Icr - Pleuritis (Rb)

Front 1

Define: Pleural effusion
Etiology:
DA:

Back 1

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.

Front 2

Describe the 3 Exudative Effusion criteria:

Back 2

1) pleural: serum protein >.5
2) pleural :serum LDH >.6
3) pleural fluid LDH > 2/3 ormal upper limit for serum

Front 3

What tests should be run if exudative effusion is suspect?

Back 3

Description of fluid, glucose level, CDC, cytology, microbiologic studies.

Front 4

What is most common effusion from?

Back 4

Left sided heart failure

Front 5

Define:Hepatic Hydrothorax

Back 5

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.

Front 6

Parapneumonic Effusion:

Back 6

EXUDATE:
Ipsalateral effusions associated w/ bacterial pneumonia, lung abscess, bronchiectasis. Empyeme - grossly purulent effusion.

Front 7

Which cancers predominantly cause Effusion?

Back 7

75% account for effusions due to: lung carcinoma, breast carcinoma, lymphoma

Front 8

Define mesothelioma.

Back 8

Malignant tumors arising from mesothelial cells lining pleural cavities...related to asbestos exposure.

Front 9

Effusion from Pulmonary Embolism:
Most common Sx:
Diagnosis made by:

Back 9

Dyspnea,
Spiral CT scan OR p. arteriography

Front 10

Tuberculous Pleuritis:

Back 10

Result of hypersensitivity rxn to TB protein in pleural space.

Front 11

Define Chylothorax.

Back 11

Chylothorax occurs when thoracic duct is disrupted and chyle accumulates in pleural space.

Primarily from Trauma; also tumors in mediastinum.

Front 12

Describe Hemothorax, what is diagnostic parameter?

Back 12

Blood in pleural fluid. Hematocrit >50% = diagnostic

Front 13

Compare/Contrast Pneumothorax & Tension Pneumothorax

Back 13

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.

Front 14

ADAPTATION

Front 15

Agenesis

Back 15

Complete absence of an organ or its anlage.

Front 16

Anthracosis

Back 16

Accumulation of carbon pigment (dust) in tissues.

Front 17

Apoptosis

Back 17

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

Front 18

Atherosclerosis

Back 18

Accumulation of fat and connective tissue within the wall of arteries, often causing progressive narrowing of the lumen and decreased blood flow to tissues.

Front 19

Atrophy

Back 19

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.

Front 20

Autolysis

Back 20

"Self

Front 21

Caseous necrosis

Back 21

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.

Front 22

Cirrhosis

Back 22

Liver disease characterized pathologically by loss of normal microscopic lobular architecture with fibrosis and nodular regeneration.

Front 23

Coagulative necrosis

Back 23

Conversion of the cell to an acidophilic, opaque structure with preservation of the basic cellular shape and outline.

Front 24

Cushing's syndrome

Back 24

A constellation of clinical findings caused by excessive blood levels of glucocorticosteroid hormones.

Front 25

Denervation

Back 25

Disruption of normal neural supply, due to traumatic or degenerative damage to the peripheral nerve or central nervous system motor neurons.

Front 26

Diabetes mellitus

Back 26

A disorder of carbohydrate metabolism, caused by relative or absolute deficiency of insulin and associated with damage to many organs and accelerated atherosclerosis.

Front 27

ACUTE INFLAMMATION

Front 28

Abscess

Back 28

a localized collection of neutrophils and necrotic debris (pus) in a cavity.

Front 29

Acute inflammation

Back 29

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

Front 30

Blood

Back 30

The fluid in the circulatory system

Front 31

Congestion (hyperemia)

Back 31

increase in the volume of blood in blood vessels of tissue or organ due to impaired venous drainage.

Front 32

Consolidation

Back 32

air spaces of lung filled with inflammatory exudate, giving lung a solid, rather than spongy, appearance.

Front 33

Cytokine

Back 33

a hormone

Front 34

Edema

Back 34

the accumulation of excess fluid in the intercellular (interstitial) tissue spaces or body cavities.

Front 35

Effusion

Back 35

An exudate or transudate that has passed into a part or tissue.

Front 36

Expectoration

Back 36

cough which produces sputum, typically a purulent exudate.

Front 37

Exudate

Back 37

protein

Front 38

Fibrinous exudate

Back 38

An exudate containing a large amount of fibrin. It is usually found upon inflammation of serosal or mucosal surfaces.

Front 39

HEMODYNAMICS

Front 40

Atherosclerosis

Back 40

Accumulation of fat and connective tissue within the intima of arteries, often causing progressive narrowing of the lumen and decreased blood flow to tissues.

Front 41

Congestion

Back 41

Accumulation of blood within an organ due to venous stasis.

Front 42

Deep vein thrombosis

Back 42

Typically occurs in the deep veins. These thrombi are usually loosely attached and thus easily dislodged.

Front 43

Edema

Back 43

The accumulation of excess fluid in the intercellular (interstitial) tissue spaces or body cavities.

Front 44

Embolus

Back 44

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).

Front 45

Heart failure

Back 45

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.

Front 46

Heart failure cells

Back 46

Hemosiderin containing macrophages within alveolar spaces caused by microscopic or macroscopic hemorrhage.

Front 47

Hyperemia

Back 47

Accumulation of blood within dilated arteries.

Front 48

Infarct or infarction

Back 48

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

Front 49

Lines of Zahn

Back 49

Laminations of platelets and fibrin in a thrombus. Easier to visualize in arterial thrombus than in venous thrombus.

Front 50

Mural thrombus

Back 50

A non

Front 51

Organization

Back 51

the process of repair and granulation tissue formation within a thrombus.

Front 52

Propagation of thrombus

Back 52

increase in size of an already formed thrombus.

Front 53

Recanalization

Back 53

Reestablishment of a lumen, through organization, in a vessel previously obstructed by a thrombus.

Front 54

Stroke

Back 54

the lay term used to describe the sudden onset of signs and symptoms in a patient with a cerebral infarct.

Front 55

Thrombus

Back 55

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

Front 56

Transudate

Back 56

An ultrafiltrate of blood plasma that has passed from within blood vessels into tissues due to a change in hydrostatic pressure (low protein concentration)

Front 57

Volvulus

Back 57

A twisting of the intestine about the axis of its mesentery or around an abnormal fibrous band (often a postsurgical adhesion).