What is edema?
Accumulation of excess fluid within the interstitial tissue and body cavities.
p.44
Shock Types and Pathophysiology
What causes Amniotic Fluid Embolism?
Infusion of amniotic fluid or fetal tissue into maternal circulation.
p.53
Shock Types and Pathophysiology
What is hypovolemic shock?
A condition caused by loss of blood or plasma volume.
p.24
Hemostasis and Thrombosis
What is the primary purpose of the fibrinolytic system?
To break down fibrin in clots to prevent the formation of excessively large blood clots.
p.24
Hemostasis and Thrombosis
What does the fibrinolytic system help to prevent?
The formation of excessively large blood clots and the persistence of unwanted clots.
p.16
Congestion and Hyperemia
What is chronic venous congestion in the lung characterized by?
Excess blood fluid filling the alveolar microcapillaries.
What are the key factors that contribute to water balance in the body?
Hydrostatic pressure, osmotic pressure, interstitial pressure, and lymphatics.
p.34
Hemostasis and Thrombosis
What is an organized thrombus?
A thrombus that has undergone a process of organization, where the body attempts to repair and remodel the clot.
p.48
Infarction and Ischemic Necrosis
What is a White (Anemic) Infarct?
An infarct caused by arterial occlusion in solid organs.
p.48
Infarction and Ischemic Necrosis
In which types of organs are White Infarcts commonly found?
In solid organs such as the heart, spleen, kidney, and brain.
p.52
Shock Types and Pathophysiology
What are the initial consequences of shock?
Hypotension, impaired tissue perfusion, and cellular hypoxia.
p.41
Embolism Types and Mechanisms
When do clinical findings of fat embolism typically appear?
1 to 3 days after injury.
p.34
Hemostasis and Thrombosis
What is the significance of recanalization?
It allows for the restoration of blood flow in vessels previously occluded by a thrombus.
p.52
Shock Types and Pathophysiology
What can reversible cellular injury lead to if not addressed?
Irreversible tissue injury and organ failure.
p.34
Hemostasis and Thrombosis
What does recanalization refer to in the context of thrombus?
The process by which new channels form through a thrombus, restoring blood flow.
p.48
Infarction and Ischemic Necrosis
What is an anatomic or functional end artery?
An artery that supplies a specific area without collateral circulation.
p.16
Hemodynamic Disorders
What color do macrophages turn when they metabolize hemoglobin?
Yellow-brown due to hemosiderin.
p.53
Shock Types and Pathophysiology
What is cardiogenic shock?
A condition caused by cardiac pumping failure.
p.51
Infarction and Ischemic Necrosis
What anatomical difference influences the development of infarcts?
The vascular supply, such as lung and liver vs kidney and spleen.
p.49
Infarction and Ischemic Necrosis
What does the term 'infarction' refer to?
Tissue death due to lack of blood supply.
p.13
Hyperemia and Congestion
What is hyperemia?
Local increased blood volume in a particular tissue due to arteriolar dilation and increased blood inflow.
p.30
Hemostasis and Thrombosis
What is the significance of the term 'benign' in the context of abnormal tissue growth?
It refers to non-cancerous growths.
p.23
Hemostasis and Thrombosis
What is the primary function of the coagulation cascade?
To facilitate blood clotting.
p.23
Hemostasis and Thrombosis
What role do activated factors play in the coagulation cascade?
They accelerate the reactions in the cascade.
p.2
Hemostasis and Thrombosis
What circulatory disturbances are of an obstructive nature?
Hemostasis, thrombosis, embolism, and infarction.
p.19
Hemostasis and Thrombosis
What is hemostasis?
The interaction of endothelial cells, platelets, and clotting factors at the site of vascular injury to form blood clots.
p.35
Disseminated Intravascular Coagulation (DIC)
What characterizes Disseminated Intravascular Coagulation (DIC)?
Widespread fibrin thrombi in the microcirculation.
p.49
Infarction and Ischemic Necrosis
What is the gross appearance of a white infarct?
Triangular or wedge-shaped with sharp margins.
p.42
Embolism Types and Mechanisms
What is fat embolism?
A condition where fat globules enter the bloodstream and can cause blockages.
p.27
Embolism Types and Mechanisms
什么是感染性心内膜炎引起的脑部血肿的原因？
心内膜的vegetation脱落形成emboli，导致脑血管堵塞。
p.9
Pathophysiologic Causes of Edema
What is a primary cause of edema related to sodium and water retention?
Increasing hydrostatic pressure.
p.9
Pathophysiologic Causes of Edema
What conditions are associated with sodium and water retention leading to edema?
Acute glomerulonephritis, acute renal failure, congestive heart failure.
p.22
Hemostasis and Thrombosis
What substances are found in dense (δ) granules of platelets?
