Medical Terminology in Hematology and Thrombosis
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Questions and Answers

Which of the following is the most common origin of systemic emboli?

  • Aortic aneurysm
  • Valvular thrombi
  • Cardiac mural thrombi (correct)
  • Atherosclerotic plaque

    • What is the primary underlying cause of venous thrombi formation?

  • Stasis (correct)
  • Endothelial injury
  • Hypercoagulability
  • Bacterial infection

    • Which of the following is NOT a potential fate of a thrombus?

  • Embolization
  • Dissolution
  • Propagation
  • Calcification (correct)

    • A scuba diver ascends too rapidly, leading to the formation of nitrogen bubbles in the bloodstream. What type of embolism is this?

    <p>Air embolism (A)</p> Signup and view all the answers

    Occlusion of the vascular supply leads to ischemic necrosis in a tissue. What is this condition called?

    <p>Infarction (A)</p> Signup and view all the answers

    What is the primary consequence of impaired lymphatic drainage?

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

    Which condition directly results from increased permeability of glomerular capillaries, leading to protein loss?

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

    Which of the following is a prothrombotic property of endothelial cells?

    <p>Activation of clotting factors (A)</p> Signup and view all the answers

    What initiates the coagulation cascade?

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

    What is the expected appearance of a tissue sample under microscopic examination with oedema?

    <p>Clearing and separation of extracellular matrix (C)</p> Signup and view all the answers

    What process degrades thrombi?

    <p>Fibrinolysis (A)</p> Signup and view all the answers

    Which of the following best describes secondary hemostasis?

    <p>A more stable plug containing red blood cells and leukocytes. (B)</p> Signup and view all the answers

    What term describes the extravasation of blood into the pericardial sac?

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

    Which of the following mechanisms primarily contribute to the development of hyperaemia?

    <p>Arteriolar dilation and increased blood inflow. (C)</p> Signup and view all the answers

    In the context of fluid movement in tissues, what distinguishes transudate from exudate?

    <p>Transudate is protein-poor, while exudate is protein-rich. (D)</p> Signup and view all the answers

    A patient presents with massive generalized oedema. Which term accurately describes this condition?

    <p>Anasarca (A)</p> Signup and view all the answers

    Which condition is most likely to result in localized oedema due to impaired venous return?

    <p>Deep vein thrombosis (DVT). (A)</p> Signup and view all the answers

    What is the primary mechanism by which reduced plasma osmotic pressure leads to oedema?

    <p>Reduced ability to retain fluid within blood vessels (B)</p> Signup and view all the answers

    Which of the following is a direct consequence of increased central venous pressure in congestive heart failure that contributes to generalized edema?

    <p>Increased hydrostatic pressure in capillaries (D)</p> Signup and view all the answers

    Albumin plays a crucial role in maintaining colloid osmotic pressure. Which condition associated with albumin deficiency can lead to a reduction in plasma osmotic pressure?

    <p>Reduced albumin synthesis. (C)</p> Signup and view all the answers

    Which of the following conditions directly contributes to generalized edema by causing sodium and water retention?

    <p>Renal failure. (D)</p> Signup and view all the answers

    What type of infarction is most commonly associated with arterial obstruction?

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

    Which factor does NOT influence infarct development?

    <p>Presence of microbial infection (C)</p> Signup and view all the answers

    What type of necrosis is primarily observed in brain infarctions?

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

    In which type of shock is there a systemic immune response to microbial infection?

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

    Which type of shock results from inadequate blood volume?

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

    Flashcards

    Haemodynamic Disorders

    Disruptions in blood flow affecting tissue perfusion.

    Thromboembolism

    Obstruction of blood vessel by a thrombus that dislodges.

    Shock

    A critical condition where blood flow is insufficient to meet tissue demands.

    Hyperaemia

    Increased blood flow to a tissue, often during inflammation or exercise.

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    Congestion

    Impaired blood outflow from a tissue, resulting in swelling.

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    Oedema

    Swelling due to excess fluid in interstitial spaces.

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    Increased Hydrostatic Pressure

    Pressure in blood vessels that pushes fluid out, causing oedema.

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    Reduced Plasma Osmotic Pressure

    Lower levels of plasma proteins leading to fluid leakage from vessels.

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    Arterial Thrombi

    Thrombi formed due to endothelial injury affecting arteries or cardiac surfaces.

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    Venous Thrombi

    Thrombi that form in veins, typically at sites of blood flow stasis.

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    Embolus

    A solid, liquid, or gaseous mass carried by blood to a distant site.

