Edema and Its Pathophysiology

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Questions and Answers

Match the following types of edema with their causes:

Transudates = Hydrodynamic disturbances with specific gravity 1.012 Exudates = Increased vascular permeability with specific gravity 1.020 Hydrothorax = Fluid collection in thoracic cavity Hydropericardium = Fluid collection in pericardial cavity

Match the following factors to their effects on edema:

Increased capillary hydrostatic pressure = Results in fluid retention Decreased colloid osmotic pressure = Increases fluid leakage into interstitial space Inflammatory mediators = Enhance vascular permeability Lymphatic obstruction = Impedes fluid drainage

Match the following conditions with their related effects:

Congestive heart failure = Generalized systemic edema due to reduced cardiac output Deep venous thrombosis (DVT) = Localized edema due to impaired venous return Renin-angiotensin-aldosterone axis = Triggers sodium and water retention Diuretics = Promote fluid excretion to reduce edema

Match the following descriptions with terms related to edema:

Interstitial fluid pressure = Increased due to fluid overload Capillary bed = Interface between arterial and venous flows Fluid drainage = Essential for preventing edema Vascular hydrostatic pressure = Influences fluid movement between spaces Signup and view all the answers

Match the following terms with their respective definitions:

Edema = Increase of fluid in interstitial spaces Hydroperitoneum = Fluid collection in peritoneal cavity Hydrostatic pressure = Pressure exerted by fluids within blood vessels Colloid osmotic pressure = Pressure that pulls fluid back into vessels Signup and view all the answers

Match the following types of shock with their characteristics:

Hypovolemic shock = Real decrease in blood volume Cardiogenic shock = Relative decrease in blood volume Neurogenic shock = Inadequate blood supply due to nerve injury Anaphylactic shock = Severe allergic reaction causing vasodilation Signup and view all the answers

Match the following causes of hypovolemic shock:

Hemorrhage = Blood loss from injury or surgery Severe vomiting = Fluid loss from gastrointestinal tract Burns = Fluid loss from damaged skin Diarrhea = Excess fluid loss and dehydration Signup and view all the answers

Match the following conditions to their effects on blood flow:

Aneurysm = Weakening and potential rupture of blood vessel Atheroma = Plaque build-up in arteries Carcinoma invasion = Neoplastic invasion affecting blood vessels Varicose veins = Increased venous pressure leading to complications Signup and view all the answers

Match the following blood loss scenarios with their potential outcomes:

Loss of 20% blood volume = Slight effect on the body Sudden loss of 33% blood volume = Leads to death Gradual loss of over 50% blood volume = Serious but not necessarily fatal Chronic blood loss = Can cause iron-deficiency anemia Signup and view all the answers

Match the following physiological responses to blood vessel constriction:

Venous return = Increases return of blood to the heart Arteriolar constriction = Decreases blood flow to select organs Shock = Inadequate supply of blood to meet metabolic demands Systemic hypotension = Characterized by reduced cardiac output Signup and view all the answers

Match the following causes of reduced plasma osmotic pressure with their descriptions:

Increased loss of albumin = Nephrotic syndrome Reduced protein synthesis = Cirrhosis Malnutrition = Reduced protein synthesis Intestinal diseases = Protein losing enteropathy Signup and view all the answers

Match the following types of lymphatic obstruction with their causes:

Inflammatory obstruction = Filariasis Post-surgical obstruction = Cancer of breast surgery Post-irradiation obstruction = Scarring from treatments Neoplastic obstruction = Infiltration of lymphatics Signup and view all the answers

Match the following special forms of edema with their specific conditions:

Pulmonary edema = Left sided heart failure Pulmonary infection = Frothy blood-tinged fluid Respiratory distress syndrome = Dependent distribution in lung Localized edema of brain = Due to abscess or neoplasm Signup and view all the answers

Match the following descriptions of pitting edema with their indicators:

Substantial edema = Displaces interstitial fluid Depression = Seen after finger pressure Dependent edema = Common in legs or sacrum Local swelling = Indicates underlying issue Signup and view all the answers

Match the following organs or tissues with their common edema occurrences:

Subcutaneous tissues = Most commonly involved Lungs = Dependent distribution noted Brain = Localized edema possible Legs = Seen when standing Signup and view all the answers

Match the following characteristics of edema morphology with their corresponding descriptions:

Microscopically = Clearing of extracellular matrix Common distribution = Influenced by gravity Pitting edema = Leaves a depression Local edema = Absent in healthy tissue Signup and view all the answers

Match the following examples of edema with the terms used to describe them:

Peau d'orange = Edema of breast skin Elephantiasis = Genitalia and lower limb edema Post-mastectomy lymphedema = Edema of upper limb Dependent edema = Legs when standing Signup and view all the answers

Match the following types of congestion with their descriptions:

Generalized systemic congestion = Right ventricular failure with venous blood accumulation Pulmonary venous congestion = Left ventricular failure causing blood accumulation in lungs Localized venous congestion = Deep vein thrombosis causing limb edema Chronic passive congestion = Long-standing hypoxia due to lack of blood flow Signup and view all the answers

Match the types of hemorrhage with their characteristics:

Petechiae = Minute hemorrhage (1-2 mm) in skin Purpura = Slightly larger hemorrhages (≥3 mm) Ecchymosis = Subcutaneous hematoma (1-2 cm) Hematoma = Blood encased within tissue Signup and view all the answers

