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consequences of thrombosis/emboli (infarction (red/hemorrhagic infarcts…
consequences of thrombosis/emboli
infarction
red/hemorrhagic infarcts
tissues with dual circulations (ex: intestines), venous occlusions, following reperfusion
white/plate infarcts
solid organs, arterial occlusions, no reperfusion
ischemic necrosis caused by occlusion of arterial supply or venous drainage
all infarcts tend to be
wedge-shaped
with occluded vessel at the apex
septic infarcts: following embolization of infected thrombus
disseminated intravascular coagulation
(DIC)
results from activation of
I coagulation system:
widespread release of tissue factor causes widespread thrombus formation and exhaustion of platelets
II fibrinolytic system:
plasmin degrades fibrinogen and fibrin producing fibrin degradation products (this makes the bleeding worse)
disorders associated with DIC
malignancies
obstetric emergencies (ex: amniotic fluid embolism)
organ destruction
sepsis/severe infection
severe toxic or immunologic reactions (ex: snake bite, recreational drugs)
trauma
vascular abnormalities
lab dx
abnormal coagulation values: increased PT/aPTT, elevated D-dimers (FDPs), Thrombocytopenia, hemolytic anemia
shock
systemic
hypoperfusion
due to reduced cardiac output or reduction in blood volume
result:
hypotension, followed by impaired tissue perfusion and cellular hypoxia
types
cardiogenic
hypovolemic
septic
neurogenic:
loss of vascular tone w/ peripheral pooling of blood
anaphylatic:
increased vascular permeability (IgE mediated hypersensitivity response)
pathogenesis of septic shock: microbes trigger inflammatory cells, which activate the complement cascade, which activates clotting factor XII, which activates endothelial cells