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Path BRS ch. 3
hemodynamic dysfunction
| Question | Answer |
|---|---|
| heart failure cells | hemosiderin laden macrophages from capillary rupture caused by left sided heart failure and pulmonary congestion |
| what do platelets release after adhesion? | ADP, histamine, serotonins, PDGF |
| how do platelets make thromboxane A2, and what does thromboxane A2 (TxA2) do? | cyclooxygenase pathway from arachidonic acid. potent vasoconstrictor and platelet aggregant |
| PGI2 - who makes it, and what does it do? | made by endothelial cells, antagonistic to platelet TxA2. |
| what activates antithrombin? and what does it do? | heparin. endothelial cells release heparin-like molecules |
| what molecules promote aggregation? | ADP thrombin, TxA2, collagen, epinephrine, PAF |
| what do endothelial cells do to prevent aggregation? | produce heparin-like molecules, tissue plasminogen activator (TPA), degrades ADP, clears thrombin, activates protein c (APC) which cleaves Va and VIIIa. synthesizes protein S (APC cofactor) and synthesizes PGI2 and NO |
| what does XIIa do? | activates intrinsic pathway, activates prokallikrein to kallikrein, which in turn activates HMWK to bradykinin, and plasminogen to plasmin. Plasmin degrades fibrin, and activates complement |
| what does APC (active protein c) cleave? | Va and VIIIa |
| factor V leiden | altered cleavage site on facto V normally recognized by APC |
| prothrombin 20210A transition | most common hereditary thrombophilia. mutation in prothrombin gene - elevated plasma prothrombin levels. |
| anticardiolipin antibody | associated with SLE, gives false positive tests for syphilis |
| "lupus anticoagulant" | antiphospholipid antibody that increases thrombosis. It actually shows an in vitro artifact prolonged PTT time. It is often associated with SLE |
| HIT syndrome | heparin induced thrombocytopenia. Antibodies against heparin-platelet factor 4 complex. |
| what causes mural thrombi of left atrium and left ventricle | atrium: mitral stenosis, ventricle: myocardial infarction |
| what is a paradoxical embolus? | venous embolus that went to arterial side by way of right-to-left shunt (ASD, or foramen ovale) |
| amniotic fluid in the blood... | means embolus, and DIC |
| what is anasarca | generalized edema |
| most important anatomic finding in shock | acute tubular necrosis |