Hemodynamics 1 - Nichols Flashcards
Does pneumococcus bacteria have capsule? Does staph?
yes. Staph does not.
What is required for a diagnosis of SIRS?
any two of these: hyper or hypothermia high heart rate high respiratory high or low WBC or bandemia
can be from infection or systemic inflammation.
Does the gallbladder often get infected by bacteria and viruses?
No.
What do gall stones often require as treatment?
cholecystectomy
What is TSS?
toxic shock syndrome consists of high fever, shock, diffuse red skin rash and multisystem dysfunction usually due to a staph aureus superantigen that nonspecifically activates many clones of T lymphocytes causing a cytokine storm.
What is edema?
generalized swelling of tissue due to increased fluid in interstitial tissue spaces. Can be localized or generalized.
What is the most common cause of edema?
heart failure.
What is hydrothorax?
fluid in a pleural cavity (pleural effusion).
What is ascites?
fluid in the abdominal cavity (peritoneal effusion)
What is anasarca? What can cause it?
Generalized edema. Renal failure (only one example)
What is one of the first signs of nephrotic syndrome?
periorbital edema (or edema in tissues with loose connective tissue matrix) 99% of the time it is pitting so usually periorbital edema refers to pitting edema.
What are the 5 categories of edema?
- increased hydrostatic pressure
- decreased plasma osmotic pressure
- lymphatic obstruction
- sodium retention
- inflammation
What typically causes hydrostatic pressure edema in legs/lower body?
deep venous thrombosis or right heart failure
What typically causes hydrostatic pressure edema in the lungs?
left heart failure
When would you expect hydrostatic edema in the legs to be worse: recumbant or standing?
What about if it were in the sacrum?
worse in legs when standing
worse in sacrum when recumbant (lying down)
What type of edema would you commonly expect with increased hydrostatic pressure?
Sodium retention edema
Increased hydrostatic pressure edema can cause decreased renal blood flow, which activates the renin-angiotensisn-aldosterone system. Increased aldosterone causes retention of sodium and water, which causes further edema.
What type of edema is caused by nephrotic syndrome?
edema from decreased plasma osmotic pressure. Nephrotic syndrome is due to protein loss through the kidneys.
What protein makes up nearly half of total plasma protein?
albumin. It plays a major role in plasma osmotic pressure
What will hypoalbuminemia cause?
generalized edemaand secondary hyperaldosteronism, which then causes sodium retention edema
What usually causes edema due to sodium retention?
heart or kidney failure
Where is sodium retention edema be localized?
sodium retention edema is always generalized throughout body
What can cause edema due to inflammation to become a generalized global event?
SIRS or sepsis
What typically causes lymphedema?
lymphatic obstruction.
What type of edema generates a “peau d’orange” skin characteristic?
lymphedema. Skin begins to resemble an orange peel
What is the most common cause of pulmonary edema? What are some other causes?
left heart failure.
acute respiratory distress syndrome (ARDS), hypersensitivity reactions, pneumonia and renal failure.
What is a major symptom/sign of pulmonary edema?
dyspnea (shortness of breath) and pulmonary crackles
What makes cerebral edema potentially fatal?
herniation of the cerebellar tonsils into the foramen magnum, which compresses the brainstem and suppresses the respiration center
What is hyperemia?
erythema. an active increase in arterial blood flow, causing an abnormal reddish coloration due to the presence of excess oxygenated blood in a tissue
What is the most common cause of hyperemia?
inflammation
What is congestion?
passive decrease in venous outflow. It caues cyanosis (an abnormal bluish coloration due to excess deoxygenated blood)
What pathological states can cause cyanosis?
congestion, failure of lungs to load oxygen in blood, cardiovascular or pulmonary diseases, right heart failure.
What is nutmeg liver associated with?
passive congestion from right heart failure.
Where is passive congestion the worst?
centrilobular areas
What is nutmeg liver?
alternating red and tan tissue casuinng the cut surface of the liver to resemble the cut surface of a nutmeg
Can hyperemia or congestion be fatal?
Not according to nichols
What would cause accumulation of hemophages in pulmonary alveoli (with iron from blood that has leaked into the alveoli due to capillaries burst from the high pressure)?
chronic sublethal left heart failure
What is a hematoma?
when a hemorrhage is enclosed within tissue
What are petechiae?
tiny (1-2 mm) hemorrhages due to platelet deficiency
What are purpura?
Medium (3-10 mm) hemorrhages due to vaculitis, vessel fragility, etc