure is commonly caused by which of the following?
Acute inflammation
What is a common underlying mechanism of nutritional edema?
Dietary protein deficiency causing hypoproteinemia
Which disorder is associated with impaired hepatic production of albumin and increased portal blood pressure?
Hepatic Edema
Which factor is responsible for edema due to lymphatic obstruction?
Neoplasia
In which type of edema are adrenal hormones such as those in Cushing disease involved?
Endocrine Edema
What results from sodium and water retention in the context of edema?
Increased aldosterone secretion
Which condition can increase capillary permeability and cause edema?
Acute inflammation
Which type of edema is marked by increased capillary permeability and is often seen around the eyelid and face?
Allergic Edema
In which conditions is renal edema commonly seen?
Diabetes mellitus
What kind of edema is associated with increased fluid flow from vessels to the interstitial tissue due to increased capillary hydrostatic pressure?
Edema caused by venous congestion
Which condition is NOT a cause of edema related to increased tissue osmotic pressure?
Liver failure
What is a primary cause of turbulence in blood flow?
Atheroma
Which of the following does stasis of blood flow prevent?
Dilution of activated clotting factors
Which condition leads to increased platelet adhesiveness?
Post-surgical recovery
Which is a key factor in laminar blood flow?
Clear zone of plasma
During which condition is increased fibrinogen most commonly observed?
Pregnancy
How does endothelial injury contribute to thrombosis?
By activating local thrombosis
Which factor is known to increase blood viscosity?
Decreased plasma volume
What is a common effect of stasis on blood flow?
Brings platelets into contact with endothelium
Which type of thrombus is described as having a fibrin network entangling abundant red blood cells and fibrin?
Red thrombus
What is a common characteristic of venous thrombosis that distinguishes it from arterial thrombosis?
Presence of eddy currents around valves
Which type of venous thrombosis is associated with inflammation caused by septic lesions?
Septic thrombophlebitis
A thrombus formed in the left auricle in cases of mitral stenosis with atrial fibrillation is known as?
Auricular thrombi
Which of the following types of thrombus contains both red and pale areas?
Mixed thrombus
What is an example of arterial conditions that can lead to thrombosis?
Vasculitis
Which factor is directly involved in the initial step of thrombus formation by causing endothelial injury?
PAF (Platelet Activating Factor)
Which of the following substances are released from aggregated and activated platelets and induce more platelet aggregation and vasoconstriction?
ADP and Thromboxane-A2
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?
Thrombin
Which component plays a crucial role in the formation of the primary hemostatic plug following endothelial injury?
Aggregated platelets
What directly activates the coagulation cascade leading to the formation of the secondary hemostatic plug?
Release of tissue factor
Which of the following is NOT a predisposing factor of thrombosis?
Hypotension
What is the primary cause of inflammatory edema?
Increased vascular permeability
Which factor is NOT a cause of venous obstruction leading to pitting edema?
Inflammation as in filariasis
Which of the following correctly describes lymphatic obstruction?
It results in non-pitting edema called lymphodema.
What makes edema of the brain and lungs particularly dangerous?
They are the most life-threatening forms of abnormal fluid retention.
Which condition is most likely to cause endothelial injury leading to thrombosis?
Hypertension
Which of the following is incorrect regarding the formation of a thrombus?
It can be formed outside the cardiovascular system.
Which condition is primarily associated with the development of brown induration of the lungs?
Mitral stenosis
What microscopic feature is NOT typically observed in brown induration of the lungs?
Smooth outer surface of the lung
Which of these features is characteristic of the liver in right-sided heart failure?
Enlarged, heavy liver with a smooth outer surface
What is the appearance of the cut surface of a liver affected by nutmeg liver?
Firm with alternating areas of brown and yellow coloration
What gross morphological change is NOT associated with brown induration of the lungs?
Liver has a smooth outer surface
Which of the following statements is true regarding the alveolar spaces in brown induration of the lungs?
They frequently have hemosiderin-laden macrophages.
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)
- General venous congestion (systemic):
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
Learn about hyperemia and congestion, including their definitions, types, and causes. Understand the differences between physiological and pathological conditions.
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