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Questions and Answers
What physiological change is primarily responsible for the bluish discoloration observed in cyanosis?
What physiological change is primarily responsible for the bluish discoloration observed in cyanosis?
- Decreased oxygen saturation leading to an increased percentage of reduced hemoglobin. (correct)
- Increased bilirubin levels in the blood.
- Reduced blood flow to the skin surface, causing increased oxygen extraction.
- Elevated levels of methemoglobin, which cannot effectively carry oxygen.
Which of the following conditions primarily results in central cyanosis rather than peripheral cyanosis?
Which of the following conditions primarily results in central cyanosis rather than peripheral cyanosis?
- Exposure to cold temperatures causing vasoconstriction in the extremities.
- Arterial occlusion in the fingers and toes.
- Congenital heart defects that cause mixing of oxygenated and deoxygenated blood. (correct)
- Venous stasis in the lower extremities leading to poor local oxygen delivery.
In the context of cyanosis, which statement best differentiates the underlying mechanism between central and peripheral cyanosis?
In the context of cyanosis, which statement best differentiates the underlying mechanism between central and peripheral cyanosis?
- Central cyanosis is primarily due to reduced hemoglobin saturation at the tissue level, while peripheral cyanosis results from decreased oxygen-carrying capacity of the blood.
- Central cyanosis involves decreased arterial oxygen saturation, whereas peripheral cyanosis is caused by increased oxygen extraction by peripheral tissues. (correct)
- Central cyanosis typically affects the core body, while peripheral cyanosis is limited to the extremities.
- Central cyanosis is corrected by warming the patient, while peripheral cyanosis requires supplemental oxygen.
Why might the sclera of the eye be one of the first locations where jaundice is detected?
Why might the sclera of the eye be one of the first locations where jaundice is detected?
What is the underlying mechanism by which vasopressin can induce pallor?
What is the underlying mechanism by which vasopressin can induce pallor?
Why is pallor best assessed in areas such as the conjunctiva and buccal mucosa?
Why is pallor best assessed in areas such as the conjunctiva and buccal mucosa?
Which of the following best explains why anemia can cause pallor?
Which of the following best explains why anemia can cause pallor?
How does increased skin thickness, like that seen in hypothyroidism, contribute to pallor?
How does increased skin thickness, like that seen in hypothyroidism, contribute to pallor?
What is the primary physiological mechanism that leads to edema of the face and skin contributing to pallor in conditions like anasarca?
What is the primary physiological mechanism that leads to edema of the face and skin contributing to pallor in conditions like anasarca?
Which of the following physiological changes primarily contributes to pallor in patients experiencing low cardiac output, such as in left-sided heart failure or shock?
Which of the following physiological changes primarily contributes to pallor in patients experiencing low cardiac output, such as in left-sided heart failure or shock?
What is the fundamental difference in how oxygen saturation is affected in generalized cyanosis versus perioral cyanosis?
What is the fundamental difference in how oxygen saturation is affected in generalized cyanosis versus perioral cyanosis?
What is the key characteristic that distinguishes differential cyanosis from other forms of cyanosis?
What is the key characteristic that distinguishes differential cyanosis from other forms of cyanosis?
Which major cause of jaundice involves issues after the liver?
Which major cause of jaundice involves issues after the liver?
What is the significance of assessing Schamroth's sign in the context of upper limb examination?
What is the significance of assessing Schamroth's sign in the context of upper limb examination?
In the context of lower limb examination, what is the clinical relevance of differentiating between pitting and non-pitting edema?
In the context of lower limb examination, what is the clinical relevance of differentiating between pitting and non-pitting edema?
How would you best interpret a jugular venous pressure (JVP) measurement that is elevated above normal?
How would you best interpret a jugular venous pressure (JVP) measurement that is elevated above normal?
What distinguishes third-degree clubbing from first and second-degree clubbing?
What distinguishes third-degree clubbing from first and second-degree clubbing?
