Thrombosis

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Questions and Answers

Which type of hemorrhage results from moderate injury to endothelial cells in the capillary beds?

Ecchymotic hemorrhages (ecchymoses) (correct)

Hemorrhage, anticoagulant (warfarin‐containing) rodenticide toxicosis

Suffusive hemorrhage

None of the above

Which vitamin deficiency is attributed to the extensive hemorrhage in the subcutis of the dog?

Vitamin C

Vitamin E

Vitamin D

Vitamin K (correct)

What is the cause of suffusive hemorrhage in the stomach of the dog?

Vitamin K deficiency

Moderate injury to endothelial cells in the capillary beds

Severe injury to endothelial cells in the capillary beds (correct)

Anticoagulant rodenticide toxicosis

What is the most common cause of septic shock?

Gram-negative infections Signup and view all the answers

Which type of shock results from failure of the cardiac pump?

Cardiogenic shock Signup and view all the answers

What characterizes the nonprogressive stage of shock?

Activation of reflex compensatory mechanisms Signup and view all the answers

What are the cellular and tissue changes induced by shock essentially due to?

Hypoxic injury due to hypoperfusion Signup and view all the answers

What is the most common cause of hypovolemic shock?

Hemorrhage Signup and view all the answers

What is the result of systemic vasodilation and increased vascular permeability mediated by IgE hypersensitivity reaction?

Anaphylactic shock Signup and view all the answers

What is the clinical triad of septic shock?

Hypotension, DIC, metabolic disturbances Signup and view all the answers

What is the result of loss of vascular tone leading to peripheral blood pooling?

Neurogenic shock Signup and view all the answers

Which type of thrombus is characterized by abundant RBCs and is red in color?

Stasis thrombus Signup and view all the answers

What is the main cause of pulmonary thrombosis according to the text?

Tortuous vessels Signup and view all the answers

What is responsible for making platelets in the bone marrow?

Megakaryocyte cells Signup and view all the answers

What causes the laminated appearance of larger arterial thrombi?

Alternating layers of platelets and fibrin Signup and view all the answers

What happens during the recanalization of a thrombus?

Small cavernous structures lined by new endothelial cells are formed Signup and view all the answers

How is an artery distinguished from a vein?

Presence of smooth muscle and elastin Signup and view all the answers

What causes venous infarction?

Stagnation of blood flow and reduction of venous return Signup and view all the answers

What prevents the venous return in a case of small intestinal volvulus?

Compression of the veins by the volvulus Signup and view all the answers

What is the outcome of arterial obstruction according to the text?

Abrupt coagulative necrosis Signup and view all the answers

What is the appearance of acute pale infarcts in the kidney?

Multiple pale white to tan pyramidal-shaped infarcts Signup and view all the answers

What does the presence of a saddle thrombus indicate?

Pulmonary embolism Signup and view all the answers

What leads to the formation of a venous infarct?

Stagnation of blood flow and reduction or loss of venous return Signup and view all the answers

What is the role of platelets in hemostasis?

Adhering to subendothelial collagen and undergoing reactions such as adhesion, shape change, secretion, and aggregation Signup and view all the answers

What are the contents of platelet alpha-granules?

P-selectin Signup and view all the answers

What can influence thrombosis?

Endothelial injury, stasis or turbulence in blood flow, and blood hypercoagulability Signup and view all the answers

What are the morphological features of thrombi on heart valves?

Vegetations Signup and view all the answers

What is the consequence of arterial thrombosis?

Frequently occlusive and can lead to downstream tissue infarction, especially in the brain, kidneys, and spleen Signup and view all the answers

What is the consequence of venous thrombosis?

Invariably occlusive and can lead to tissue infarction Signup and view all the answers

What is the role of the coagulation cascade in hemostasis?

Inducing localized hemostatic plug formation at the site of injury Signup and view all the answers

What is the difference between normal hemostasis and thrombosis?

Normal hemostasis maintains clot-free blood in vessels, while thrombosis involves blood clot formation in uninjured vessels Signup and view all the answers

What can lead to thrombosis?

Stasis or turbulence in blood flow Signup and view all the answers

What are the essential contents of platelet dense (delta) granules?

Calcium and ADP Signup and view all the answers

What can thrombi lead to in affected tissues?

Ischemic damage and necrosis Signup and view all the answers

Which type of embolus is a detached, intravascular mass that can cause partial or complete vascular occlusion and ischemic necrosis?

