Trastornos Pleurales
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This document discusses pleural disorders and describes pleural effusion, its causes, and diagnostic criteria. Pleural effusion occurs when there is an abnormal accumulation of fluid in the pleural cavity due to imbalances in vascular and lymphatic flow into and out of the pleural space. Effusions can be transudative or exudative based on their cause and composition. Diagnostic techniques for pleural effusion include chest x-rays, thoracentesis, and analysis of pleural fluid. Pneumothorax is also discussed and defined as the presence of air in the pleural space, which can cause lung collapse.
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Portal hypertension
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Portal Hypertension in Children
Portal hypertension occurs when blood pressure within the portal venous system exceeds normal levels. It can be caused by prehepatic issues like portal vein obstruction, or intrinsic liver diseases that increase fibrosis within the liver. Children with portal hypertension may experience bleeding from esophageal varices, splenomegaly, ascites, or other clinical signs. Diagnosis involves medical history, lab tests, imaging like Doppler ultrasound or CT, and often measurement of portal pressure. Treatment depends on severity but may include medication, balloon tamponade, endoscopic procedures to band or sclerose varices, or shunt procedures like TIPS to decompress the portal system.
1. portal hypertension converted
Here are the revisions to the document:
1. Normal portal venous pressure is less than 5 mm Hg.
2. Oesophageal balloon used to achieve temporary haemostasis is Sengstaken-Blakemore tube.
3. TIPSS stands for transjugular intrahepatic portosystemic shunt.
4. Median GCS score in hepatic coma is below 8.
5. Diet recommended for hepatic coma is low in protein and sodium.
Edema; Harrison 19th edition
Edema can be categorized as intracellular (66%), extracellular (33%) with most extracellular fluid located interstitially (75%) and a smaller amount intravascularly (25%). Edema develops when Starling forces are altered, increasing fluid movement from blood vessels into tissues. Causes of edema include capillary leakage, reduced arterial volume, renal factors activating the renin-angiotensin-aldosterone system, vasopressin, endothelin 1, and natriuretic peptides. Edema distribution provides clues to its underlying cause, such as heart failure causing leg edema worse at night, hepatic cirrhosis indicated by ascites, and hypoalbuminemia in nephrotic syndrome shown through facial swelling worse in morning
Portal hypertension
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Edema
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Portal hypertension by kiran maindale
Portal hypertension occurs when blood pressure in the portal vein system, which drains blood from the gastrointestinal tract to the liver, increases above normal levels. It is defined as a hepatic venous pressure gradient greater than 15 mmHg. Two key factors that contribute to portal hypertension are increased vascular resistance and increased blood flow. Investigation may include blood tests and imaging of the liver, portal system, and varices. Complications include variceal bleeding, ascites, and hepatic encephalopathy. Treatment depends on severity but may involve medication, endoscopic procedures, transjugular intrahepatic portosystemic shunt placement, or surgical shunting of blood flow to reduce portal pressure.
Portal hypertension
This document discusses portal hypertension and its management. It defines portal hypertension as increased portal pressure and describes how hepatic venous pressure gradient (HVPG) is used to measure it noninvasively. The main causes of portal hypertension are discussed as pre-hepatic, intra-hepatic, and post-hepatic. Clinical features include gastroesophageal varices, ascites, and splenomegaly. Management involves screening and treatment of varices, diuretics for ascites, and splenectomy in rare cases. Transjugular intrahepatic portosystemic shunt (TIPS) or surgical shunts are considered if medication fails or is not available.
Portal hypertension:A disease better controlled than cured.
Portal hypertension is one of the common causes of upper gastrointestinal bleeding. It is a very lethal condition. Prompt diagnosis and commencement of early medical treatment can help keeping the disease under control. Surgery is a very useful adjunct in uncontrollable bleeding and in long term prevention in certain selected cases.
Portal Hypertension
The portal vein is formed by the superior mesenteric and splenic veins. It drains blood from the intestines, pancreas, colon and rectum. Blood from the portal and hepatic arteries mixes in the liver sinusoids before draining into the hepatic vein and inferior vena cava. Portal hypertension occurs when pressure increases due to increased resistance in the liver from cirrhosis and increased blood flow. It can cause ascites, variceal bleeding, and other complications.
