FAT EMBOLISM - DNB Orthopaedics MS Orthopedics MRCS Exam GUIDE - Orthodnb.com

DNB Orthopaedics  MS Orthopedics  MRCS Exam GUIDE - Orthodnb.com

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Wednesday 7 February 2018



  • microscopic fat globules found in circulation
  • # of long bones – fat released from bone marrow or adipose tissue near injury – enter circulation by rupture of marrow vascular sinusoids and venules
  • symptoms begin 1-3 days after injury – sudden onset
Image result for FAT EMBOLISM
  • causes biochemical injury and mechanical obstruction
    • microemboli of neutral fat cause occlusion of microvasculature
    • aggravated by local platelet and erythrocyte aggregation
    • exacerbated by release of free fatty acids from fat globules – cause local toxic injury to endothelium
    • vascular assault completed by platelet activation and granulocyte recruitment
  • Ziehl Neelsen staining
    • Step I – flame slides to heat fix
    • Step II – flood the slide full with Carbol Fuchsin – heat the slide until they are steaming
    • Step III – low or intermittent heat – steaming for 5 minutes
    • Step IV – rinse the slide with water
    • Step V – flood slide with 3% acid-alcohol – allow to decolorize for 5 minutes – continuously flood the slide for 5 minutes
    • Step VI – rinse the slide with water – drain of excess stain from slide
    • Step VII – flood the slide with counter stain (methylene blue) – keep counter stain for 1 minute
    • Step VIII – rinse thoroughly with water
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