Match the causes of hemorrhage with their examples:

Trauma = Penetrating wounds to the heart Aortic aneurysm rupture = Causes retroperitoneal hematoma Miscellaneous = Can include various medical conditions Rupture of vessels = May cause significant blood loss Signup and view all the answers

Match the clinical symptoms of congestion with their effects:

Increased JVP = Dilated veins Edema = Swelling in limbs and abdomen Hepatosplenomegaly = Enlargement of liver and spleen Cough with blood-stained sputum = Heart failure cells in the lungs Signup and view all the answers

Match the liver morphology findings with their descriptions:

Nutmeg liver = Mottled appearance from chronic venous congestion Congestion of central venule = Resulting from increased pressure Necrosis of hepatocytes = Due to hypoxia and pressure Fatty change = Peripheral liver cells responding to congestion Signup and view all the answers

Match the types of hemorrhage to their sizes:

Petechiae = 1-2 mm Purpura = ≥3 mm Ecchymosis = 1-2 cm Massive hematoma = Significant blood loss encased in tissue Signup and view all the answers

Match the descriptions with the types of hemorrhage:

Insignificant bruises = Small external injuries Massive hemorrhage = Can lead to life-threatening conditions Acute external bleeding = Immediate blood loss exposed to the environment Chronic internal bleeding = Long-term blood loss within tissues Signup and view all the answers

Match the symptoms of pulmonary congestion with their consequences:

Heart failure cells = Macrophages engulfing RBCs in alveoli Cough = May produce blood-stained sputum Pulmonary edema = Fluid accumulation in lung spaces Tachypnea = Increased respiratory rate due to congestion Signup and view all the answers

Match the types of edema with their locations:

Ascites = Fluid in the abdominal cavity Peripheral edema = Swelling in limbs Pulmonary edema = Fluid in the lungs Cerebral edema = Swelling in the brain Signup and view all the answers

Match the terms related to hemorrhage with their definitions:

Extravascular space = Area outside of blood vessels where blood can escape Hematoma = Mass of blood trapped within tissues External hemorrhage = Blood loss that is visible outside the body Internal hemorrhage = Blood loss that occurs within the body tissues Signup and view all the answers

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Study Notes

Edema

Edema is the accumulation of excess fluid in the interstitial spaces or body cavities.
Specific conditions related to edema include hydrothorax, hydropericardium, and hydroperitoneum (ascites).
Fluid movement is regulated by vascular hydrostatic pressure and plasma colloid osmotic pressure, balancing outflows and inflows in the vascular system.
Increased interstitial hydrostatic pressure results from factors such as capillary hydrostatic pressure or decreased colloid osmotic pressure.
Inflammatory mediators can increase vascular permeability, contributing to edema.
Lymphatic obstruction impairs fluid drainage and causes localized edema, which may result from conditions like filariasis or post-surgical changes.
Edematous fluid categorized as transudates has a specific gravity of 1.012, while exudates, resulting from inflammatory processes, have a specific gravity of 1.020.
Examples of localized conditions include elephantiasis from lymphatic obstruction or edema due to breast cancer treatment.

Morphology and Distribution

Microscopic examination reveals clearing and separation in the extracellular matrix.
Common sites for edema include subcutaneous tissues, lungs, and brain, often exhibiting dependent edema influenced by gravity.
Pitting edema occurs when finger pressure leaves a depression in significantly edematous tissues.

Special Forms of Edema

Pulmonary Edema: Associated with conditions like left-sided heart failure, respiratory distress syndrome, or pulmonary infections, resulting in frothy, blood-tinged fluid in the lungs.
Brain Edema: Can be localized or generalized, causing symptoms from abscesses, tumors, or long-standing congestion, leading to hypoxia and potential hemorrhages.
Liver Congestion: Chronic passive congestion leads to a "nutmeg liver" appearance due to increased pressure and liver cell necrosis.

Hemorrhage

Hemorrhage involves the extravasation of blood into tissues, classified as external or internal (hematoma).
Petechiae are minute hemorrhages (<2 mm), while purpura are slightly larger (≥3 mm), and ecchymosis refers to subcutaneous hematoma (1-2 cm).
Causes of hemorrhage include trauma, vessel wall abnormalities, and high blood pressure.
Acute hemorrhage effects vary based on volume; loss of <20% may be insignificant, while loss of >33% can be fatal.

Shock

Shock is characterized by inadequate blood supply to meet metabolic demands, leading to systemic hypotension.
Types of Shock:
- Hypovolemic Shock: Real decrease in blood volume due to hemorrhage or severe fluid loss from vomiting, diarrhea, burns.
- Cardiogenic Shock: Relative decrease in blood volume resulting from myocardial infarction, ruptured heart, or arrhythmias.
- Septic Shock: Caused by severe bacterial infections (gram-positive/negative), associated with significant hemodynamic instability and a high mortality rate.
- Neurogenic Shock: Results from loss of vascular tone due to anesthesia or spinal cord injury.

Pathogenesis and Stages of Shock

Septic shock involves inflammatory mediators leading to vascular permeability, thrombosis, and significant organ dysfunction.
Stages of shock include:
- Non-Progressive Phase: Compensatory mechanisms stabilize blood pressure through arteriolar constriction and increased heart rate.
- Progressive Phase: Occurs when additional stressors exacerbate the condition, compromising cardiovascular function further.

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