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49 Cards in this Set
- Front
- Back
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What is the definition of edema?
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A swelling of any tissue due to the accumulation of excessive fluids in the tissues
E.g. cerebral edema, pulmonary edema, peripheral edema |
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What is the definition of effusion?
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Accumulation of fluid in a body cavity
-e.g.: pleural (thoracic) effusion, pericardial effusion, peritoneal (abdominal) effusion |
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What is angioedema?
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Rapid swelling (edema) of the *skin, *mucosa, and submucosal tissues
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In the past, angioedema was referred to by the term angioneurotic edema, what is wrong with this term?
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Implies that the phenomenom is due to neurosis
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Is an increase in arterial blood pressure or venous blood pressure the primary cause of net fluid loss resulting in edema?
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Increased venous pressure
-increased arterial BP RARELY causes edema |
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Why does it take a 25 torr increase in pressure to cause edema in the lungs compared to 15 torr everywhere else?
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Lung= very tight junctions
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What is the starling equation?
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net fluid efflux= filtration coefficient [(capillary hydrostatic pressure-interstitial hydrostatic pressure)-coefficient( capillary oncotic pressure- interstitial oncotic pressure)
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What are the 3 types of capillaries?
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1) Continuous
2) Fenestrated 3) Sinusoidal |
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Where are continuous capillaries located? What can pass through them? How?
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Lungs, skin, muscle
-tight junctions, transport vesicles -Water and ions via intracellular clefts |
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Where are fenestrated capillaries located? What moves through them? How?
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Glomeruli, endocrine glands
-pores with diaphragms -small protein molecules -high coefficient of filtration |
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Where are sinusoidal capillaries located in the body? what passes through them and how? What are they?
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Liver, marrow, lymph nodes
-Gaps with continuous basal lamina -Large proteins and cells |
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What type of an exudate is produced with hypoproteinemia?
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Pure transudate
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*****What are the 4 pathogeneses of edema/ effusions?
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1) Increased hydrostatic pressure
2) Reduced oncotic pressure 3) Impaired lymphatic drainage 4) Loss of vascular integrity -inflammation, neoplasia, leaky vessels (heat/ toxins) |
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Why doesn't putting an animal with pulmonary edema in an oxygen tank not help?
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Because they have decreased tidal volume you need to get the fluid off the chest using diuretics
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How would you treat an animal with pulmonary edema? pleural effusion?
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Pulmonary edema: diuretics
Pleural effusion: tap the chest |
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Give 3 examples of different types of effusions.
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1) Pleural (thoracic) effusions
2) Abdominal effusions (ascites) 3) Pericardial effusion |
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What are 5 diagnostic methods used for abdominal distension and effusions?
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1) Physical exam- palpation
2) Centesis and fluid analysis 3) Radiography -doesn't tell cause 4) Ultrasonagraphy 5) Cross-sectional imaging (CT/ MRI) |
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What are 3 causes of abdominal distension?
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1) Organomegaly
-gastric dilatation/ torsion -small intestine -LI -Urinary bladder (usually neurogenic) -Liver, spleen, kidney 2) Abdominal mass lesions 3) Effusions |
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What are 4 ways to classify fluid analysis?
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1) Transudates
2) Modified transudates 3) Exudates 4) Neoplastic |
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What are 3 examples of exudates?
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1) Chyle
2) blood 3) inflammation -sept or not |
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What type of fluid is most common with heart failure?
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Modified transudate
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What causes transudate formation?
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Decreased plasma oncotic pressure
-for most part its hypoproteinemia |
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What is the specific gravity and cell count of transudates?
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SG <1.015
Cells < 1500 /microliter |
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What are 7 differentials for a modified transudate abdominal or thoracic effusion?
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1) Liver disease w/ portal hypertension (post-sinusoidal)
2) Budd-Chiari syndrome -CVC obstruction 3) Heart failure* 4) Pericardial disease 5) Lung lobe torsion* 6) Diaphragmatic hernia 7) Neoplasia |
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What are 2 differential diagnoses for a transudate abdominal or thoracic effusion?