ADP, ATP, ionized calcium, histamine, serotonin, and epinephrine.
p.35
Disseminated Intravascular Coagulation (DIC)
What is a consequence of widespread fibrin thrombi in DIC?
Depletion of clotting factors and platelets.
p.19
Hemostasis and Thrombosis
What role does vasoconstriction play in hemostasis?
It reduces blood flow at the site of vascular injury.
p.53
Shock Types and Pathophysiology
What are common causes of cardiogenic shock?
Myocardial damage (infarction), ventricular arrhythmias, extrinsic compression, and outflow obstruction.
p.32
Clinical Consequences of Thrombosis and Embolism
What can be a consequence of thrombus formation?
Decreased lumen, occlusion of lumen, or embolus leading to infarction.
p.33
Hemostasis and Thrombosis
How does fibrin contribute to thrombus stability?
Fibrin forms a mesh that stabilizes the thrombus and helps trap blood cells.
p.52
Shock Types and Pathophysiology
What causes systemic hypoperfusion in shock?
Reduced cardiac output or reduced effective circulating blood volume.
p.39
Embolism Types and Mechanisms
What is the significance of a saddle embolus?
It can obstruct blood flow to both lungs, leading to severe respiratory distress.
p.31
Hemostasis and Thrombosis
Where is venous thrombosis most commonly located?
In the veins of the lower extremities (90%).
What is the primary consequence of chronic venous congestion?
Hypoxia leading to parenchymal cell degeneration or death.
What are common causes of prolonged gradual venous obstruction?
Thrombosis and external compression.
p.58
Shock Types and Pathophysiology
What pathologic change occurs in the heart as a result of shock?
Focal or diffuse coagulation necrosis and subendocardial hemorrhage.
p.20
Hemostasis and Thrombosis
What are the prothrombotic properties of endothelial cells?
Activation of platelets, activation of clotting factors, and antifibrinolytic effects.
p.58
Shock Types and Pathophysiology
What is the effect of shock on the kidneys?
Tubular ischemic injury, specifically acute tubular necrosis.
p.30
Hemostasis and Thrombosis
What does 'malignant' refer to in abnormal tissue growth?
It refers to cancerous growths.
p.14
Hyperemia and Congestion
What are some causes of local acute venous congestion?
Thrombosis, strangulation, and torsion.
p.51
Infarction and Ischemic Necrosis
What role does blood oxygen content play in infarct development?
Lower blood oxygen content can exacerbate tissue vulnerability to infarction.
p.32
Clinical Consequences of Thrombosis and Embolism
What is collateral circulation?
An alternative pathway for blood flow that can develop in response to occlusion.
p.43
Embolism Types and Mechanisms
What are the clinical manifestations of focal ischemia due to air embolism?
Ischemia in the brain, heart, and lungs, leading to respiratory distress (the chokes).
What are the two main categories of disturbances related to water?
Edema (and effusions) and dehydration.
p.2
Hyperemia and Congestion
What disturbances are associated with circulating volume?
Hyperemia, congestion, and hemorrhage.
p.24
Hemostasis and Thrombosis
What is the role of plasmin in the fibrinolytic system?
To dissolve fibrin clots.
p.16
Hemodynamic Disorders
What do macrophages do in response to RBCs in the lungs?
They phagocytize RBCs and metabolize hemoglobin into hemosiderin.
p.19
Hemostasis and Thrombosis
What is the coagulation cascade?
A series of events that activate clotting factors leading to blood clot formation.
p.42
Embolism Types and Mechanisms
How can fat be removed from the kidney?
By washing it away with alcohol, leaving behind empty spaces.
p.50
Infarction and Ischemic Necrosis
What factors influence the microscopic findings in infarction?
Time and size of the infarction.
p.27
Infarction and Ischemic Necrosis
脑血管堵塞后会导致什么情况？
因压力导致动脉壁的炎症或感染，进而造成血管破裂形成血肿。
p.25
Hemostasis and Thrombosis
What are some causes of vessel rupture leading to hemorrhage?
Trauma, atherosclerosis, inflammatory or neoplastic erosion of vessel wall.
p.13
Hyperemia and Congestion
What causes active hyperemia?
Arteriolar dilation, often due to inflammation or excising skeletal muscle.
p.57
Shock Types and Pathophysiology
What are the clinical signs of the non-progressive stage of shock?
Hypotension, weak and rapid pulse, tachycardia, tachypnea, peripheral vasoconstriction, and renal conservation of fluid.
p.20
Hemostasis and Thrombosis
What is the role of endothelial cells in hemostasis?
They act as central regulators with both antithrombotic and prothrombotic properties.
p.39
Embolism Types and Mechanisms
What is a saddle embolus?
