Hemodynamic Disorders Module Session 6
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Questions and Answers

What is identified in the lumen of the coronary artery from the 60 year old man?

  • Plaque buildup
  • Normal blood flow
  • Atherosclerosis
  • Thrombus (correct)

What underlying condition is primarily associated with coronary artery obstruction?

  • Atherosclerosis (correct)
  • Hypertension
  • Hyperlipidemia
  • Diabetes

What is a common treatment for myocardial infarction caused by ischemia?

  • Corticosteroids
  • Beta-blockers
  • Angioplasty (correct)
  • Antihypertensives

In the elderly patient with dyspnea and pleural effusion, what imaging study is critical for diagnosis?

<p>X-ray (D)</p> Signup and view all the answers

What type of pleural fluid is indicated by low protein content and negative Gram stain?

<p>Transudate (C)</p> Signup and view all the answers

What laboratory procedure is performed to analyze pleural fluid?

<p>Thoracentesis (D)</p> Signup and view all the answers

What symptom is commonly associated with myocardial ischemia in the described cases?

<p>Severe chest pain (A)</p> Signup and view all the answers

What is a potential cause of transudative pleural effusion?

<p>Liver cirrhosis (D)</p> Signup and view all the answers

What is the likely characteristic of pleural fluid in an exudative condition?

<p>Turbid yellow in color (D)</p> Signup and view all the answers

What causes increased vascular permeability leading to the formation of exudative pleural fluid?

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

What is the most common risk factor for pulmonary embolism in the described case?

<p>Recent hip surgery (C)</p> Signup and view all the answers

Which diagnostic test is crucial to confirm a diagnosis of pulmonary embolism?

<p>CT pulmonary angiography (A)</p> Signup and view all the answers

What type of shock is indicated by symptoms such as hypotension and rapid pulse in a patient with severe abdominal pain?

<p>Septic shock (B)</p> Signup and view all the answers

What pathological process is associated with congestive symptoms when an intestine is not removed promptly?

<p>Hemorrhagic infarction (C)</p> Signup and view all the answers

In a case of hypovolemic shock, what characteristic symptom might a patient exhibit?

<p>Cold, clammy extremities (D)</p> Signup and view all the answers

What is the most likely cause of red infarction in the intestine?

<p>Dual blood supply to the intestine (C)</p> Signup and view all the answers

What type of shock is indicated by an 81-year-old female with hypotension, tachycardia, and warm extremities?

<p>Neurogenic (C)</p> Signup and view all the answers

In a scenario where a 38-year-old male has severe gastrointestinal upset, hypotension, and cool, dry skin, what type of shock is most likely?

<p>Hypovolemic (B)</p> Signup and view all the answers

What type of shock may be present in a 41-year-old male admitted after a road traffic accident with bradycardia and warm extremities?

<p>Neurogenic (B)</p> Signup and view all the answers

What symptom is most commonly associated with septic shock?

<p>Warm, flushed skin (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic of neurogenic shock?

<p>Severe hypertension (B)</p> Signup and view all the answers

In a patient with anaphylactic shock, which symptom would most likely be present?

<p>Shortness of breath (D)</p> Signup and view all the answers

What is a characteristic sign of obstructive shock?

<p>Central venous pressure changes (C)</p> Signup and view all the answers

When assessing for cardiogenic shock, which of the following symptoms is essential to recognize?

<p>Tachycardia with cool skin (B)</p> Signup and view all the answers

Flashcards

Coronary Artery Thrombosis

A blood clot (thrombus) forming in a coronary artery, blocking blood flow.

Atherosclerosis

A disease where plaque builds up inside the artery walls, narrowing the artery.

Myocardial Infarction

Heart attack; a severe reduction in blood supply to the heart muscle, leading to tissue damage.

Pleural Effusion

Accumulation of fluid in the pleural space (between the lungs and chest wall).

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Transudate

Non-inflammatory pleural fluid (low protein content).

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Hydrostatic Pressure Imbalance

An imbalance in the forces that regulate fluid movement in the body, leading to fluid buildup.

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Pleural Fluid Analysis

Analyzing pleural fluid to determine its characteristics and identify the cause of pleural effusion.

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Thoracentesis

Procedure to remove fluid from the pleural space with a needle.

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Exudative Pleural Fluid

Pleural fluid that indicates inflammation due to increased vascular permeability or lymphatic obstruction.

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Differential Diagnosis

Possible causes of a set of symptoms or signs, to figure out the right one.

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Pulmonary Embolism (PE) Risk Factors

Factors increasing the chance of a blood clot traveling to the lungs.

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Red Infarction (Intestine)

Area of dead intestine tissue due to a lack of blood supply.