Which of the following explains why jaundice might not be initially apparent even when bilirubin levels are elevated?
Which of the following explains why jaundice might not be initially apparent even when bilirubin levels are elevated?
How does decreased skin pigmentation, as seen in panhypopituitarism, lead to pallor?
How does decreased skin pigmentation, as seen in panhypopituitarism, lead to pallor?
Flashcards
Complexion
Complexion
The color of the skin and mucous membranes.
Pallor
Pallor
Paleness of the skin; loss of color.
Cyanosis
Cyanosis
Bluish discoloration due to increased reduced hemoglobin (≥5 gm) in capillary blood.
Central cyanosis
Central cyanosis
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Peripheral cyanosis
Peripheral cyanosis
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Differential cyanosis
Differential cyanosis
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Jaundice
Jaundice
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Sclera
Sclera
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Causes of jaundice
Causes of jaundice
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Clubbing
Clubbing
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Schamroth's sign
Schamroth's sign
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Pitting edema
Pitting edema
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Non-pitting edema
Non-pitting edema
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Study Notes
- Complexion refers to the color of the skin and mucous membranes.
- Complexion includes pallor, jaundice, and cyanosis.
Pallor
- Pallor is the color of skin minus its redness.
- Pallor gives an idea about the level of hemoglobin or blood perfusion.
- Pallor can be detected on the inner surface of the lips, the palm of the hand, the nail bed, and mucous membranes like the conjunctiva and buccal.
- Pallor can be true or false.
- Anemia, low cardiac output, and drugs that cause peripheral vasoconstriction such as vasopressin can cause true pallor.
- Edema of the face and skin, increased skin thickness, and decreased skin pigmentation can cause false pallor.
Cyanosis
- Cyanosis is the bluish discoloration of skin and mucous membrane because of an increased percentage of reduced hemoglobin (≥5 gm) in capillary blood.
- Normally, reduced hemoglobin does not increase 2.5 in capillary blood
Central Cyanosis
- Central cyanosis is caused by cardiac or respiratory issues.
- Central cyanosis can be observed at the lateral edge of the under-surface of the tongue.
- Central Cyanosis indicated a defect in oxygenation
- Conditions include heart disease, COPD, asthma, anemia, pulmonary embolism, congenital heart defects, and collapsed lung.
Peripheral Cyanosis
- The peripheral cyanosis sites include the nail bed, outer surface of the lip, tip of nose and ear pinna.
- Peripheral cyanosis indicates stagnation of blood in peripheral circulation.
- Generalized cyanosis on a baby indicates total anomalous pulmonary venous return, and an oxygen saturation level of 80%.
- Perioral cyanosis exists when a baby has mild cyanosis above the lips, but the mucous membranes remain pink.
Differential Cyanosis
- Differential cyanosis exists where cyanosis is only present in one half of the body, and is normal in the other half.
Jaundice
- Jaundice results from an abnormally high accumulation of bilirubin in the blood, which causes a yellowish discoloration to the skin and deep tissues.
- Jaundice is detectable when serum bilirubin concentration rises above 50 µmol/L (3 mg/dL).
- The sclera of the eye often shows Jaundice first, since it contains considerable elastic fibers.
Major Causes of Jaundice
- Excessive destruction of red blood cells
- Impaired uptake of bilirubin by the liver cells
- Decreased conjugation of bilirubin
- Obstruction of bile flow in the canaliculi of the hepatic lobules or in the intrahepatic or extrahepatic bile ducts
Upper Limb Examination
- Clubbing is a painless enlargement of distal phalanges.
- In Clubbed fingers, the normal angle of the nail bed becomes distorted.
- First degree clubbing has an absent window sign.
Lower Limb Examination
- Pitting edema can be seen with cardiac, renal, and liver diseases as well as nutritional hypoalbuminemia.
- Non-pitting edema can be seen with lymphatic filariasis.
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