An embolus that lodges at the bifurcation of the pulmonary artery.
p.9
Pathophysiologic Causes of Edema
What role does inflammation play in edema?
It can cause both acute and chronic inflammation, leading to edema.
p.2
Shock Types and Pathophysiology
What are the types of shock mentioned?
Cardiogenic, hypovolemic, septic, and others.
p.28
Hemostasis and Thrombosis
What is thrombosis?
Formation of a clotted mass (thrombus) of blood within the non-interrupted cardiovascular system.
p.5
Pathophysiologic Causes of Edema
What is one pathophysiologic cause of edema related to fluid dynamics?
Increased hydrostatic pressure.
p.30
Clinical Consequences of Thrombosis and Embolism
What are some clinical consequences of arterial thrombosis?
Arrhythmias, dilated cardiomyopathy, myocardial infarct, and atherosclerosis.
p.35
Disseminated Intravascular Coagulation (DIC)
Is DIC a primary disease?
No, it is a complication of various conditions associated with systemic activation of thrombin.
p.33
Hemostasis and Thrombosis
What is the primary structure of a thrombus?
A thrombus is organized into layers, typically consisting of platelets, fibrin, and red blood cells.
p.44
Shock Types and Pathophysiology
What are common clinical symptoms of Amniotic Fluid Embolism?
Postpartum sudden severe dyspnea, cyanosis, shock, headache, seizures, coma.
p.53
Shock Types and Pathophysiology
What are common causes of hypovolemic shock?
Hemorrhage and fluid loss (such as burns or trauma).
What are the effects of chronic venous congestion on the lungs?
Formation of heart failure cells.
p.37
Embolism Types and Mechanisms
What is an embolism?
A detached intravascular solid, liquid, or gaseous mass (embolus) carried by blood from its point of origin to a distant site.
p.58
Shock Types and Pathophysiology
What pathologic change is observed in the lungs due to shock?
Diffuse alveolar damage, also known as shock lung.
p.13
Hyperemia and Congestion
What is congestion?
Passive condition characterized by reduced venous outflow, leading to increased blood volume.
p.25
Hemostasis and Thrombosis
What are defects of primary hemostasis?
Platelet defects, aspirin ingestion, von Willebrand disease.
p.18
Hyperemia and Congestion
What causes centrilobular congestion in the liver?
It is often due to heart failure or other conditions affecting blood flow.
p.46
Infarction and Ischemic Necrosis
What are the two types of infarction based on appearance?
Red (hemorrhagic) and white (anemic) infarction.
p.6
Pathophysiologic Causes of Edema
What condition is associated with arteriolar dilation and increased hydrostatic pressure?
Congestive heart failure.
What are the main topics covered in the course?
Hemodynamic Disorders, Thromboembolic Disease, and Shock.
p.23
Hemostasis and Thrombosis
What is the significance of feedback mechanisms in the coagulation cascade?
They enhance the efficiency of the coagulation process.
p.28
Hemostasis and Thrombosis
What is the Virchow triad?
A set of three factors that contribute to thrombosis, although specific factors are not detailed in the provided text.
p.16
Hemodynamic Disorders
In which patients can heart failure cells be observed?
In patients with lung congestion due to heart failure.
p.20
Hemostasis and Thrombosis
What are the antithrombotic properties of endothelial cells?
Anti-platelet, anticoagulant, and fibrinolytic properties.
p.25
Hemostasis and Thrombosis
What is hemorrhage?
Extravasation of blood due to vessel rupture.
p.42
Embolism Types and Mechanisms
What happens to fat when it is stained?
It can be visually identified in tissues.
p.32
Hemostasis and Thrombosis
What happens during the organization and recanalization of a thrombus?
The thrombus is covered by cells, and tissue is repaired by stem cells, phagocytes, and fibroblasts.
p.44
Shock Types and Pathophysiology
What are the causes of death in Amniotic Fluid Embolism?
Mechanical blockage of pulmonary microcirculation, pulmonary edema, diffuse alveolar damage, DIC.
What liver conditions are associated with chronic venous congestion?
Nutmeg liver and cardiac cirrhosis.
p.53
Shock Types and Pathophysiology
What is anaphylactic shock?
A rare type of shock that is IgE-mediated hypersensitivity.
p.36
Disseminated Intravascular Coagulation (DIC)
What happens to platelets and clotting factors in DIC?
They are consumed, leading to bleeding diathesis.
What conditions can cause generalized edema?
Heart failure and nephrotic syndrome.
p.58
Shock Types and Pathophysiology
What pathologic changes occur in the gastrointestinal tract due to shock?
Focal mucosal hemorrhage and necrosis.
p.37
Embolism Types and Mechanisms
Name some types of emboli.
