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57 Cards in this Set

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Define: Pleural effusion
Etiology:
DA:
an excess quantity of fluid in the pleural space

(formation from capillaries, ISF, peritoneal cavity via small holes in diaphagm > absorption from lymphatics in pleural space)

DA: determine transudate / exudate. Transudate (systemic factors)<-- Lt Vent failure, P. embolism, cirrhoseis. Exudate (local factors)<-- bacterial pneumonia, malignancy, virus, p embolism.
Describe the 3 Exudative Effusion criteria:
1) pleural: serum protein >.5
2) pleural :serum LDH >.6
3) pleural fluid LDH > 2/3 ormal upper limit for serum
What tests should be run if exudative effusion is suspect?
Description of fluid, glucose level, CDC, cytology, microbiologic studies.
What is most common effusion from?
Left sided heart failure
Define:Hepatic Hydrothorax
where cirrhotic liver develops ascites in peritoneal cavity & fluid traverses diaphragm (thru small holes) into pleura. --> need liver transplant or transjugular intrahepatic portal systemic shunt.
Parapneumonic Effusion:
EXUDATE:
Ipsalateral effusions associated w/ bacterial pneumonia, lung abscess, bronchiectasis. Empyeme - grossly purulent effusion.
Which cancers predominantly cause Effusion?
75% account for effusions due to: lung carcinoma, breast carcinoma, lymphoma
Define mesothelioma.
Malignant tumors arising from mesothelial cells lining pleural cavities...related to asbestos exposure.
Effusion from Pulmonary Embolism:
Most common Sx:
Diagnosis made by:
Dyspnea,
Spiral CT scan OR p. arteriography
Tuberculous Pleuritis:
Result of hypersensitivity rxn to TB protein in pleural space.
Define Chylothorax.
Chylothorax occurs when thoracic duct is disrupted and chyle accumulates in pleural space.

Primarily from Trauma; also tumors in mediastinum.
Describe Hemothorax, what is diagnostic parameter?
Blood in pleural fluid. Hematocrit >50% = diagnostic
Compare/Contrast Pneumothorax & Tension Pneumothorax
Pneumothorax (generally) means gas in pleural space.