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1) Hypoalbuminemia
-protein-losing enteropathy -Protein-losing nephropathy -Liver disease 2) Liver disease w/ portal hypertension -presinusoidal -sinusoidal |
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What are 2 pathophysiologies underlying modified transudate production?
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1) Increased hydrostatic pressure
2) Damaged vascular wall** |
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What type of a fluid is produced by liver disease with post-sinusoidal portal hypertension?
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Modified transudate
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What is the specific gravity and cell count of a modified transudate?
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SG 1.015- 1.025
Cells < 7000 / uL |
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How can you tell between caudal vena cava obstruction, pericardial disease and cranial vena cava obstruction via physical examination?
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-Caudal vena cava= constrictive pericarditis= no jugular distension
-Pericardial: extended, pulsing jugular vein -cranial vena cava: jugular distension NOT pulsing |
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Is a jugular pulse abnormal?
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Normal if vein isn't distended, but if vein extends more than 1/3 of neck= abnormal
-have to evaluate in standing position w head up |
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What are 2 causes of jugular vein distention?
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Increased mean right atrial pressure
Vena caval obstruction |
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You have an animal with a modified transudate chest effusion and you can't tell if the jugular vein is distended, what should you do?
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Measure central venous pressure
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What is the "normal" right atrial pressure? What pressure causes ascites formation?
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Normal < 5 mm Hg
Ascites= > 15 mmHg |
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What is a normal pulmonary capillary wedge pressure (PCWP-an indirect measurement of left atrial pressure)? What pressure causes pulmonary edema?
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Normal <10 mmHg
Pulmonary edema > 25 mmHg |
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What's the pathophysiology behind pleural effusion?
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Elevated right atrial pressure and PCWP
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What are 4 cardiac causes of pleural effusion?
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1) Myocardial disease
2) pericardial disease 3) Mitral and tricuspid insufficiency 4) Severe right or left congestive heart failure |
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What are 5 differentials for abdominal and thoracic chyle effusions?
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1) Trauma
2) Neoplasia 3) Idiopathic -majority in cats 4) Heart failure -2nd most common cats 5) Lung lobe torsion |
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What are 4 differentials for abdominal and thoracic effusions of blood?
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1) Coagulopathy****
-top differential 2) Neoplasia (HSA) 3) Trauma 4) Lung lobe torsion |
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What is the pathophysiology behind inflammatory effusions?
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Increased vascular permeability
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What is the specific gravity and cell count of inflammatory (exudates) effusions?
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SG > 1.025
Cells > 7000 uL |
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What are 4 differential diagnoses for septic inflammatory effusions?
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1) Bowel perforation
2) Esophageal perforation 3) Foreign body 4) Pneumonia / empyema |
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What are 5 differentials for non-septic inflammatory effusions?
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1) Pancreatitis
2) FIP 3) Urine (irritating) 4) Bile (irritating) 5) Neoplasia |
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20% of pericardial effusions are _______, 75% are _____ and the other 5% is other causes.
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20%= idiopathic
75%= neoplastic |
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What are the 3 types of tumors that cause pericardial effusion?
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1) Hemangiosarcoma
2) Heartbase tumors -chemodecomas (neoplasia of chemoreceptors, at base of heart) -thyroid/ parathyroid (ectopic) 3) Mesothelioma -primary tumor of pericardium |
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What are 4 "other causes" of pericardial effusion in dogs?
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1) Infectious
2) Uremia 3) Foreign body 4) LA tear |
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What is Beck's tried?
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What you find on physical exam of an animal with pericardial effusion:
1) Muffled heart sounds 2) Venous congestion (jugular pulses) 3) Weak femoral pulses |
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What are 3 clinical signs of idiopathic effusions?
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1) RHF
2) Collapse 3) Dyspnea |
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What are 3 diagnostic methods used to work up idiopathic effusions?
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Echocardiogram
Radiographs ECG -then either cytology or pericardiocentesis |
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How would you work up a suspected heart base tumor in a dog that presents for pericardial effusion?
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Echo, ECG, rads, then pericardiocentesis & cytology
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