Last 5 pages of hemo. for patho

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xcutex17  on October 28, 2010

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Wju Nuclear Med

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Last 5 pages of hemo. for patho

Arterial Thrombi Morphology
adherent masses of blood that have areas of pale alternating with areas of red - lines of zahn
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Arterial Thrombi Morphology adherent masses of blood that have areas of pale alternating with areas of red - lines of zahn
4 Arterial Thrombi outcome 1. resolution
2. organization/incorporation
3. embolization (arterial)
4. propagation
*all similar to venous thrombi
Disseminated Vascular Coagulation a sudden onset of fibrin thrombi in the microcirculation with consumption of coagulation factors and formation of fibrin degradation products. Potential complication with widespread of thrombin.
Embolism a detached solid, gaseous, or liquid mass that is carried by the blood from site of origin to a distal site. May lodge in pulmonary or systemic circulation.
5 types of embolisms Thrombi, fat, amniotic fluid, foreign substances, and bone marrow
Pulmonary Thromboembolism -20 to 25 per 100,000 PTs have it
-fatal if 60% of circulation is obstructed
Patho of Pulmonary Thromboembolism deep venous thrombi is usual cause; often following immobilization, i.e. bed rest from hospitalization
Sequelae sudeen death, clinically silent; resolution, organization, dyspnea, pulmonary infarct
Pumonary Infarct emobilzation to small distal vessels in lung may cause ischemic necrosis of tissue infarct
Paradoxical emboli emboli that travel from venous arterial circulation via a communication between arterial and venous circulation
Infarction ischemic necrosis of tissue distal to an area of arterial occulsion or in an area of obstructed venous outflow
Red infarct hemorrhagic; organs with dual blood supply; soft aerated tissues
Anemic infarct white; organs with single blood supply
Edema excess fluid in the interstital spaces of the body
Oncotic (albumin) major factors KEEPING fluid in vessel
Hydrostatic Pressure major factors PUSHING fluid out of vessel
Hyperemia (erythema) increased inflow into a vessel; i.e. exercise, inflammation
Congestion (cyanosis/hypoxia) decreased outflow of a vessel; i.e. local obstruction, congestive heart failure
Shock hypoperfusion of tissues; the circulatory system can no longer supply nutrients and oxygen to peripheral tissues.
Hypovolemic shock loss of blood volume; i.e. hemorrhages, water loss from burns, vomitting/diarrhea
Cardiogenic shock pump failure; i.e. secondary to MI, conduction block or arrythmia, myocarditis or valvular heart disease
Hypotonic shock loss of peripheral vascular tone and pooling of blood in dilated peripheral blood vessels
3 causes of hypotonic shock Allergen (bee sting), neurogenic (spinal cord, pain from trauma), and bacterial endotoxins (septic shock)
Is shock reversible? early stages of shock are reversible and treatable. in the early stages, peripheral vasoconstriction helps compensate for hypoperfusion. the central pooling redirects blood to vital organs. if untreated, can cause death.
Pathology of shock (upon autopsy) interal organs are congested and wet from edema; the lungs are 2-3 times heavier. the liver is congested and blood oozes from it. the intestines are dark from blood pooling and wet. the kidneys are swollen, pale, and congested. and the brain is edematous, flattened gyri.
Why are hemorrhages widespread? because of DIC
Clinicopatholgic correlations of shock -early of compensated shock
-decompensated, but reversible shock
-irreversible shock
Compensated shock a set of adaptations occur to compensate for the circulatory imbalance. i.e. tachycardia, vasoconstriction of peripheral arteries, and reduced urine production
Decompensated shock when early shock fails: hypotension occurs, BP and CO fall. Tachypnea and SOB lead to heart failure and pulmonary edema causing anoxia, lead to ARDS.
Oliguria constriction of the renal cortical vessels reduces GFR. results in renal output.
Acidosis mixed acidosis occurs. result of renal, anaerobic glycolosis, and respiratory insufficiency.
Irreversible shock the end result of decompensated shock. marked by: circulatory collapse, hypoperfusion of vital organs, and loss of vital functions. PTs are in distress and are frantic, DIC is common, and high mortality.

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