Fat droplets, air (nitrogen bubbles), amniotic fluid, atherosclerotic debris (cholesterol emboli), tumor fragments, bone marrow, foreign bodies.
p.57
Shock Types and Pathophysiology
What causes the irreversible stage of shock?
Severe cellular and tissue injury.
p.59
Pathophysiologic Causes of Edema
What is edema?
Accumulation of fluid in interstitial spaces.
p.41
Embolism Types and Mechanisms
What neurologic symptoms can occur with fat embolism?
Irritability, restlessness, delirium, and coma.
p.43
Embolism Types and Mechanisms
In what environments is air embolism more likely to occur?
Specific situations such as diving, surgery, or trauma.
p.38
Embolism Types and Mechanisms
What is a saddle embolus?
A type of embolism that can block blood flow in the pulmonary arteries.
p.54
Shock Types and Pathophysiology
What role do inflammatory and counter-inflammatory responses play in septic shock?
They contribute to the overall pathophysiology of the condition.
p.22
Hemostasis and Thrombosis
What is the role of platelets in hemostasis?
They form a primary plug that seals vascular defects and provides a surface for binding and concentrating activated coagulation factors.
p.22
Hemostasis and Thrombosis
What are the contents of α granules in platelets?
P-selectin, fibrinogen, fibronectin, coagulation factors V and VIII, platelet factor 4, PDGF, and TGF-β.
What is the contact method for the instructor?
Email: chencl@tmu.edu.tw.
p.19
Hemostasis and Thrombosis
What are the main phases of hemostasis?
Vasoconstriction, primary hemostasis, secondary hemostasis, thrombosis, and antithrombotic events.
p.32
Hemostasis and Thrombosis
What are the possible fates of a thrombus?
Dissolution (fibrinolysis), propagation (enlarging), embolization, organization, and recanalization.
p.8
Pathophysiologic Causes of Edema
What can cause post-operative lymphedema?
Removal of lymph nodes in the upper limb.
p.44
Shock Types and Pathophysiology
What can be found in maternal pulmonary microcirculation in cases of Amniotic Fluid Embolism?
Epithelial squames, vernix caseosa, mucus, lanugo hairs.
p.27
Embolism Types and Mechanisms
感染性心内膜炎如何影响脑部？
通过形成emboli导致脑血管堵塞，进而引发血肿。
p.25
Hemostasis and Thrombosis
What is hemorrhagic diathesis?
Abnormal bleeding due to defects in hemostasis.
p.18
Hyperemia and Congestion
What are the visual characteristics of nutmeg liver?
It has a mottled appearance with areas of congestion.
What type of edema is characterized by pitting?
Dependent edema and renal edema.
p.14
Hyperemia and Congestion
How does acute venous congestion affect the liver?
It causes dilated central veins and sinusoids filled with blood.
p.50
Infarction and Ischemic Necrosis
What is observed in the cell structure during the early stages of infarction?
Cellular structural changes.
p.46
Infarction and Ischemic Necrosis
What are the two classifications of infarction?
Septic and bland infarction.
p.36
Disseminated Intravascular Coagulation (DIC)
How can trauma or surgery trigger DIC?
Extensive tissue damage releases tissue factors that trigger the coagulation response.
p.26
Hemostasis and Thrombosis
What is ecchymosis and how does it occur?
Ecchymosis, or bruises, are larger (1-2 cm) areas on the skin caused by trauma.
What is a potential consequence of pulmonary edema?
Blood cannot return effectively, leading to complications.
p.36
Disseminated Intravascular Coagulation (DIC)
How can tumors contribute to DIC?
Certain malignant tumors can release pro-coagulant substances that trigger DIC.
p.10
Pathophysiologic Causes of Edema
How does decreased oncotic pressure contribute to systemic edema?
It reduces the ability of blood vessels to retain fluid, leading to leakage into tissues.
p.56
Shock Types and Pathophysiology
How does endothelial dysfunction contribute to septic shock?
It causes increased vascular permeability and contributes to hypotension.
p.59
Infarction and Ischemic Necrosis
What are infarcts?
Areas of ischemic necrosis most commonly caused by arterial occlusion.
p.10
Pathophysiologic Causes of Edema
How does cirrhosis affect systemic edema?
It leads to decreased albumin production and increased portal hypertension.
p.48
Infarction and Ischemic Necrosis
What happens when there is arterial occlusion in a solid organ?
It can lead to significant necrosis, often resulting in large areas of tissue death.
p.30
Hemostasis and Thrombosis
What are the main causes of arterial thrombosis?
Endothelial injury and turbulence.
p.52
Shock Types and Pathophysiology
What contributes to cellular injury during shock?
