Hemodynamic Disorders Ii

HEMODYNAMIC DISORDERS II R. HUGO MARTÍNEZ LOZANO, M.D. SEP-06, 2006

LEARNING OBJECTIVES KNOW & UNDERSTAND THE MOST IMPORTANT FEATURES RELATED WITH: - THROMBOSIS – Pathogenesis - Causes - Morphology - D.I.C. (General features) - EMBOLISM – types - INFARCTION - SHOCK – Types - Septic shock – Pathogenesis - Morphology - ¡¡¡ CLINICAL SIGNIFICANCE !!! Ref: pp. 130-142 & lecture’s information

ENDOTHELIAL INJURY       

TOBACCO SMOKE BACTERIAL LPS ELEVATED HOMOCYSTEINE ELEVATED LDL RADIATION VASCULITIS ETC.

ABNORMAL BLOOD FLOW  

TURBULENCE STASIS

M.I.

VENOUS INSUFICIENCY

HYPERCOAGULABILITY STATES  -

-

PRIMARY: MUTATIONS IN: FACTOR V GENE (LEIDEN) PROTHROMBIN GENE METHYLTETRAHYDROFOLATE GENE (HYPERHOMOCYSTEINEMIA) OTHER

HYPERCOAGULABILITY STATES  -

SECONDARY: IMMOBILIZATION M.I. ATRIAL FIBRILLATION TISSUE DAMAGE CANCER CARDIAC VALVES PROSTHESIS D.I.C. ANTI-PHOSPHOLIPID SX. OTHER: ESTROGENS, SMOKING.

DISSEMINATED INTRAVASCULAR COAGULATION (D.I.C.)

THROMBUS: EVOLUTION    

PROPAGATION EMBOLIZATION DISSOLUTION/RECANALIZATION RESOLUTION

VENOUS INSUFICIENCY IDEM

EMBOLIZATION, PULMONARY THROMBO-EMBOLISM

SMALL PULMONARY INFARCT

EMBOLISM: TYPES 

FAT

EMBOLISM: TYPES 

AIR

EMBOLISM: TYPES 

NEOPLASTIC

EMBOLISM: TYPES 

AMNIOTIC FLUID

EMBOLISM: TYPES 

SEPTIC

INFARCTION ISCHEMIA-----------------------NECROSIS MORPHOLOGY – RED - WHITE

RED (HEMORRAGHIC) INFARCT

RED (HEMORRAGHIC) INFARCT

RED (HEMORRAGHIC) INFARCT 

INTESTINAL INFARCT (SMALL INT.)

WHITE (ANEMIC) INFARCT 

KIDNEY

RENAL (OLD) INFARCT

WHITE (ANEMIC) INFARCT 

SPLEEN

PULMONARY THROMBOEMBOLISM

SHOCK: DEFINITON.

SHOCK: TYPES      

HYPOVOLEMIC CARDIOGENIC NEUROGENIC SEPTIC “TOXIC” ANAPHYLACTIC

MORPHOLOGY: SNC

“SHOCK KIDNEYS”

ACUTE TUBULAR NECROSIS

SEPTIC SHOCK PATHOGENESIS

SEPTIC SHOCK

QUESTIONS?