title:
<h2 align=center>Disturbed Hemodynamics</h2>
<p>Practice your knowledge of the concepts raised in the small group discussions and lectures dealing wth <b>hemodynamics</b> in these clinical scenarios.  
<br>In the multiple choice answers click on whichever answer you feel is the best or most appropriate answer.  This quiz has been set up to provide you with a series of questions pertaining to a clinical scenario. Each clinical scenario has one to three questions and in most cases images of the normal tissue or organ has been included for comparison to the pathological sample.  Complete the questions for each scenario before proceeding on to the next.

<p><hr size=2>
header:
<h3 align="center">Disturbed Hemodynamics</h3>
footer:
[ <a href="http://www.uwo.ca/cgi-bin/geniq/pathol/MedsI/quizzes/hemodynamics/fluids2.iq">Next clinical scenario</a> ] 
<p><address>Please e-mail feedback to <a href="mailto:bgarcia@uwo.ca">The Meds I Pathology Course Coordinator</a></address>

delivery:
simultaneous


question:
<p>
<table align="center" width="90%" cellspacing="2" cellpadding="5" border="2">
<tr align="center"><td><img src="http://www.uwo.ca/pathol/MedsI/quizzes/hemodynamics/nliver.jpg"></td><td><img src="http://www.uwo.ca/pathol/MedsI/quizzes/hemodynamics/lnecrosis.jpg"></td></tr>
<tr align="center"><td>Microscopic view of normal liver, showing the central vein and sinusoids.</td><td>Microscopic view of the liver showing centrilobular necrosis.</td></tr></table></p>
This is a section of liver from autopsy of a 50-year-old female, who died of congestive cardiac failure. Microscopically there were features of 'centrilobular necrosis'.<br>
 What is the most probable underlying event which resulted in this type of injury to the liver?
ans:
Active hyperemia.
fbk:
Incorrect, occurs when arterial and arteriolar dilatation produces an increased flow of blood into capillary beds. e.g. at sites of inflammation.
ans:
Passive congestion.
fbk:
Correct, results from venous obstruction leading to impaired outflow from a tissue, as in this case, due to congestive cardiac failure.
ans:
Hemorrhage.
fbk:
Incorrect, hemorrhage is the extravasation of blood due to ruptured blood vessels. It can be associated with necrosis but is not a cause.
ans:
Inflammation.
fbk:
Incorrect, results in active hyperemia.
ans:
Infection.
fbk:
Incorrect, causes inflammation and if acute, leads to active hyperemia.
correct_answer:
2
<p>


question:
With a longstanding process, this liver would show features of which of the following?
ans:
Hyperplasia.
fbk: 
Incorrect, does not occur in passive congestion.
ans:
Thrombosis.
fbk:
Incorrect, refers to thrombus formation within the vascular system due to inappropriate activation of hemostatic process.
ans:
Fibrosis.
fbk: 
Correct, in chronic passive congestion, the hepatocellular injury can eventually lead to degeneration of parenchymal cells with subsequent fibrosis also known as 'cardiac cirrhosis'.
ans:
Abscess.
fbk:
Incorrect, an abscess is a localized collection of pus, not seen in chronic congestion.
correct_answer:
3
<p>