Exudates And Transudates

Exudates And Transudates

Question 1. Give the difference between exudate and transudate.
Or
Write the differences between exudate and transudate.
Answer:

Question 2. What are circulatory disturbances (only name them)? Write changes in lung and liver due to chronic passive congestion.
Answer:

Circulatory or hemodynamic disturbances are considered under two broad headings:

• Disturbances in the volume of circulating blood:
  • Hyperemia and congestion
  • Hemorrhage and shock
• Disturbances due to obstruction:

Exudate vs transudate

Thrombus, embolism, ischemia and infarction.

1. Changes in the lung due to chronic venous congestion or CVC Lung: CVC of the lung occurs in left heart failure resulting in an increase in pulmonary venous pressure

Grossly

• Lungs become heavy and firm in consistency.
• The Cut surface is dark and rusty brown in color referred to as the brown induration of the lungs.

Histological features

• The alveolar septa is widened and thickened. Widen due to the presence of interstitial edema, dilated and congested capillaries. Thickened due to an increase in fibrous connective tissue.
• Rupture of the dilated and congested capillary may result in minute intra-alveolar hemorrhage
• Breakdown of RBCs liberates hemosiderin pigment which is taken up by alveolar macrophages so-called heart failure cells, present in the alveolar lamina.
• Brown induration is due to pigmentation and fibrosis.

2. Changes in the liver due to chronic venous congestion or CVC Liver: Chronic venous congestion of the liver occurs in right heart failure and sometimes due to occlusion of the inferior vena cava and hepatic vein.

Grossly

• The liver is enlarged, and tender, and the capsule is tense.
• The cut surface shows nutmeg due to the red and yellow mottled appearance.

Difference between exudate and transudate

Microscopically

• Microscopically the changes in congestion are more marked in the centrilobular zone.
• The centrilobular hepatocytes undergo degenerative changes and eventually, centrilobular hemorrhage necrosis may be seen.
• Longstanding cases may show fie centrilobular fibrosis and regeneration of hepatocytes, resulting in cardiac cirrhosis.
• The peripheral zone of the lobule is less severely affected by chronic hypoxia and shows some fatty changes in hepatocytes.