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Congestion (Infarction)

Blood accumulation in a tissue due to impaired drainage.

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Hypovolemic Shock

Shock caused by a significant loss of blood volume.

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Cardiogenic Shock

Shock caused by the heart's inability to pump blood adequately.

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Septic Shock

A life-threatening condition due to severe infection with low blood pressure and rapid pulse.

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What is shock?

A life-threatening condition where the body's organs aren't getting enough blood flow, leading to cell damage and potentially organ failure.

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Anaphylactic Shock

Shock caused by a severe allergic reaction, triggered by exposure to an allergen.

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Neurogenic Shock

Shock caused by a disruption in the nervous system's control of blood vessel tone, leading to dilation and decreased blood pressure.

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Obstructive Shock

Shock caused by an obstruction in the blood flow, preventing blood from reaching the heart or lungs.

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Warm vs. Cool Extremities in Shock

Warm extremities (like in septic shock) indicate high blood flow to the periphery, while cool extremities (like in hypovolemic shock) indicate a shunting of blood to vital organs.

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Study Notes

Hemodynamic Disorders Module Session 6

  • Hemodynamic disorders are a focus of this session
  • Dr. Adnan Anwer, an M.B.Ch.B., F.I.B.M.S. (hematopath), led the small group discussions

Case 1: Coronary Artery Obstruction

  • Observation A: Normal coronary artery
  • Observation B: Coronary artery from a 60-year-old man who died of severe chest pain. Shows a thrombus (blood clot) within the lumen.
  • Observation C: Transverse section of a heart affected by coronary artery obstruction. Reveals myocardial infarction.
  • Luminal Deposition Causes (Case B): Atherosclerosis is a key contributor
  • Effects on the Heart (Case C): Angina and myocardial infarction (ischemia) are potential outcomes
  • Treatment Options: Anti-platelet drugs (aspirin) and angioplasty. Thrombectomy is another possible treatment

Case 2: Pleural Effusion

  • Patient Details: 68-year-old man with hypertension, presenting with dyspnea and pleural effusion (hemothorax).
  • Investigations: X-ray, ultrasound, and thoracentesis (pleural fluid analysis) are needed.
  • Pleural Fluid Significance: Analysis aids in pinpointing the cause of effusion, differentiating between transudate and exudate types, and guiding treatment.
  • Case 2 Pleural Fluid Findings: Protein level of 2 gm/dL, few cellularity, and negative Gram stain and TB tests indicate a transudate type of pleural effusion. (non-inflammatory)
  • Causes of Transudate Pleural Effusion: Imbalances in hydrodynamic pressure, particularly increased capillary pressure, are the key causes

Case 3: Pleural Effusion

  • Patient Details: 32-year-old female with fever, pleuritic chest pain, dyspnea and pleural effusion.
  • Pleural Fluid Findings: Turbid yellow color, protein level of 6 gm/dL, many cells (mostly neutrophils), and positive bacterial culture in pleural fluid indicate an exudative type of effusion.
  • Exudative Causes: Elevated vascular permeability and lymphatic obstruction are implicated.

Case 4: Pulmonary Embolism (PE)

  • Patient Details: 64-year-old male with a history of hip surgery 20 days prior, experiencing dyspnea, pleuritic chest pain, and hypoxia. Clinically diagnosed with DVT (deep vein thrombosis).
  • Differential Diagnosis: The patient's symptoms need to be differentiated, particularly from causes that are not PE.
  • PE Risk Factors (Case 4): Immobility after hip surgery is a significant factor.
  • Diagnosis Confirmation: CXR (chest X-ray), duplex Doppler of legs, ECG, arterial blood gas analysis, D-dimer levels, and CT pulmonary angiography can be used to confirm or rule out PE.
  • Treatment: The exact treatment is not mentioned in this document.

Case 5: Intestinal Infarction

  • Patient Details: 70-year-old male presenting with severe abdominal pain that escalated to shock, with subsequent death despite surgery.
  • Intestinal Appearance: The intestine shows congestion and hemorrhagic infarction as a clinical presentation.
  • Cause of Symptoms: The cause is an infarction to the intestines, with possible dual blood supply issues.
  • Congestion Cause: The congestion can happen if blood supply is restricted to the intestine

Types of Shock

  • The subsequent cases discuss different types of shock scenarios
  • Cases focus on identifying the shock type based on patient characteristics and symptoms, such as hypotension, tachycardia, presence of fever, or altered mental status and skin condition.

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Description

This session focuses on hemodynamic disorders, led by Dr. Adnan Anwer. Key cases discussed include coronary artery obstruction and pleural effusion, highlighting causes, effects, and treatments. The session aims to enhance understanding of these critical cardiovascular conditions.

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