Thromboembolism Signup and view all the answers

What is the primary origin of most pulmonary emboli that can lead to sudden death or right ventricular failure?

Deep leg vein thrombi Signup and view all the answers

Which complication of labor is caused by the entry of amniotic fluid into the maternal circulation?

Amniotic fluid embolism Signup and view all the answers

Where is the dominant histologic characteristic of infarction ischemic coagulative necrosis, except for which organ where liquefactive necrosis occurs?

Brain Signup and view all the answers

What can lead to vessel obstruction, embolization, dissolution, or organization and recanalization?

Thromboembolism Signup and view all the answers

Which type of embolism can occur during obstetric procedures or chest wall injury, leading to pleural rupture?

Air embolism Signup and view all the answers

What can lead to pulmonary insufficiency and neurologic syndromes and is often found after long bone fractures?

Fat embolism Signup and view all the answers

What are areas of ischemic necrosis caused by occlusion of arterial supply or venous drainage?

Infarcts Signup and view all the answers

What is the final common pathway for potentially lethal events and results in systemic hypoperfusion?

Shock Signup and view all the answers

Which type of infarct can be red (hemorrhagic) or white (anemic), and may be septic or bland?

Arterial infarct Signup and view all the answers

What primarily arises from intracardial mural thrombi or aortic aneurysms?

Systemic thromboembolism Signup and view all the answers

What can cause partial or complete vascular occlusion and ischemic necrosis?

Embolism Signup and view all the answers

Which type of shock results from failure of the cardiac pump?

Cardiogenic shock Signup and view all the answers

What primarily causes septic shock?

Endotoxic shock Signup and view all the answers

What is the result of loss of vascular tone leading to peripheral blood pooling?

Neurogenic shock Signup and view all the answers

What is the consequence of venous thrombosis?

Ischemic necrosis Signup and view all the answers

What are the cellular and tissue changes induced by shock essentially due to?

Hypoperfusion and thrombosis Signup and view all the answers

What is the most common cause of hypovolemic shock?

Hemorrhage Signup and view all the answers

What is the result of systemic vasodilation and increased vascular permeability mediated by IgE hypersensitivity reaction?

Anaphylactic shock Signup and view all the answers

What is the outcome of arterial obstruction according to the text?

Cellular hypoxia Signup and view all the answers

Which of the following is not a consequence of atherosclerosis?

Pulmonary embolism Signup and view all the answers

What is the characteristic feature of a true aneurysm?

Involves all three layers of arterial wall Signup and view all the answers

Which condition results from loss of smooth muscle cells and fragmentation of elastic fibers in the aortic wall?

Aortic dissection Signup and view all the answers

What is the primary cause of aneurysms?

Atherosclerosis Signup and view all the answers

What is the major risk factor implicated in aortic dissection in animals?

Hypertension Signup and view all the answers

Which type of vasculitis is characterized by immune-mediated inflammation?

Noninfectious vasculitis Signup and view all the answers

What is the primary component of fibrous plaques in mild atherosclerosis?

Collagen Signup and view all the answers

What is the pathological basis of degenerative diseases in the presence of hyperplastic arteriosclerosis?

Elastic fibers erratic Signup and view all the answers

What is the primary characteristic of hyaline arteriosclerosis?

Homogeneous deposition of protein-like material Signup and view all the answers

What is the function of peripheral resistance in regulating blood pressure?

Caliber and tone of arterioles Signup and view all the answers

What is the primary consequence of disseminated intravascular coagulopathy (DIC)?

Systemic endothelial and leukocyte activation Signup and view all the answers

What is the primary function of blood pressure in the body?

Maintaining cardiac output Signup and view all the answers

Which of the following is a characteristic of left-sided heart failure?

Hypertrophy, dilation, fibrosis, and extracardiac lesions Signup and view all the answers

Which condition initially causes left-to-right shunt due to low pressures in pulmonary circulation?

Patent ductus arteriosus Signup and view all the answers

What is the most common cause of right-sided heart failure?

Left ventricular failure Signup and view all the answers

Which clinical syndrome is often associated with obstructive atherosclerotic disease?

Angina pectoris Signup and view all the answers

What is the result of necrosis of heart muscle due to ischemia?

Myocardial infarction Signup and view all the answers

What contributes to arrhythmias and results in a decrease in ATP production?

Ischemia Signup and view all the answers

Which tumor is a malignant tumor of blood vessels?

