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
2
Q
Causes of Central Cyanosis
A
- Cyanotic Congenital Heart Disease, Eisenmenger complex
- Persistent fetal circulation seen in newborn at risk:
Big baby with perinatal asphyxia
IDM
Hypocalcaemia
Hypoglycaemia
Polycythaemia
Down’s Syndrome - Chronic lung diseas (BPD,CF, Kartageners and Pulmonary fibrosis)
- Methaemoglobinaemia (High PaO2 but low SaO2)
Ddx - Traumatic facial cyanosis
3
Q
Steps to clinical examination of Cyanosis
A
- Demonstrate cyanosis of central origin - Tongue
- Note if patient is dyspnoeic or not - if +ve —-> Pulmonary origin unless on e is in congestive HF
- 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 - Look for Pitting Oedema - Ankle and Sacrum
- Comment about the growth of the patient - Wasted/ FTT
- CVS exam - also note size of liver and measure BP
- RS exam - esp if pt is dyspneoic
- 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