Portal hypertension
Portal hypertension occurs when blood pressure increases in the portal venous system, which normally carries blood from the gastrointestinal tract to the liver. It is defined as a hepatic venous pressure gradient over 10mm Hg. There are three types - pre-hepatic, intra-hepatic, and post-hepatic - depending on the site of vascular obstruction. Common causes include cirrhosis, schistosomiasis, and portal vein thrombosis. Clinical manifestations involve complications from increased portosystemic shunting and include ascites, esophageal varices, hemorrhoids, and hepatic encephalopathy. Diagnostic evaluations involve blood tests, imaging, and endoscopy. Treatment options include medications, endoscopic therapy, TIPS procedure,
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A simplified description of ascitic fluid analysis. Aim of the presentation is to give a very clear understanding about the analysis of ascities.
Presentation will help the medical residents diagnose the cause of fluid accumulation in abdomen and thus will guide to adopt the appropriate pathway to solve the issue.
Portal Hypertension
Portal hypertension occurs when scar tissue from liver injuries disrupts blood flow, increasing pressure in the main and portal veins and diverting blood away from the liver. The most common cause is cirrhosis, but it can also be caused by blood clots, fatty liver disease, hepatitis, or schistosomiasis. Symptoms include gastrointestinal bleeding, abdominal fluid buildup, and varicose veins. Diagnosis involves medical history, lab tests, and imaging exams. Treatment focuses on medications and procedures to reduce blood pressure such as sclerotherapy and TIPS or DSRS shunt surgery in severe cases. Lifestyle changes like quitting drinking and smoking can help prevent portal hypertension.
A C U T E R E N A L F A I L U R E
Acute renal failure (ARF) is the sudden loss of kidney function, causing a build up of waste products in the blood. It can be oliguric or non-oliguric depending on urine output. ARF has three main causes - prerenal from low blood flow, intrinsic kidney damage, or postrenal from urinary obstruction. Management involves fluid management, electrolyte control, antibiotics for infection, and possibly dialysis. Nurses monitor patients closely and prevent complications through infection control and skin care.
Portal hypertension
This document discusses portal hypertension, including its definition, causes, clinical presentations, investigations, and management.
Portal hypertension is defined as elevated hepatic venous pressure gradient above 5 mmHg. It is clinically significant when the HVPG exceeds 10-12 mmHg. Common causes include cirrhosis, schistosomiasis, and portal or hepatic vein thrombosis.
The clinical triad of portal hypertension includes esophageal varices, splenomegaly, and ascites. Investigations include liver function tests, ultrasound, and endoscopy. Management involves general measures, treatment of varices with medications or endoscopic therapy, management of ascites and encephalopathy, and procedures to lower portal pressure such as T
Renal system history taking & urine analysis 2012
The document provides an overview of renal anatomy, physiology, and clinical assessment of the renal system. It describes:
1) The gross anatomy and vasculature of the kidneys and their role in fluid balance, waste excretion, and hormone production.
2) Common diseases of the kidney including infections, obstructions, and congenital abnormalities.
3) Methods for evaluating the renal system through history, physical exam findings like abnormalities in urination, and urine analysis including chemical tests, microscopy, and culture.
Upper GI bleeding & portal hypertension in Children
This document discusses signs and symptoms of gastrointestinal bleeding, including melena, haematemesis, and haematochezia. It covers evaluation, treatment, and management of variceal bleeding including pharmacologic therapies, endoscopic procedures like band ligation and sclerotherapy, and surgical options like shunts and transplantation.
Pleural effusion analysis
It is about interpretation of pleural effusion testing results including physical characteristics, biochemical test, cell counts, culture and cytology.
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Assessment of anuria & management of post obstructive diuresis
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Similar to Trastornos Pleurales
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serous fluid Dr shweta [Autosaved].pptx
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- Symptoms depend on the underlying cause but may include chest pain, difficulty breathing, and cough. Diagnosis involves physical exam, imaging like x-rays, and analyzing pleural fluid obtained via thoracentesis.
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The document discusses the approach to evaluating and diagnosing patients with pleural effusions. It outlines the leading causes of transudative and exudative pleural effusions and describes how pleural fluid analysis can be used to differentiate between them. Tests like LDH, protein, glucose and cytology are routinely performed on pleural fluid to help determine the etiology. Imaging like chest x-rays, ultrasound and CT scans can provide additional diagnostic information. When the cause remains unclear after initial testing, procedures like thoracoscopy may be needed to establish a diagnosis.