A tension pneumothorax is a medical emergency. = Positive pleural pressure --> mediastinum --> reduced venous return to heart, reduced C.O.
ADAPTATION
Agenesis
Complete absence of an organ or its anlage.
Anthracosis
Accumulation of carbon pigment (dust) in tissues.
Apoptosis
A form of cell death which is endogenously controlled or "programmed" in order to minimize the host inflammatory reaction to the necrotic cell. It is characterized by intracellular activation of endonucleases that digest nuclear DNA into smaller fragments. Physiologically, this type of cell death results in tissue retrogression observed during embryogenesis or after withdrawal of hormonal stimulation. Morphologically, apoptosis is recognized as death of single or scattered cells which form rounded, eosinophilic membrane
Atherosclerosis
Accumulation of fat and connective tissue within the wall of arteries, often causing progressive narrowing of the lumen and decreased blood flow to tissues.
Atrophy
Shrinkage in the size of the cell by loss of cell substance. The term is also used for a reduction in size of an organ due to loss of cells.
Autolysis
"Self
Caseous necrosis
Conversion of necrotic cells to an amorphous mass grossly resembling cream cheese. Histologically, appears as amorphous granular debris composed of fragmented coagulated cells. Encountered most often in tuberculosis.
Cirrhosis
Liver disease characterized pathologically by loss of normal microscopic lobular architecture with fibrosis and nodular regeneration.
Coagulative necrosis
Conversion of the cell to an acidophilic, opaque structure with preservation of the basic cellular shape and outline.
Cushing's syndrome
A constellation of clinical findings caused by excessive blood levels of glucocorticosteroid hormones.
Denervation
Disruption of normal neural supply, due to traumatic or degenerative damage to the peripheral nerve or central nervous system motor neurons.
Diabetes mellitus
A disorder of carbohydrate metabolism, caused by relative or absolute deficiency of insulin and associated with damage to many organs and accelerated atherosclerosis.
ACUTE INFLAMMATION
Abscess
a localized collection of neutrophils and necrotic debris (pus) in a cavity.
Acute inflammation
immediate response to injury characterized by vasodilatation, increased capillary permeability, presence of an exudate and emigration of leukocytes (mostly neutrophils). Clinically: calor, rubor, tumor, dolor, and loss of function. Atherosclerosis
Blood
The fluid in the circulatory system
Congestion (hyperemia)
increase in the volume of blood in blood vessels of tissue or organ due to impaired venous drainage.
Consolidation
air spaces of lung filled with inflammatory exudate, giving lung a solid, rather than spongy, appearance.
Cytokine
a hormone
Edema
the accumulation of excess fluid in the intercellular (interstitial) tissue spaces or body cavities.
Effusion
An exudate or transudate that has passed into a part or tissue.
Expectoration
cough which produces sputum, typically a purulent exudate.
Exudate
protein
Fibrinous exudate
An exudate containing a large amount of fibrin. It is usually found upon inflammation of serosal or mucosal surfaces.
HEMODYNAMICS
Atherosclerosis
Accumulation of fat and connective tissue within the intima of arteries, often causing progressive narrowing of the lumen and decreased blood flow to tissues.
Congestion
Accumulation of blood within an organ due to venous stasis.
Deep vein thrombosis
Typically occurs in the deep veins. These thrombi are usually loosely attached and thus easily dislodged.
Edema
The accumulation of excess fluid in the intercellular (interstitial) tissue spaces or body cavities.
Embolus
A detached mass within the blood stream that travels from its site of origin to lodge in a distant vessel. These may be solid (thrombo emboli, bone marrow emboli, fat emboli), liquid (amniotic fluid), or gaseous (air embolism, decompression nitrogen emboli).
Heart failure
Inability of the heart to produce a high enough cardiac output to meet the body's needs. Right heart failure leads to edema and congestion in tissues drained by the vena cava (liver, spleen, & lower extremities). Left heart failure leads to edema and congestion in the lungs.
Heart failure cells
Hemosiderin containing macrophages within alveolar spaces caused by microscopic or macroscopic hemorrhage.
Hyperemia
Accumulation of blood within dilated arteries.
Infarct or infarction
A localized area of ischemic necrosis resulting from obstruction of the arterial supply (or less commonly venous drainage). White (anemic) infarcts develop in mostly in solid organs that do not have collateral circulation (spleen, heart, kidney) following an acute arterial occlusion. Red (hemorrhagic) infarcts develop in organs whose vasculature is in a pedicle, where venous compression can occur due to twisting (gonads, intestine), organs with a dual blood supply (lung), organs that contain great amount of loose tissue and previously congested organs that undergo ischemia of arterial origin. A brain infarct is a special case. The typical brain infarct is first an anemic infarct, that later undergoes liquefaction. When the occluded vessel reopens (re
Lines of Zahn
Laminations of platelets and fibrin in a thrombus. Easier to visualize in arterial thrombus than in venous thrombus.
Mural thrombus
A non
Organization
the process of repair and granulation tissue formation within a thrombus.
Propagation of thrombus
increase in size of an already formed thrombus.
Recanalization
Reestablishment of a lumen, through organization, in a vessel previously obstructed by a thrombus.
Stroke
the lay term used to describe the sudden onset of signs and symptoms in a patient with a cerebral infarct.
Thrombus
An intravascular blood clot that develops and attaches to the wall of an artery or vein. Arterial or myocardial thrombi are usually "white thrombi" because the rapid blood flow washes red cells away, leaving only platelets and fibrin. Venous thrombi are usually "red thrombi" because sluggish flow allows the thrombi to contain all normal blood constituents. Thrombus can be differentiated from postmortem clotted blood by the presence of fibrin/platelet/red blood cell laminations (lines of Zahn). Postmortem clotted blood contains a gelatin
Transudate
An ultrafiltrate of blood plasma that has passed from within blood vessels into tissues due to a change in hydrostatic pressure (low protein concentration)
Volvulus
A twisting of the intestine about the axis of its mesentery or around an abnormal fibrous band (often a postsurgical adhesion).