Cyanosis Flashcards

1
Q

Definition of Cyanosis

A

More than 5g pg deoxygenated haemoglobin in cappillaries.

Central cyanosis - bluish of the tongue and oral mucosa

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2
Q

Causes of Central Cyanosis

A
  1. Cyanotic Congenital Heart Disease, Eisenmenger complex
  2. Persistent fetal circulation seen in newborn at risk:
    Big baby with perinatal asphyxia
    IDM
    Hypocalcaemia
    Hypoglycaemia
    Polycythaemia
    Down’s Syndrome
  3. Chronic lung diseas (BPD,CF, Kartageners and Pulmonary fibrosis)
  4. Methaemoglobinaemia (High PaO2 but low SaO2)

Ddx - Traumatic facial cyanosis

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3
Q

Steps to clinical examination of Cyanosis

A
  1. Demonstrate cyanosis of central origin - Tongue
  2. Note if patient is dyspnoeic or not - if +ve —-> Pulmonary origin unless on e is in congestive HF
  3. Examine fingers for clubbing, esp the thumb
    Stage I - Fullness of nail bed
    Stage II - Obliteration of angle between nail and nail fold
    Stage III- Convexity of nail longitudinally and Transversely
    Stage IV - Drumstick appearance
  4. Look for Pitting Oedema - Ankle and Sacrum
  5. Comment about the growth of the patient - Wasted/ FTT
  6. CVS exam - also note size of liver and measure BP
  7. RS exam - esp if pt is dyspneoic
  8. If all -ve —-> Take a drop of blood and expose to oxygen to see the persistence of blueness (Methaemoglobinaemia)

Note:
Differential Cyanosis
Pink UL and Cyanotic LL: COA + PDA
Cyanotic UL and pink LL: TGA + PDA

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