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    Pulmonary Emboli

    Emboli that travel through veins and can obstruct the pulmonary arteries, causing severe outcomes.

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    Infarct

    An area of ischemic necrosis due to the blockage of blood supply to tissue.

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    Infarct Types

    Infarcts can be classified as red (haemorrhagic) or white (anaemic).

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    Infarct Histology

    Most infarcts show ischemic coagulative necrosis except brain (liquefactive) and septic ones (abscess formation).

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    Factors Influencing Infarct

    Four key factors include vascular anatomy, rate of occlusion, tissue vulnerability, and hypoxemia.

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    Types of Shock

    Three major shock types: cardiogenic, hypovolemic, and septic, each with distinct causes and effects.

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    Septic Shock

    A life-threatening condition caused by systemic immune response to infections.

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    Colloid Osmotic Pressure Decrease

    A reduction in the pressure exerted by proteins in plasma, often due to lower albumin levels.

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    Nephrotic Syndrome

    A kidney disorder causing increased protein loss due to glomerular capillary wall damage.

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    Lymphatic Obstruction

    Impaired drainage of lymphatic fluid leading to localized swelling or lymphedema.

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    Elephantiasis

    Severe swelling typically due to parasitic infection affecting lymphatics.

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    Hemorrhage

    The escape of blood from vessels, which can manifest in various forms such as petechiae or ecchymoses.

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    Thrombosis

    Pathological formation of a blood clot within a blood vessel, disrupting normal blood flow.

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    Normal Hemostasis

    The process that maintains blood in a fluid, clot-free state, forming a plug when vessels are injured.

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    Coagulation Cascade

    A series of steps involving tissue factor and thrombin to form a stable blood clot from fibrinogen.

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    Study Notes

    Impaired Blood Flow and Bodily Fluid

    • The lecture discusses impaired blood flow and other bodily fluids, including haemodynamic disorders, thromboembolism, and shock.
    • Normal conditions maintain plasma proteins within blood vessels, with minimal water and electrolyte movement into tissues.
    • Pathologic conditions alter this balance.

    Lecture Objectives

    • Students should be able to describe haemodynamic disorders.
    • Students should be able to describe thromboembolism.
    • Students should be able to describe shock.

    Introduction

    • In normal conditions, plasma proteins remain in blood vessels.
    • Little net movement of water and electrolytes into tissues.
    • Pathologic conditions alter this balance.
    • How it happens: Altered endothelial function, Increased vascular pressure, Decreased plasma protein content.

    Hyperaemia and Congestion

    • Both hyperaemia and congestion involve changes in tissue volume.
    • Hyperaemia is an active process involving arteriolar dilation and increased blood inflow. It occurs in inflammation and exercising skeletal muscle (red).
    • Congestion is a passive process relating to impaired outflow of venous blood (blue).

    Oedema

    • Oedema is the movement of fluid from blood vessels into interstitial spaces.
    • Fluid can be protein-poor (transudate) or protein-rich (exudate).
    • Fluid can collect in body cavities like hydrothorax, hydropericardium, and hydroperitoneum (ascites).
    • Massive generalized oedema is called anasarca.

    Causes of Oedema

    • Homeostasis balances vascular hydrostatic and plasma colloid osmotic pressures. Their imbalance causes oedema.
    • Four causes include: Increased hydrostatic pressure, Reduced plasma osmotic pressure, Lymphatic obstruction (inflammation and neoplasia), Sodium and water retention (renal failure), and Increased vascular permeability (inflammation).

    Increased Hydrostatic Pressure

    • Impaired venous return leads to local venous pressure (e.g., DVT).
    • Generalized venous pressure occurs in congestive heart failure (increased central venous pressure, reduced renal perfusion).
    • Increased arteriolar dilation also contributes.

    Congestive Heart Failure

    • Congestive heart failure increases venous pressure, leading to capillary filtration and oedema.
    • Increased venous pressure, decreased cardiac output, elevated sympathetic activity, decreased renal blood flow , elevated renin, elevated angiotensin, increased aldosterone, and sodium and water retention.

    Reduced Plasma Osmotic Pressure

    • Albumin is crucial for maintaining colloid osmotic pressure.
    • Reduced albumin synthesis (cirrhosis, malnutrition) or increased loss (nephrotic syndrome) leads to decreased osmotic pressure.

    Lymphatic Obstruction

    • Impaired lymphatic drainage leads to lymphedema.
    • Common causes include inflammation, therapy complications, or neoplastic obstruction.
    • Examples include parasitic infections, radiation therapy in breast cancer, and breast carcinoma.