Hypoxia and accumulation of metabolites.
p.30
Hemostasis and Thrombosis
What types of thrombosis are included under arterial thrombosis?
Arterial thrombosis includes cardiac thrombosis.
p.50
Infarction and Ischemic Necrosis
What type of necrosis is associated with infarction?
Ischemic coagulation necrosis.
p.8
Pathophysiologic Causes of Edema
What are some infectious agents that can cause lymphatic obstruction?
Various pathogens, including those causing filariasis.
p.18
Hyperemia and Congestion
What does the term 'nutmeg liver' describe?
A pattern of congestion in the liver resembling a nutmeg seed.
p.46
Infarction and Ischemic Necrosis
What is infarction?
An area of ischemic necrosis caused by occlusion of either arterial supply or venous drainage in a particular tissue.
p.33
Hemostasis and Thrombosis
What is the significance of red blood cells in thrombus?
Red blood cells can become trapped in the fibrin mesh, contributing to the mass of the thrombus.
p.7
Pathophysiologic Causes of Edema
What are some causes of hypoproteinemia?
Inadequate synthesis, increased loss from circulation, and poor intake.
p.29
Hemostasis and Thrombosis
What are the three components of Virchow's Triad in thrombosis?
Endothelial injury, altered blood flow, and hypercoagulability.
p.45
Embolism Types and Mechanisms
What is a bone marrow embolus?
An embolus that originates from bone marrow, often released during trauma or certain medical procedures.
p.29
Hemostasis and Thrombosis
What can cause endothelial injury?
Atherosclerosis, myocardial infarction, vasculitis, hypertension, turbulence, endotoxins, and hypercholesterolemia.
p.45
Embolism Types and Mechanisms
What is a foreign body embolus?
An embolus that consists of foreign materials that enter the bloodstream, potentially causing blockages.
p.46
Infarction and Ischemic Necrosis
How can infarction be viewed in relation to thrombosis and embolism?
Infarction can be seen as the final result of thrombosis and embolism.
p.40
Embolism Types and Mechanisms
What are the most common embolization sites?
Lower extremities (75%), brain (10%), intestine, kidneys, spleen, upper extremities.
What is systemic edema?
An abnormal accumulation of fluid in the interstitial spaces of the body.
p.40
Infarction and Ischemic Necrosis
What is the consequence of thrombus formation in affected areas?
Loss of function and necrosis.
What characterizes non-inflammatory edema?
It is transudate and protein-poor, resulting from increased hydrostatic pressure or reduced intra-vascular osmotic pressure.
p.29
Hemostasis and Thrombosis
What is antiphospholipid antibody syndrome?
A condition that can be primary or secondary and is associated with increased risk of thrombosis.
p.59
Shock Types and Pathophysiology
What is shock?
Systemic tissue hypoperfusion due to reduced cardiac output and/or reduced effective circulating blood volume.
p.31
Hemostasis and Thrombosis
What are some clinical factors contributing to venous thrombosis?
Cardiac failure, decreased physical activity, vascular injury, and release of coagulation factors.
p.30
Hemostasis and Thrombosis
What is a mural thrombus?
A thrombus that forms on the wall of a blood vessel.
p.19
Hemostasis and Thrombosis
What is the role of activated platelets in hemostasis?
They aggregate at the site of injury to help form a blood clot.
p.20
Hemostasis and Thrombosis
What can cause damage to the endothelium leading to coagulation?
External factors such as nicotine, bacteria, viruses, and infections.
p.53
Shock Types and Pathophysiology
What is neurogenic shock?
A rare type of shock caused by loss of vascular tone.
p.41
Embolism Types and Mechanisms
What is the primary cause of fat embolism?
Fracture of long bones (90%).
What are the two distributions of edema?
Generalized (anasarca) and local.
p.14
Hyperemia and Congestion
What are the effects of acute venous congestion in the lungs?
Blood-engorged capillaries, alveolar septal edema, and intra-alveolar hemorrhage.
p.54
Shock Types and Pathophysiology
What is septic shock associated with?
Systemic inflammation due to microbial infection, burns, or trauma.
p.54
Shock Types and Pathophysiology
What are the primary causes of septic shock?
Mostly caused by gram-positive bacteria, gram-negative bacteria, and fungi.
p.40
Embolism Types and Mechanisms
What are common clinical conditions associated with systemic thromboembolism?
Aortic aneurysm, ulcerated atherosclerotic plaques, fragmented valvular vegetations.
p.29
Hemostasis and Thrombosis
What are the two types of altered blood flow in thrombosis?
Turbulence (arterial and cardiac) and stasis (venous).
p.57
Shock Types and Pathophysiology
What happens to the body in the irreversible stage of shock?