Angiosarcoma Signup and view all the answers

What type of congenital heart defect leads to cyanosis due to poorly oxygenated blood entering the systemic circulation?

Tetralogy of Fallot Signup and view all the answers

What is a characteristic of left-to-right shunt congenital heart defects?

Increased pulmonary blood flow and right ventricular hypertrophy Signup and view all the answers

What is the most common cause of heart failure?

Ischemic Heart Disease Signup and view all the answers

What is the consequence of right-to-left shunt defects?

Cyanosis Signup and view all the answers

Which type of tumor is an intermediate-grade tumor of blood vessels?

Kaposi Sarcoma Signup and view all the answers

Which of the following is a major cause of congenital heart disease?

Congenital infection (rubella virus) Signup and view all the answers

What is the most common initial effect of left to right shunt in congenital heart defects?

Pulmonary blood flow increase Signup and view all the answers

What is the most common type of congenital cardiac defect causing left to right shunt?

Atrial septal defect Signup and view all the answers

Which of the following is a characteristic of dilated cardiomyopathy (DCM)?

Progressive cardiac dilation and contractile dysfunction Signup and view all the answers

What is the most common cause of dilated cardiomyopathy (DCM)?

Toxic exposure (e.g., alcohol, doxorubicin) Signup and view all the answers

What is the main characteristic of hypertrophic cardiomyopathy?

Thickened myocardial cells and haphazardly arranged myofibers Signup and view all the answers

What is the cause of myocarditis?

Infectious diseases (e.g., Coxsackievirus, parvovirus) Signup and view all the answers

What is the primary characteristic of restrictive cardiomyopathy?

The walls of the heart cannot contract or relax properly Signup and view all the answers

What is the most common cause of restrictive cardiomyopathy?

Calcium, iron, or potassium defects Signup and view all the answers

Which type of tumor arises from modified smooth muscle cells of the glomus body and is involved in thermoregulation?

Glomangioma Signup and view all the answers

What is the characteristic feature of Kaposi Sarcoma?

Red to purple skin plaques Signup and view all the answers

What is the primary characteristic of hemangiosarcoma?

Malignant endothelial neoplasms Signup and view all the answers

What is the primary characteristic of hemangiopericytoma?

Rare tumors derived from pericytes Signup and view all the answers

What is the characteristic feature of Bacillary angiomatosis?

Opportunistic infection in immunocompromised persons Signup and view all the answers

Which condition is characterized by cyanosis and obstruction to the right ventricular outflow tract?

Tetralogy of Fallot Signup and view all the answers

What contributes to right to left shunt in Tetralogy of Fallot?

Aorta overriding VSD Signup and view all the answers

What is a common feature of right to left shunt defects?

Cyanosis Signup and view all the answers

What can lead to reverse flow and cyanosis in left to right shunt defects?

Right ventricular hypertrophy Signup and view all the answers

What is the primary cause of left-sided heart failure?

Ischemic heart disease Signup and view all the answers

What can cause obstruction due to narrowing and thickening of the right ventricle?

Pulmonary artery stenosis Signup and view all the answers

What can result from inadequate cardiac output or increased congestion of venous circulation?

Congestive heart failure Signup and view all the answers

What can lead to systemic and portal venous congestion?

Right-sided heart failure Signup and view all the answers

What is a characteristic of right-sided heart failure?

Cyanosis Signup and view all the answers

What is the result of ischemic heart disease?

Necrosis, fibrosis, and inflammation Signup and view all the answers

What can be caused by infections, autoimmune diseases, and alcohol abuse?

Dilated cardiomyopathy Signup and view all the answers

What allows blood flow from the aorta to the pulmonary artery during intrauterine life?

Patent Ductus Arteriosus Signup and view all the answers

Study Notes

Pathophysiology of Thrombosis, Embolism, and Infarction

Thrombosis can lead to vessel obstruction, embolization, dissolution, or organization and recanalization
An embolus is a detached, intravascular mass that can cause partial or complete vascular occlusion and ischemic necrosis
Most pulmonary emboli originate from deep leg vein thrombi and can lead to sudden death or right ventricular failure
Systemic thromboembolism primarily arises from intracardial mural thrombi or aortic aneurysms
Air embolism can occur during obstetric procedures or chest wall injury, leading to pleural rupture
Amniotic fluid embolism is a complication of labor caused by entry of amniotic fluid into the maternal circulation
Fat embolism, often found after long bone fractures, can lead to pulmonary insufficiency and neurologic syndromes
Infarcts are areas of ischemic necrosis caused by occlusion of arterial supply or venous drainage
Infarcts can be red (hemorrhagic) or white (anemic), and may be septic or bland
The dominant histologic characteristic of infarction is ischemic coagulative necrosis, except in the brain where liquefactive necrosis occurs
Factors influencing infarct development include vascular supply, rate of occlusion development, and vulnerability to hypoxia
Shock is the final common pathway for potentially lethal events and results in systemic hypoperfusion, with the brain and heart being the most sensitive organs.

