53 - oedema

Question 1

Sx of congestive heart failure

Answer 1

SOB, fatigue, leg swelling, PND, orthopnea, pleural effusion, pitting oedema

Question 2

Causes of CHF

Answer 2

CAD, MI, AF, HTN, alcohol, infection, cardiomyopathy.

Question 3

Dx of CHF

Answer 3

Diagnose with echo.

CXR, ECG, BNP to isolate cause.

Question 4

Mx of CHF

Answer 4

Modify lifestyle factors.

Treat with furosemide, start either ACE inhibitor or bisoprolol.

Add the other if still symptomatic.

Be wary of fluid overloading

Question 5

DDx for oedema causes

Answer 5

Malnutrition (kwashiorkor)
Heart failure
Renal failure
Liver failure
Venous obstruction
Lymphoedema
Anaphylaxis

Question 6

Causes of hypoproteinaemia

Answer 6

Malabsorption
Malnutrition
Liver disease (reduced albumin synthesis)
Renal disease (increased loss in urine)
Sepsis

Question 7

Triad in nephrotic syndrome

Answer 7

Proteinuria
Hypoalbuminaemia
Oedema

Question 8

What often increases in nephrotic

Answer 8

hyperlipiaemia - to compensate

Question 9

What is meant by nephrosis

Answer 9

proteins pass through kidney to filtrate

Question 10

most common cause of nephrotic syndrome

Answer 10

minimal change

Question 11

Ix in nephrotic

Answer 11

Urine dip test. May need a kidney biopsy to identify cause.

Question 12

Mx of minimal change

Answer 12

pred

Question 13

Sx/ signs of nephritic syndrome

Answer 13

Haematuria
Proteinuria
Oliguria
Hypertension

Question 14

Causes of nephritic syndrome

Answer 14

IgA nephropathy, HSP, Goodpasture, SLE, HUS, post-strep.

Blood tests and urine dip.

Question 15

Rfs pre-eclampsia

Answer 15

obesity, DM, HTN, old age, twin pregnancies, smoking.

Question 16

2 key feaures of pre-eclamosia

Answer 16

HTN and proteinura

Question 17

Complications / risks with pre-eclampsia

Answer 17

May progress to HELLP, eclampsia, ARDS, stroke and AKI

Question 18

Manage HTN in preg

Answer 18

Labetalol

Women have Labia

Question 19

Eclampsia
What do you also get?
Mx ?

Answer 19

Pre-eclampsia and tonic-clonic seizures.
High blood pressure, proteinuria.
Emergency, rapidly fatal for both mother and baby.
Treat with MGSO4. 
Delivery is the only true treatment.

Question 20

What is HELLP? Mx?

Answer 20

Haemolysis. Elevated Liver enzymes and Low Platlets.

Treat DIC with FFP
manage the HTN.