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Documenti di Cultura
Nephropathy Deparment
Zhou HongLi
Fever
1 Introduction
2 Pathlogeny and sort
3 Occurrence Mechanism
4 Clinical occurrence
5 Patterns of fever
6 FUO
Intruduction
2 Noninfective fever
aseptic necrosis mass absorption : tissue is
chemia and infarction,vascularitis, subarach
noid hemorrage
antigen-antibody reaction: acute rheumatic f
ever, still disease ,serum sickness, systemic
lupus erythematosus
familal fever: congenital familial mediterran
ean fever
endocrine disease: endocrine hyperthyroidism
tissue damage:myocardial infarction,
pullmonary infarction
drug reaction and gout
tumor: lymphomas,solid tumors
neuroleptic seizures
psychosocial factitious
Occurrence Mechanism
physiologic temperature elevated----fever
(elevation of hypothalamic set point)
Internal temperature
maintain
cellular function
Deviation >4
cellular dysfunction
Occurrence Mechanism
increased heat production
decreased heat dissipation Set point change
failure of regulating system
Temperature deviation
fever
exogenous pyrogen (bacterial, viral)
activate
neutrophil, eosinophil, mononuclear macrophage
release
endogenous pyrogen(interleukin-1(IL-1),TNF, interfero
n
fever
Occurrence Mechanism
Specific patients:
elderly patients
renal failure patients
high doses of corticosteriods
unable to mount
fever
immunocompromised hosts fever
HIV-infected fever
nosocomial fever
require special consideration
Clinical occurrence
low-grade fever:37.3-38
middle-grade fever:38.1-39
Grade
high-grade fever:39.1-41
(oral reading)
hyperthemia: 41
Clinical occurrence
Diagnosis criteria:
the illness last at least 3 weeks;
38.3 repeatedly;
no diagnosis after 1 week hospitalization
Causes:
noninfectious inflammatory disease;
infections;
malignancies (hematologic);
50% unexplained
Edema
Pathophysiology
Clinicaloccurrence
Idiopathic edema
Tropical edema
angioedema
Pathophysiology hydrostatic and oncotic pressure
A fluid fluid V
filter resorption
interstitial tissues
out
Keep in balance
equilibrating factors
Localized edema
cause: local vein or lymphatic return,soft tiss
ues disturbance or capillary permeability
disease: Inflammation infection
Enteropathy
Burns
fistulas
Idiopathic edema