The body can no longer compensate to maintain blood flow.
p.25
Hemostasis and Thrombosis
How does factor XI affect wound healing?
It impacts collagen formation, reducing wound healing ability.
p.29
Hemostasis and Thrombosis
What is hypercoagulability?
A condition where blood has an increased tendency to clot, also known as thrombophilia.
What is a common symptom of sudden high blood pressure related to edema?
Pulmonary edema with blood-tinged fluid.
p.36
Disseminated Intravascular Coagulation (DIC)
What role do immune responses play in DIC?
Autoimmune diseases or allergic reactions may also trigger DIC.
p.38
Clinical Consequences of Thrombosis and Embolism
What treatments are available for pulmonary thromboembolism?
Anticoagulation therapy and surgical repair of defects.
p.31
Hemostasis and Thrombosis
What condition can lead to thrombosis in cancer patients?
Release of substances from cancer cells.
p.33
Hemostasis and Thrombosis
What role do platelets play in thrombus organization?
Platelets aggregate at the site of injury and form the initial plug that contributes to thrombus formation.
p.14
Hyperemia and Congestion
What is acute venous congestion?
A sudden obstruction of venous return, which can be local or generalized.
What are the common locations for edema morphology?
Subcutaneous tissue, lung, and brain.
p.30
Hemostasis and Thrombosis
What is an aneurysm?
An abnormal bulge in the wall of a blood vessel.
p.45
Embolism Types and Mechanisms
What is a tumor embolus?
An embolus formed from tumor cells that can travel through the bloodstream.
p.26
Hemostasis and Thrombosis
What are the two main types of hemorrhage?
External hemorrhage and hemorrhage that accumulates within a tissue.
p.40
Embolism Types and Mechanisms
What are the primary causes of systemic thromboembolism?
Left ventricular infarcts (2/3) and dilated left atrium (25%).
p.26
Hemostasis and Thrombosis
What are petechiae and what causes them?
Petechiae are small (1-2 mm) spots on the skin, mucosa, or serosa caused by increased vascular pressure or thrombocytopenia.
p.58
Shock Types and Pathophysiology
What changes occur in the liver as a result of shock?
Fatty change and central hemorrhagic necrosis.
p.55
Pathophysiologic Causes of Edema
外毒素的來源是什麼？
由活細菌分泌到細胞外，主要由一些革蘭氏陽性菌及少數革蘭氏陰性菌產生。
p.36
Disseminated Intravascular Coagulation (DIC)
What pregnancy complications can lead to DIC?
Conditions like placental abruption or amniotic fluid embolism can cause abnormal coagulation.
p.54
Shock Types and Pathophysiology
What is induced in the body during septic shock?
A procoagulant state and metabolic abnormalities.
p.41
Embolism Types and Mechanisms
What are the two main mechanisms of pathogenesis in fat embolism?
Mechanical obstruction and biochemical injury.
p.56
Shock Types and Pathophysiology
What is coagulopathy in the context of septic shock?
A disorder of blood coagulation that can lead to disseminated intravascular coagulation (DIC).
p.59
Shock Types and Pathophysiology
What are the major types of shock?
Cardiogenic, hypovolemic, and shock associated with systemic inflammatory responses.
p.51
Infarction and Ischemic Necrosis
How does the rate of occlusion development affect infarct formation?
Insidious development leads to different outcomes compared to sudden occlusion.
p.57
Shock Types and Pathophysiology
What characterizes the non-progressive stage of shock?
Activated reflex compensatory mechanisms.
p.51
Infarction and Ischemic Necrosis
Which tissues are more vulnerable to hypoxia?
Brain and heart are more vulnerable compared to fibroblasts.
p.43
Embolism Types and Mechanisms
What are common causes of air embolism?
Obstetric or laparoscopic procedures, chest wall injury, decompression sickness.
p.37
Embolism Types and Mechanisms
What can emboli cause in the vascular system?
Complete vascular occlusion, leading to tissue dysfunction or ischemic necrosis (infarction).
p.58
Shock Types and Pathophysiology
What happens to the adrenal glands during shock?
Cortical cell lipid depletion.
p.33
Hemostasis and Thrombosis
What factors can influence the organization of a thrombus?
Blood flow dynamics, the presence of anticoagulants, and the nature of the vascular injury can all influence thrombus organization.
What are some causes of local edema?
Inflammation and venous obstruction.
p.36
Disseminated Intravascular Coagulation (DIC)
What can cause DIC related to infections?
Severe infections like sepsis can lead to a systemic inflammatory response that activates the coagulation system.
p.7
Pathophysiologic Causes of Edema
How does protein malnutrition contribute to edema?