Acute and Chronic Renal Failure
Acute and chronic renal failure are discussed. Acute renal failure is a sudden decline in kidney function leading to a build-up of waste products and electrolyte imbalances, with symptoms like reduced urine, nausea, and back pain. It requires urgent hospital treatment like dialysis. Chronic renal failure is a gradual loss of kidney function over years due to issues like diabetes and hypertension, with symptoms including fatigue, itchy skin, and twitching. Diagnosis involves tests of kidney function and size, and treatment focuses on managing symptoms and slowing disease progression with medications.
Pleural Effusion By Akhtar Totakhail.pptx
Pleural effusions can be transudative or exudative based on the ratio of fluid to serum proteins and lactate dehydrogenase levels. Common causes include congestive heart failure, cirrhosis, pneumonia, and malignancy. Diagnosis involves physical exam, imaging like chest x-ray, and thoracentesis to analyze fluid characteristics. Treatment depends on the underlying cause but may include drainage, antibiotics for infection, or pleurodesis for recurrent malignant effusions.
Fluids & electrolytes
1) The document discusses body fluids and electrolytes, including total body water content, intracellular fluid, extracellular fluid, and the normal exchange between fluid compartments.
2) Volume deficits (dehydration) and volume excess are described, along with their causes, signs and symptoms, and assessment. Ongoing fluid losses are also discussed.
3) Sodium balance and disorders like hyponatremia and hypernatremia are covered, including definitions, causes, and approaches to determining the type and treating each condition.
Pleural Effusiion
This document discusses pleural effusions, which are collections of fluid in the pleural space between the lungs and chest wall. It covers the etiology, mechanisms, classification as transudates or exudates, clinical presentation, diagnostic evaluation including thoracentesis, and treatment approaches for pleural effusions. Common causes include congestive heart failure, pneumonia, malignancy, and pulmonary embolism. Diagnostic thoracentesis is performed to analyze pleural fluid characteristics and determine the underlying condition. Treatment depends on the cause but may involve drainage procedures, chemotherapy, or sclerosing agents.
Evaluation of ascites
Evaluation of ascites - tapping diagnosis evaluation management SAAG Ratio and physician and updates and guidelines
ACUTE RENAL FAILURE_FINAL PRESENTATION.pptx
Acute renal failure (ARF) is defined as a rapid decline in kidney function over days or weeks. It can be caused by pre-renal factors that decrease blood flow to the kidneys, intrinsic renal disease, or post-renal obstruction of urine flow. ARF is characterized by rising levels of blood urea and creatinine, decreased urine output, and a decline in glomerular filtration rate. Diagnosis involves laboratory tests of blood and urine as well as imaging studies like ultrasound. Complications of ARF include electrolyte imbalances, pulmonary edema, bleeding, and metabolic acidosis. Prevention focuses on avoiding dehydration in high-risk patients and using caution with nephrotoxic drugs.
CYTOLOGY 3.pptx
This document discusses body fluid and semen analysis. It describes the collection, handling, and laboratory evaluation of various body fluids including pleural fluid, peritoneal fluid, cerebrospinal fluid, and semen. For each fluid, it outlines the anatomy, normal physiology, causes of abnormal fluid accumulation, laboratory tests performed, and clinical significance of the test results. The goals of analyzing these fluids are to diagnose disease states, identify infectious or malignant processes, and assess fertility potential in the case of semen analysis.
Pleural diseases
The pleura is a membrane that covers the lungs and lines the chest cavity. Pleural effusions occur when there is an imbalance between pleural fluid formation and absorption, causing excess fluid in the pleural space. Effusions can be transudative or exudative based on fluid characteristics. Common causes include heart failure, pneumonia, cancer, and cirrhosis. Symptoms range from none to chest pain and dyspnea. Diagnosis involves chest imaging, fluid analysis, and other tests. Treatment focuses on resolving the underlying cause and draining significant fluid accumulations.
Renal disorders
This document discusses the manifestations and complications of renal disease and uremic syndrome. It covers the biochemical disturbances that occur like acidosis, electrolyte abnormalities, and fluid retention. Symptoms affecting various organ systems are described, like gastrointestinal issues, neurological signs, hematological problems, and skeletal disorders. Medical management including conservative therapies focusing on diet, medications, and preparing for dialysis are outlined. The two main types of renal replacement therapy, hemodialysis and peritoneal dialysis, are explained in detail. Oral health considerations for patients undergoing treatment are also noted.
ASCITIC FLUID ANALYSIS
- Ascitic fluid appearance can indicate underlying conditions, such as clear fluid indicating uncomplicated cirrhosis, milky fluid indicating malignancy or lymphoma, and bloody fluid indicating trauma or malignancy.
