Ebook On rounds - 1000 internal medicine pearls: Part 2
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Ebook On rounds - 1000 internal medicine pearls: Part 2
Fever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2IONDIURNAL VARIATION IN TEMPERATURENIGHT SWEATSCENTRAL REGULATION OF CORE TEMPERATURETemperature in humans is controlled by the hypothalamus around a set point of about 37 °C (98.6 °F), by a complex series of mechanisms that permit the generation, conservation, and dissipation of heat.Homeothermy re Ebook On rounds - 1000 internal medicine pearls: Part 2quires a balance of heat generation, heat conservation, and heat dissipation. This is accomplished by a remarkable series of coordinated cardiovasculaEbook On rounds - 1000 internal medicine pearls: Part 2
r and metabolic responses integrated in the hypothalamus, and fine tuned in the effector organs peripherally. These responses involve the autonomic neFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2resetting of the temperature set point up; antipyretics adjust the set point down when the latter is elevated by fever.Fever is distinct from hyperthermia.In hyperthermia the core temperature rises because heat dissipation mechanisms are impaired, or because heat production exceeds the capacity of h Ebook On rounds - 1000 internal medicine pearls: Part 2eat dissipation mechanisms, not because of an increase in central temperature set point.Infections cause fever via cytokine release from inflammatoryEbook On rounds - 1000 internal medicine pearls: Part 2
cells.In fact, the first cytokine described was called “endogenous pyre https://khothuvien.corn from host leukocytes after exposure to bacteria. It haFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2lignancy.THERMOGENESISThermogenesis, literally heat production, is not synonymous with fever.In warm-blooded mammals (homeotherms) basal heat production (or basal metabolic rate [BMR]) is the heat produced at rest by mitochondria throughout the body. BMR is regulated by thyroid hormones.Excessive sw Ebook On rounds - 1000 internal medicine pearls: Part 2eating is the clinical manifestation of increased heat production without a rise in temperature.In hyperthyroidism BMR is increased (thermogenesis), bEbook On rounds - 1000 internal medicine pearls: Part 2
ut fever is absent unless the increased heat production overwhelms the heat dissipation mechanisms.HEAT GENERATION AND DISSIPATIONHeat dissipation mecFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2loss. The latter is regulated by cholinergic sympathetic nerves to the sweat glands.A rise in temperature of 1 °C results in a 10% to 13% increase in metabolic rate, contributing to the weight loss noted during prolonged febrile illness.Maintenance of normal body temperature in spite of differing am Ebook On rounds - 1000 internal medicine pearls: Part 2bient conditions (homeothermy, the “warm blooded” state) consumes a significant amount of total energy production (about 50% in normally active man).REbook On rounds - 1000 internal medicine pearls: Part 2
igors reflect the rapidity of a rise in temperature; they are not specific for any particular cause of the fever.Heat generation occurs by the musculaFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2hat rigors are caused principally by gram-negative bacterial infections.BAT is a heat-generating organ.Although the role for BAT in physiologic heat production in small mammals and human neonates has been well accepted, BAT was long dismissed as irrelevant in adult humans. BAT has now been resuscita Ebook On rounds - 1000 internal medicine pearls: Part 2ted and is generally recognized as functional in many adults. Itis a faux pearl that BAT is neither present nor functional in c https://khothuvien.corEbook On rounds - 1000 internal medicine pearls: Part 2
n role for BAT (or lack thereof) in the pathogenesis of obesity is unG—_The production of metabolic heat in BAT is regulated by the sympathetic nervouFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2led so that substrate oxidation results in the production of heat rather than the synthesis of ATP. The location of BAT around the great vessels in the thorax facilitates distribution of the generated heat throughout the body. Heat production in BAT is markedly enhanced by chronic cold exposure, a p Ebook On rounds - 1000 internal medicine pearls: Part 2rocess known as cold acclimation; in the cold acclimated state metabolic heat replaces the need to shiver during cold exposure.In humans the extremitiEbook On rounds - 1000 internal medicine pearls: Part 2
es play an important role in temperature regulation.Heat conservation occurs via vasoconstriction of arteries and superficial veins in the extremitiesFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2orm a plexus around the arteries in the extremities, are more heavily endowed with cx-1 receptors. External cooling decreases a-1 receptor affinity for NE in deep veins but increases a-2 affinity in the superficial veins, favoring a shift of blood to the deep venous system. The deep veins form a ple Ebook On rounds - 1000 internal medicine pearls: Part 2xus around the arteries that supply the extremities, thus providing the anatomic basis for a countercurrent heat exchange mechanism. These vascular chEbook On rounds - 1000 internal medicine pearls: Part 2
anges efficiently return heat from the arterial system perfusing the extremities to the central vascular compartment. The opposite vascular changes poFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2gs at a regular interval rather than PRN for a rise in temperature, in order to avoid repeated heat generation and diaphoresis as the antipyretic wears off and is readministered.During a febrile response heat is both conserved and generated, thereby raising the core temperature. Paradoxically, the p Ebook On rounds - 1000 internal medicine pearls: Part 2atient feels cold since the core temperature is below the new (febrile) set point. When the fever breaks, either through resolution of the infection oEbook On rounds - 1000 internal medicine pearls: Part 2
r the administration of antipyretics, heat is dissipated by vasodilation and sweating; the patient, paradoxically, feels warm, the core temperature noFever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATI Ebook On rounds - 1000 internal medicine pearls: Part 2 single daily spike.Fever, Temperature Regulation, and ThermogenesisCENTRAL REGULATION OF CORE TEMPERATUREFEVER AND HYPERTHERMIATHERMOGENESISHEAT GENERATION AND DISSIPATIGọi ngay
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