复旦大学：《儿科学》课程教学资源（PPT课件讲稿）Problem based learning

Problem based learning (Session I) Cyanosis Moderator: Dr Gui yonghao

Problem based learning (Session I) Cyanosis Moderator: Dr. Gui yonghao

Cyanosis---Hints a Central cyanosis: implies decreased arterial oxygen saturation Peripheral cyanosis: caused by a decreased rate of peripheral blood flow

Cyanosis---Hints ◼ Central cyanosis: implies decreased arterial oxygen saturation ◼ Peripheral cyanosis: caused by a decreased rate of peripheral blood flow

Differential diagnosis Cardiovascular disease Congenital heart disease Eisenmenger syndrome Pulmonary arteriovenous fistulae Systemic arteriovenous fistulae Primary pulmonary hypertension

Differential diagnosis ◼ Cardiovascular disease -Congenital heart disease -Eisenmenger syndrome -Pulmonary arteriovenous fistulae -Systemic arteriovenous fistulae -Primary pulmonary hypertension

Differential diagnosis Congestive heart failure/ low output state Respiratory diseases Nasal obstruction Foreign body aspiration -Tracheal compression Bronchiolitis -Reactive airway disease

Differential diagnosis -Congestive heart failure/ low output state ◼ Respiratory diseases -Nasal obstruction -Foreign body aspiration -Tracheal compression -Bronchiolitis -Reactive airway disease

Differential diagnosis RDS Meconium aspiration Pneumonia Plural effusion Diaphragmatic hernia Lung hypoplasia

Differential diagnosis -RDS -Meconium aspiration -Pneumonia -Plural effusion -Diaphragmatic hernia -Lung hypoplasia

Differential diagnosis Metabolic disease -Hypoglycemia ■ Neurologic diseases Seizures Edema Hemorrhage

Differential diagnosis ◼ Metabolic disease -Hypoglycemia ◼ Neurologic diseases -Seizures -Edema -Hemorrhage

Differential diagnosis Miscellaneous Crying Sepsis Breath holding Drug: respiratory depressants

Differential diagnosis ◼ Miscellaneous -Crying -Sepsis -Breath holding -Drug: respiratory depressants

Differential diagnosis Discussion Cardiovascular Neonates with cyanosis by chd 1. Poor mixing of the systemic and pulmonary circulations Transposition Normal Heart A Ao RA Foramen Ovale

Differential diagnosis Discussion ◼ Cardiovascular -Neonates with cyanosis by CHD 1. Poor mixing of the systemic and pulmonary circulations

Differential diagnosis Discussion Decreased pulmonary blood flow and normal peripheral perfusion Pulmonary Atresia with Intact Ventricular Septum Tetralogy of A Fallot

Differential diagnosis Discussion ◼ Decreased pulmonary blood flow and normal peripheral perfusion

Differential diagnosis Discussion Increased pulmonary venous pressure leading to pulmonary edema and poor gas exchange View of ab norn al Ao Oxygenated pulmonary blood from veins behind the right the heart RA Oxygenated blood from RV the left lung TAPVD

Differential diagnosis Discussion ◼ Increased pulmonary venous pressure leading to pulmonary edema and poor gas exchange