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Questions and Answers
What is the main cause of acute generalized venous congestion?
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?
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?
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?
Which type of hyperemia is typically observed after exercise?
What is the result of right-sided heart failure in terms of venous congestion?
What is the result of right-sided heart failure in terms of venous congestion?
Which of the following is NOT a clinical effect of general venous congestion?
Which of the following is NOT a clinical effect of general venous congestion?
What is the main cause of transudate fluid in edema?
What is the main cause of transudate fluid in edema?
What is a possible microscopic effect of chronic hypoxia on central hepatocytes?
What is a possible microscopic effect of chronic hypoxia on central hepatocytes?
Which feature is exclusive to pitting edema?
Which feature is exclusive to pitting edema?
Which condition is NOT a typical cause of acute local congestion?
Which condition is NOT a typical cause of acute local congestion?
In cardiac edema, where does the swelling first appear?
In cardiac edema, where does the swelling first appear?
Which of the following is a common outcome of acute venous congestion?
Which of the following is a common outcome of acute venous congestion?
Which condition is not associated with generalized edema?
Which condition is not associated with generalized edema?
Which of the following is not true about exudate fluid?
Which of the following is not true about exudate fluid?
What pathological condition is characterized by profound subcutaneous tissue swelling?
What pathological condition is characterized by profound subcutaneous tissue swelling?
What type of edema fluid typically clots on standing?
What type of edema fluid typically clots on standing?
What is the definition of edema?
What is the definition of edema?
Which complication is likely in patients with portal hypertension?
Which complication is likely in patients with portal hypertension?
Which condition is an example of increased capillary hydrostatic pressure leading to edema?
Which condition is an example of increased capillary hydrostatic pressure leading to edema?
Which of the following is a cause of decreased plasma osmotic pressure?
Which of the following is a cause of decreased plasma osmotic pressure?
Which condition typically results in periorbital edema before generalizing?
Which condition typically results in periorbital edema before generalizing?
Increased tissue osmotic pressure is commonly caused by which of the following?
Increased tissue osmotic pressure is commonly caused by which of the following?
What is a common underlying mechanism of nutritional edema?
What is a common underlying mechanism of nutritional edema?
Which disorder is associated with impaired hepatic production of albumin and increased portal blood pressure?
Which disorder is associated with impaired hepatic production of albumin and increased portal blood pressure?
Which factor is responsible for edema due to lymphatic obstruction?
Which factor is responsible for edema due to lymphatic obstruction?
In which type of edema are adrenal hormones such as those in Cushing disease involved?
In which type of edema are adrenal hormones such as those in Cushing disease involved?
What results from sodium and water retention in the context of edema?
What results from sodium and water retention in the context of edema?
Which condition can increase capillary permeability and cause edema?
Which condition can increase capillary permeability and cause edema?
Which type of edema is marked by increased capillary permeability and is often seen around the eyelid and face?
Which type of edema is marked by increased capillary permeability and is often seen around the eyelid and face?
In which conditions is renal edema commonly seen?
In which conditions is renal edema commonly seen?
What kind of edema is associated with increased fluid flow from vessels to the interstitial tissue due to increased capillary hydrostatic pressure?
What kind of edema is associated with increased fluid flow from vessels to the interstitial tissue due to increased capillary hydrostatic pressure?
Which condition is NOT a cause of edema related to increased tissue osmotic pressure?
Which condition is NOT a cause of edema related to increased tissue osmotic pressure?
What is a primary cause of turbulence in blood flow?
What is a primary cause of turbulence in blood flow?
Which of the following does stasis of blood flow prevent?
Which of the following does stasis of blood flow prevent?
Which condition leads to increased platelet adhesiveness?
Which condition leads to increased platelet adhesiveness?
Which is a key factor in laminar blood flow?
Which is a key factor in laminar blood flow?
During which condition is increased fibrinogen most commonly observed?
During which condition is increased fibrinogen most commonly observed?
How does endothelial injury contribute to thrombosis?
How does endothelial injury contribute to thrombosis?
Which factor is known to increase blood viscosity?
Which factor is known to increase blood viscosity?
What is a common effect of stasis on blood flow?
What is a common effect of stasis on blood flow?
Which type of thrombus is described as having a fibrin network entangling abundant red blood cells and fibrin?
Which type of thrombus is described as having a fibrin network entangling abundant red blood cells and fibrin?
What is a common characteristic of venous thrombosis that distinguishes it from arterial thrombosis?
What is a common characteristic of venous thrombosis that distinguishes it from arterial thrombosis?
Which type of venous thrombosis is associated with inflammation caused by septic lesions?
Which type of venous thrombosis is associated with inflammation caused by septic lesions?
A thrombus formed in the left auricle in cases of mitral stenosis with atrial fibrillation is known as?
A thrombus formed in the left auricle in cases of mitral stenosis with atrial fibrillation is known as?
Which of the following types of thrombus contains both red and pale areas?
Which of the following types of thrombus contains both red and pale areas?
What is an example of arterial conditions that can lead to thrombosis?
What is an example of arterial conditions that can lead to thrombosis?
Which factor is directly involved in the initial step of thrombus formation by causing endothelial injury?
Which factor is directly involved in the initial step of thrombus formation by causing endothelial injury?
Which of the following substances are released from aggregated and activated platelets and induce more platelet aggregation and vasoconstriction?
Which of the following substances are released from aggregated and activated platelets and induce more platelet aggregation and vasoconstriction?
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?
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?
Which component plays a crucial role in the formation of the primary hemostatic plug following endothelial injury?
Which component plays a crucial role in the formation of the primary hemostatic plug following endothelial injury?
What directly activates the coagulation cascade leading to the formation of the secondary hemostatic plug?
What directly activates the coagulation cascade leading to the formation of the secondary hemostatic plug?
Which of the following is NOT a predisposing factor of thrombosis?
Which of the following is NOT a predisposing factor of thrombosis?
What is the primary cause of inflammatory edema?
What is the primary cause of inflammatory edema?
Which factor is NOT a cause of venous obstruction leading to pitting edema?
Which factor is NOT a cause of venous obstruction leading to pitting edema?
Which of the following correctly describes lymphatic obstruction?
Which of the following correctly describes lymphatic obstruction?
What makes edema of the brain and lungs particularly dangerous?
What makes edema of the brain and lungs particularly dangerous?
Which condition is most likely to cause endothelial injury leading to thrombosis?
Which condition is most likely to cause endothelial injury leading to thrombosis?
Which of the following is incorrect regarding the formation of a thrombus?
Which of the following is incorrect regarding the formation of a thrombus?
Which condition is primarily associated with the development of brown induration of the lungs?
Which condition is primarily associated with the development of brown induration of the lungs?
What microscopic feature is NOT typically observed in brown induration of the lungs?
What microscopic feature is NOT typically observed in brown induration of the lungs?
Which of these features is characteristic of the liver in right-sided heart failure?
Which of these features is characteristic of the liver in right-sided heart failure?
What is the appearance of the cut surface of a liver affected by nutmeg liver?
What is the appearance of the cut surface of a liver affected by nutmeg liver?
What gross morphological change is NOT associated with brown induration of the lungs?
What gross morphological change is NOT associated with brown induration of the lungs?
Which of the following statements is true regarding the alveolar spaces in brown induration of the lungs?
Which of the following statements is true regarding the alveolar spaces in brown induration of the lungs?
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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
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