Cardiovascular Pathology Overview

Infectious vasculitis involves invasion of vascular walls by microbial agents, leading to nodular, proliferating immune-mediated vasculitis like Polyarteritis Nodosa (PAN).
Tumors of blood vessels include benign variants like hemangioma, lymphangioma, and glomangioma, as well as intermediate-grade tumors like Kaposi Sarcoma and malignant tumors like Angiosarcoma.
Congenital heart disease encompasses abnormalities of the heart or greater vessels present at birth, with causes including congenital infections and genetic factors, divided into three major groups based on their effects.
Left-to-right shunt congenital heart defects, such as septal defects and patent ductus arteriosus, initially cause left-to-right shunt due to low pressures in pulmonary circulation, leading to increased pulmonary blood flow and right ventricular hypertrophy.
Left-to-right shunt defects can progress to pulmonary hypertension and right ventricular hypertrophy, causing a reverse flow and resulting in cyanosis.
Right-to-left shunt defects, such as Tetralogy of Fallot, lead to cyanosis because poorly oxygenated blood enters the systemic circulation, bypassing the pulmonary circulation.
Heart failure, also known as congestive heart failure (CHF), can affect the left side, right side, or both sides of the heart, with common causes including Ischemic Heart Disease and systemic hypertension.
Left-sided heart failure is characterized by hypertrophy, dilation, fibrosis, and extracardiac lesions, leading to symptoms like dyspnea, cardiomegaly, and tachycardia.
Right-sided heart failure is most commonly caused by left ventricular failure, leading to systemic and portal venous congestion, peripheral edema, and pleural effusion.
Ischemic heart disease is prevalent in human medicine and is often due to obstructive atherosclerotic disease, leading to clinical syndromes like angina pectoris, acute myocardial infarction, chronic IHD, and sudden cardiac death.
Myocardial infarction, also known as a heart attack, results from necrosis of heart muscle due to ischemia, often caused by acute coronary artery thrombosis, leading to irreversible ultrastructural changes and myocyte death.
Ischemia also contributes to arrhythmias and results in a decrease in ATP production, accumulation of noxious breakdown products, and loss of contractility within minutes.

Congenital Heart Defects and Diseases

Ventricular Septal Defects (VSD) and Atrial Septal Defects (ASD) are examples of septal defects in congenital heart disease
Pulmonary hypertension and right ventricular hypertrophy can lead to reverse flow and cyanosis in left to right shunt defects
Patent Ductus Arteriosus allows blood flow from the aorta to the pulmonary artery during intrauterine life
Cyanosis, caused by poorly oxygenated blood entering systemic circulation, is a common feature of right to left shunt defects
Tetralogy of Fallot is characterized by cyanosis and obstruction to the right ventricular outflow tract
Four factors contribute to right to left shunt in Tetralogy of Fallot: VSD, obstruction to RV outflow tract, aorta overriding VSD, and RV hypertrophy
Stenotic pulmonary artery causes obstruction due to narrowing and thickening of the right ventricle
Heart failure, also known as congestive heart failure (CHF), can result from inadequate cardiac output or increased congestion of venous circulation
Left-sided heart failure is commonly caused by ischemic heart disease, systemic hypertension, or valvular disease
Myocardial infarction, a result of ischemic heart disease, is characterized by necrosis, fibrosis, and inflammation
Dilated cardiomyopathy can be caused by infections, autoimmune diseases, alcohol abuse, and other factors
Right-sided heart failure is often due to left ventricular failure, pulmonary hypertensive diseases, or pulmonary valvular disease, leading to systemic and portal venous congestion

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Description

Test your knowledge of the pathophysiology of thrombosis, embolism, and infarction with this quiz. Explore the mechanisms, clinical implications, and histologic characteristics of these vascular events, including pulmonary emboli, systemic thromboembolism, and different types of infarcts. Gain insights into the factors influencing infarct development and the role of shock in systemic hypoperfusion.