It leads to decreased serum albumin levels.
p.26
Hemostasis and Thrombosis
What are some examples of internal hemorrhage?
Hematoma, hemothorax, hemopericardium, hemoperitoneum, and hemoarthrosis.
p.56
Shock Types and Pathophysiology
What are the major pathogenic pathways involved in septic shock?
They include immune response dysregulation, endothelial dysfunction, and coagulopathy.
p.6
Pathophysiologic Causes of Edema
What is a potential consequence of blood clot formation in relation to edema?
It can lead to impaired venous return and increased hydrostatic pressure.
p.38
Pathophysiologic Causes of Edema
How does slow blood flow contribute to thrombus formation?
It causes blood to pool, increasing the risk of clot formation.
p.38
Embolism Types and Mechanisms
What is paradoxical embolism?
When a thrombus crosses from the right side of the heart to the left through a defect, entering systemic circulation.
p.7
Pathophysiologic Causes of Edema
What is a primary cause of reduced plasma osmotic pressure leading to edema?
Hypoproteinemia, specifically decreased serum albumin.
p.32
Clinical Consequences of Thrombosis and Embolism
How does thrombus formation affect arteries compared to veins?
Severe effects occur in arteries, potentially leading to hypoxia, while the impact on veins is less severe.
p.43
Embolism Types and Mechanisms
What is the acute form of air embolism characterized by?
Gas bubbles in muscles and supporting tissues around joints (the bends).
p.41
Embolism Types and Mechanisms
What are some other causes of fat embolism?
Soft tissue trauma and burns.
p.25
Hemostasis and Thrombosis
What are defects of secondary hemostasis?
Coagulation factor defects, such as hemophilia.
What are the characteristics of pulmonary edema?
Increased weight, frothy, and blood-tinged fluid.
p.14
Hyperemia and Congestion
What causes generalized acute venous congestion?
Raised venous pressure due to acute heart failure or asphyxia.
p.26
Hemostasis and Thrombosis
What is purpura and what can cause it?
Purpura are larger (3-5 mm) spots on the skin caused by trauma, vasculitis, or increased vascular fragility.
p.43
Embolism Types and Mechanisms
Why does air embolism lead to bone necrosis?
Air bubbles can obstruct blood flow, especially in arteries supplying bones, leading to ischemic necrosis.
What is hydropericardium?
Accumulation of fluid in the pericardial cavity.
p.41
Embolism Types and Mechanisms
What hematologic findings are associated with fat embolism?
Thrombocytopenia, anemia, and diffuse petechial rash.
p.6
Pathophysiologic Causes of Edema
What does the phrase '太多' and '太少' refer to in the context of edema?
Too much fluid entering and too little fluid exiting.
p.38
Pathophysiologic Causes of Edema
What are some causes of deep venous thrombosis (DVT)?
Slow blood flow, structural compression, and coagulation abnormalities.
p.29
Hemostasis and Thrombosis
What are examples of secondary hypercoagulability?
Stasis, vascular injury, smoking, obesity, and heparin-induced thrombocytopenia (HIT) syndrome.
p.10
Pathophysiologic Causes of Edema
What role does lymphatic obstruction play in systemic edema?
It prevents the normal drainage of interstitial fluid, causing accumulation.
p.10
Pathophysiologic Causes of Edema
What is the effect of inflammation on systemic edema?
It increases vascular permeability, allowing fluid to escape into tissues.
p.36
Disseminated Intravascular Coagulation (DIC)
What is a major consequence of Disseminated Intravascular Coagulation (DIC)?
Widespread microthrombi formation leading to ischemia in organs such as the brain, lungs, heart, and kidneys.
p.57
Shock Types and Pathophysiology
What causes the progressive stage of shock?
Tissue hypoperfusion and circulatory/metabolic imbalance.
p.13
Hyperemia and Congestion
How can congestion be classified?
It can be classified as localized or generalized.
p.57
Shock Types and Pathophysiology
What are the clinical manifestations of the progressive stage of shock?
Acidosis, arteriolar dilation, peripheral pooling, confusion, and decreased urine output.
p.13
Hyperemia and Congestion
What are the two types of congestion?
Acute and chronic congestion.
What causes brain edema?
Trauma, infections, neoplasm, hypertensive crises, ventricular or venous obstruction.
What is hydroperitoneum?
Ascites, or accumulation of fluid in the peritoneal cavity.
p.29
Hemostasis and Thrombosis
What are examples of primary hypercoagulability?
Genetic factors such as factor V mutation (factor V Leiden) and prothrombin mutation.
p.56
Shock Types and Pathophysiology
What role does the immune response play in septic shock?
It can lead to excessive inflammation and tissue damage.
p.59
Embolism Types and Mechanisms
What is an embolus?