    Morphology of Oedema

    • Gross inspection shows organ enlargement.
    • Microscopic examination reveals clearing and separation of extracellular matrix elements.

    Haemorrhage

    • Haemorrhage is the extravasation of blood from vessels.
    • It can occur in various conditions, like hemorrhagic diatheses, trauma, atherosclerosis.
    • Common manifestations include petechiae, purpura, ecchymoses, and hematomas.
    • Clinical severity depends on blood loss volume, rate, and location.

    Haemostasis and Thrombosis

    • Normal haemostasis maintains blood in a fluid state, forming a localized plug at injury sites.
    • Pathologic haemostasis (thrombosis) involves blood clots within intact vessels.

    Haemostasis

    • Vasoconstriction is the initial response to injury.
    • Primary hemostasis involves platelet aggregation forming a plug.
    • Secondary hemostasis (more stable) contains RBCs and leukocytes.
    • Antithrombotic factors (fibrinolysis) degrade thrombi.

    Roles of Endothelium

    • Endothelial cells regulate hemostasis.
    • Antithrombotic properties involve inhibiting platelets, coagulation factors, and promoting fibrinolysis.
    • Prothrombotic properties involve activating platelets and clotting factors.
    • Antifibrinolytic effects also occur.

    Roles of Platelets

    • Platelet adhesion, activation, and aggregation are crucial steps in hemostasis.
    • Specific receptors (GPIb-IX, GPVI, allbβ3) are involved.

    Roles of Coagulation Cascade

    • Tissue factor starts the coagulation cascade.
    • Thrombin converts fibrinogen into fibrin, forming a hemostatic plug.

    Thrombosis

    • Three factors are involved in thrombosis:
    • Endothelial injury
    • Abnormal blood flow
    • Hypercoagulability

    Morphology

    • Arterial or cardiac thrombi often occur at sites of endothelial injury.
    • Venous thrombi occur at sites of stasis.
    • Mural thrombi form in heart chambers or aorta.
    • Vegetations are thrombi in heart valves

    Fate of Thrombus

    • Propagation, embolization, dissolution, or organization and recanalization can follow thrombus formation.

    Clinical Correlation

    • Arterial thrombosis leads to coronary and cerebral vessel obstruction, causing myocardial infarction and stroke.
    • Venous thrombosis (e.g., DVT) can embolize to the lung.

    Embolism

    • An embolus is a foreign substance (solid, liquid, gaseous) carried by blood.
    • Thromboembolism originates from a dislodged thrombus.
    • Systemic effects include infarction, and pulmonary involvement leads to hypoxia and right heart failure.

    Two Types of Emboli

    • Pulmonary emboli travel through venous pathways, often from deep vein thrombosis. Large emboli can be life-threatening.
    • Systemic emboli travel through arterial pathways, often arising from cardiac mural thrombi, valvular thrombi, aortic aneurysms, and atherosclerosis.

    Fat, Amniotic Fluid, and Air Emboli

    • Fat emboli arise from soft tissue or bone fractures.
    • Amniotic fluid emboli originate from placental tears.
    • Air emboli can occur during surgery or during rapid decompression in certain activities like scuba diving.

    Infarction

    • An infarct is a region of ischemic (lack of blood) tissue necrosis.
    • Arterial occlusion is the most common cause.
    • Types include red (haemorrhagic) and white (anemic) infarcts.
    • Possible locations include myocardial, cerebral, and pulmonary.

    Morphology/ Histology of Infarction

    • In most tissues the infarction is ischemic coagulative necrosis.
    • Brain, however, undergoes liquefactive necrosis.
    • Septic infarctions become abscesses.

    Factors Influencing Infarct Development

    • Vascular anatomy
    • Rate of occlusion
    • Tissue vulnerability to ischaemia
    • Hypoxemia

    Shock

    • Shock is a final common pathway for several lethal events.
    • Examples include exsanguination, extensive trauma/burns, myocardial infarction, pulmonary embolism, and sepsis.

    Three Major Types of Shock

    • Cardiogenic shock involves pump failure (e.g., myocardial infarction or arrhythmias).
    • Hypovolemic shock results from insufficient blood volume (e.g., hemorrhage, burns, or dehydration).
    • Septic shock is a systemic response to infection (e.g., endotoxic shock).

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    Description

    This quiz covers essential concepts in hematology and thrombus formation. It assesses knowledge on embolism types, thrombosis mechanisms, ischemic conditions, and lymphatic drainage issues. Ideal for medical students and healthcare professionals focusing on this specialization.

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