20. DDX of abdominal fluid

Question 1

possible causes of ascites

Answer 1

right heart failiure 
hyponatremia 
hypoproteinemia 
peritonitis 
neoplasm
bleeding 
infections

Question 2

ddx of big distended abdomen

Answer 2

ascites 
pregnancy 
obesity 
distended bladder
pyometra

Question 3

etiology of fluid leakage in general

Answer 3

increased hydrostatic pressure
decreased oncotic pressure (hypoalbuminemia)
increased permeability of vessels
problem with lymphatic circulation

Question 4

types of fluid from different causes

Answer 4

right heart fail - modified transudate 
tumor: modified transudate, exudate, blood 
infections - exudate 
thrombosis - modified transudate
hypoproteinemia - transudate

Question 5

types of transudate

Answer 5

protein poor below 25 g/l

protein rich

Question 6

protein poor transudate causes

Answer 6

hypoalbuminemia (PLE, PLN)
abnormal lymphatic flow
liver cirrosis

Question 7

protein rich transudate causes

Answer 7

right sided heart fail
congestion
prehepatic hypertension

Question 8

types of exudate and its causes

Answer 8

sterile: pancreatitis, FIP, uroperitoneum
septic: infectious

Question 9

classification of ascites

Answer 9

prehepatic
hepatic
posthepatic

Question 10

what is prehepatic ascites

Answer 10

v. porta, A. hepatica
caused by portal hypertension
intestinal lymph (water like, low protein and cells)

Question 11

what is hepatic ascites

Answer 11

intestinal + hepatic lymph

Question 12

what is post hepatic ascites

Answer 12

vena hepatica, vena cava caudalis 
passive congestion 
hepatic lymph (more protein)

Question 13

ddx hemorrhagic fluid

Answer 13

tumour
trauma
uroperitoneum - ruptured bladder
intestinal strangulation

Question 14

ddx chyloperitoneum

Answer 14

TG ascites > tg blood
cholesterol acsites < cholesterol blood
tumor, heart fail, lymphangiectasia