- Diagnosis of ascites involves physical examination and ultrasound, as 1,500mL of fluid is needed for flank dullness. Cell count with differential is most helpful test, with >250 polymorphonuclear cells indicating spontaneous bacterial peritonitis.
- Causes of ascites include portal hypertension from cirrhosis, hypoalbuminemia, peritoneal disease like cancer, and other rare conditions. Serum-ascites albumin gradient helps determine if ascites is caused by portal hypertension.
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Trastornos Pleurales
- 1. TRANSTORNOS PLEURALES Alumno: Flores Céspedes, Rodrigo E.
- 2. DERRAME PLEURAL Acumulación anormal de liquido en la cavidad pleural. Cuando se alteran las fuerzas homeostáticas que controlan el flujo vascular y linfático que entra y sale del espacio pleural.
- 3. LIQUIDO PLEURAL: 0.1 - 0.2 mL/kg • Espacio Pleural mide 0 a 20 micras de espesor. • Capa de Cel. Mesoteliales sobre Tej. Conectivo. • Se mueve 5-10 L/día
- 4. Causas
- 5. TRASUDADO • Alteración de la presión hidrostática • Alteración de la presión osmótica EXUDADO • Lesión o ruptura de las membranas pleurales o del sistema vascular. • Aumento de la permeabilidad capilar o disminución del drenaje linfático CRITERIOS LIGHT
- 6. No se punzan Toracocentesis • Criterios de Light • Gradiente de Albúmina: AlbS- AlbLP: >1.2g/dL(Transudado)
- 11. CUADRO CLINICO DOLOR PLEURITICO Px. acuesta decúbito contralateral al derrame DISNEA (+1/3 hemitórax) Frémito vocal Disminuido en Base Pulm • Murmullo vesicular Disminuido en base. • Se ausculta Soplo Pleurítico(mv en E) • Pectoriloquia Áfona(sus) • Egofonía(vcaprin). • Presencia frote pleural(hojas secas).
- 12. Técnicas de Imagen Rx. Tórax: Presencia de derrame o engrosamiento pleural difuso o masas.
- 13. Define la invasión dela pared torácica.
- 14. Toracocentesis PUNCION PLEURAL - Cuando: >1cm (5to-6to EIC) (Excepto: coagulopatia grave no corregible o de enf. asociada a trasudado IC, cirrosis hepática, IRC) - Tinción GRAM - Cultivo (aerobios y anaerobios) - Estudio citopatológico - Hemocultivo (glucosa, LDH, pH, ADA) - Gasometría arterial (pH 7,3 y 7,45), cuando es menor Empiema, pleuritis reumatoide. - Estudio de anaerobios: cuando tiene olor fétido - Urinotórax (cuando huele a orina) determinar creatinina en sangre y en liquido pleural. - Liquido hemorrágico: indicar neoplasia recomienda centrifugar y medir Hto - Amilasa en LP ante sospecha de pancreatitis.
- 15. ANALISIS DE LIQUIDO PLEURAL • NIVELES ALTOS DE ACIDO HIALURONICO > 100 000 ng/mL (niveles elevados se relacionan con mejor supervivencia) • VALORES ELEVADOS LDH 500 U/L - peor pronostico • ADA ELEVADOS pero se recomienda un cultivo M. tuberculosis • CITOLOGIA: Dificultad para distinguir si es benigno o maligno
- 16. NEUMOTÓRAX • Es la presencia de AIRE en el espacio pleural. Por aire procedente del pulmón subyacente o aire directamente del exterior, el aire con la presión negativa causan un colapso pulmonar.
- 20. CUADRO CLINICO
- 23. BIBLIOGRAFÍA: • https://www.ucm.es/data/cont/docs/420-2014-03-27- 06%20Patologia%20pleural%20y%20neumotorax%20ppt.pdf • https://ac.els-cdn.com/S1636541017878727/1-s2.0-S1636541017878727- main.pdf?_tid=98112f9a-e068-403b-b9de- a0231b42e11c&acdnat=1523081337_e07c33d18eaba43ee301f9a54a4608eb • http://www.medigraphic.com/pdfs/medlab/myl-2009/myl091-2b.pdf • LONGO, F. K. (2012). HARRISON PRINCIPIOS DE MEDICINA INTERNA. McGrawHill. • Rozman, C. "Farreras: Medicina Interna" 13 era. edición. Doyma, Madrid, 1995.