A solid, liquid, or gaseous mass in circulation.
p.46
Infarction and Ischemic Necrosis
What are the primary causes of infarction?
Arterial thrombotic or embolic events (99%), vasospasm, expansion of atheroma, compression, torsion of vessels, traumatic vascular rupture, and entrapment in hernia sac.
p.50
Infarction and Ischemic Necrosis
What happens to the tissue if the patient survives an infarction?
Scar tissue formation (fibrosis).
p.36
Disseminated Intravascular Coagulation (DIC)
What type of anemia can result from injury to RBCs in DIC?
Microangiopathic hemolytic anemia.
p.25
Hemostasis and Thrombosis
What generalized defects can involve small vessels?
Vasculitis, vitamin C deficiency (Scurvy).
What conditions can lead to pulmonary edema?
Left heart failure, renal failure, acute respiratory distress syndrome, infection, hypersensitivity reactions.
p.29
Hemostasis and Thrombosis
What conditions can lead to altered blood flow?
Atherosclerotic plaque, aneurysm, and myocardial infarction.
p.46
Infarction and Ischemic Necrosis
What happens to tissue during infarction?
The tissue begins to necrose due to lack of oxygen and nutrients, ultimately leading to tissue death.
p.59
Hemostasis and Thrombosis
What can happen to thrombi?
They may propagate, resolve, become organized, or embolize.
p.10
Pathophysiologic Causes of Edema
What is one mechanism that can cause systemic edema?
Increased hydrostatic pressure.
p.55
Pathophysiologic Causes of Edema
外毒素的穩定性如何？
對熱和化學物質敏感，不穩定，通常在60℃以上可迅速破壞。
p.38
Clinical Consequences of Thrombosis and Embolism
What can result from a paradoxical embolism?
Severe consequences such as stroke or myocardial infarction.
p.43
Embolism Types and Mechanisms
What is caisson disease?
The chronic form of air embolism characterized by multifocal ischemic necrosis of the heads of bones.
p.54
Shock Types and Pathophysiology
What do microbial products activate in septic shock?
Inflammatory mediators that activate vascular wall cells and leukocytes.
p.45
Embolism Types and Mechanisms
How can CPR relate to embolism?
CPR can potentially dislodge bone marrow or other materials, leading to embolism.
p.38
Clinical Consequences of Thrombosis and Embolism
What are the common consequences of pulmonary thromboembolism?
Asymptomatic (60-80%), sudden death, cor pulmonale, pulmonary hemorrhage, pulmonary infarction, and pulmonary hypertension.
p.56
Shock Types and Pathophysiology
What is septic shock?
A severe condition resulting from sepsis, characterized by systemic inflammation and organ dysfunction.
p.43
Embolism Types and Mechanisms
What is the significance of clinical cases of air embolism?
There are clear reports and studies linking air embolism to bone necrosis, making it an important medical issue.
p.59
Clinical Consequences of Thrombosis and Embolism
How do thrombi cause tissue injury?
By local occlusion or by distal embolization.
p.59
Embolism Types and Mechanisms
Where do pulmonary emboli primarily derive from?
Lower extremity deep vein thrombi.
p.10
Pathophysiologic Causes of Edema
How does heart failure contribute to systemic edema?
It leads to increased venous pressure and fluid accumulation in tissues.
p.41
Embolism Types and Mechanisms
What are the pulmonary symptoms associated with fat embolism?
Sudden onset of tachypnea, dyspnea, and tachycardia.
p.54
Shock Types and Pathophysiology
What are the consequences of systemic vasodilation in septic shock?
Hypotension, diminished myocardial contractility, endothelial injury, and multi-organ failure.
p.55
Pathophysiologic Causes of Edema
內毒素存在於哪裡？
存在於革蘭氏陰性菌的細胞壁中，通常在細菌死亡或溶解時釋放。
p.40
Hemostasis and Thrombosis
What can lead to the formation of thrombi in the heart?
Changes in blood flow dynamics and blood stasis.
What characterizes inflammatory edema?
It is exudate and protein-rich, resulting from increased vascular permeability.
p.54
Shock Types and Pathophysiology
What metabolic abnormalities are associated with septic shock?
Lactic acidosis, insulin resistance, and hyperglycemia.
p.10
Pathophysiologic Causes of Edema
What is the role of medications in causing systemic edema?
Certain drugs can lead to fluid retention and increased capillary permeability.
p.10
Pathophysiologic Causes of Edema
How can sodium retention lead to systemic edema?
It increases blood volume, which raises hydrostatic pressure in capillaries.
p.10
Pathophysiologic Causes of Edema
What is the impact of renal disease on systemic edema?
It can cause fluid retention and decreased oncotic pressure due to protein loss.
