Week 8 - Clinical Manifestations of Inflammation Flashcards
What are the characteristics to look for when assessing clinical manifestations of local and systemic responses to infection?
- Extensiveness (ie. local - small paper cut)
- Location
- Dependent on pt immune response (ie. chronically ill w/ bands only = cannot fight infection)
- Dependent on acute vs chronic
What are the clinical manifestations of a local response? (6)
- swelling
- pain
- heat
- redness
- Exudate/impaired function
– serous/fibrinous/purulent/
hemorrhagic
Proinflammatory hormones are the reason
What are the clinical manifestations of a systemic response? (5)
- Neutrophilia
- excess of neutrophils, telling our bands to grow up - fever
- Malaise
- Loss of appetite
- Muscle catabolism
In lecture, where do we normally see systemic responses?
- mostly chronic inflammation pts
think:
outside the body = local
Inside the body = systemic
What should you assess for in terms of inflammation? (3, 6)
- Hx
- Physical assessment
- look for trauma
- Check colour, temp, pain, swelling (edema)
- look for any drainage (what do you see, small?) - Diagnostics
- radiographic, blood
Inflammation blood work slide
What can you do for primary prevention of inflammation?
in lecture: wear seatbelt, education, hand hygiene
What can you do for secondary prevention of inflammation?
screening (but there is none)
What are collaborative interventions that can be done to manage inflammation? (2, 6)
- The goal is to mediate inflammatory process and promote healing and repair
- Treat underlying cause
- Infection = eliminate cause
- Hypersensitivity response = manage inflammation and manage the pathologic issue (eg. DM, RA, MS)
- Sprain/strain = RICE and NSAIDS
- Chronic = monitor to prevent further tissue damage, treat cause, support ongoing tissue function, meds (ex. type 1 diabetes, provide insulin)
What does RICE stand for?
- Rest
- Ice
- Compression
- Elevation
How should we use RICE? (5)
- First 24-48 hours after injury
- rest to prevent further injury and trigger inflammation
- ice for 10 minutes at a time every 2-3 hours
- compression to reduce swelling (increase flow, cap leak_
- Elevate above level of heart to minimize swelling (send blood back to heart)
Which medications are used to reduce inflammation? (2)
- Steroidal agents (reduce inflammation itself)
- Glucocorticoids: prednisone - NSAIDS = ibuprofen
Which medications are used to manage fever? (4)
Proinflammatory hormones
1. antipyretics
- acetaminophen
- aspirin (bleed, tons of side effects so ibuprofen is 1st line)
- NSAIDS
Which medications are used as pain relief? (5)
Analgesics
- acetaminophen
- Aspirin
- NSAIDS
- opioids if pain is severe
Reducing inflammation MOA slide
Prednisone drug card
What are the adrenal glands controlled by?
controlled by release of ACTH from pituitary gland through negative feedback
What occurs in the negative feedback mechanism for the adrenal glands?
Exogenous cortisol suppresses pituitary release of ACTH and suppresses production of natural cortisol by adrenal glands
What is adrenal crisis? (5)
- results from sudden withdrawal
May experience: - hypotension
- flu symptoms
- seizures
- shock
How can we treat adrenal crisis short term?
therapy (less than 10 days)
How can we treat adrenal crisis if it is long term? (2)
- give EOD
- requires dose to be tapered as it is discontinued so adrenals resume production
ie. 40 becomes 20… that way natural mechanism is turned backed on
Key points to this lecture (3)
- Inflammation is not the same as infection
- Local and systemic manifestations
- Pharmacology
- Antipyretics
- analgesics
- Anti-inflammation
