Abdominal enlargement/effusions

Question 1

what are you 7 Fs for abdo enlargement

Answer 1

1. Fluid
2. Fat
3. Faeces
4. Foetus
5. Flatus
6. Feel a big mass
7. Floppy (weak abdo musculature)

Question 2

how do you confirm abdo fluid?

Answer 2

1. often leads to marked abdo enlargement
2. Detectable ‘fluid wave’ on ballottement
3. Confirm w/ abdo US
4. Abdominocentesis

Question 3

characterise a transudate

Answer 3

• low-protein (pure) transudates

Question 4

list some fluids that may accum in the abdo

Answer 4

• transudates (ascites)
• exudates (septic/non-septic)
• blood
• urine
• chyle
• neoplastic effusions
• eosinophilic effusions

Question 5

3 causes of transudate accumulation in the abdomen

Answer 5

1. hypoproteinaemia (decreased oncotic presure)
2. portal hypertension (increased hydrostatic pressure)
3. lymphatic obstruction (rare)

Question 6

modified transudates result from..

Answer 6

increased hydrostatic pressure –> forced fluid from intravasc. space to interstitium (ascites) usu. w/out pleural effusion + high protein/cell counts

Question 7

a pure transudate ascites results from…

Answer 7

low oncotic pressure –> movement of water along osmotic gradient from intravasc space to interstitium –> leads to ascites then pleural effusion (+/- SC oedema)

Question 8

causes of modified transudates

Answer 8

1. hepatic and post-hepatic portal hypertension

MOST hepatic diseases (cirrhosis, hepatitis) and post-hepatic (RCHF)

Question 9

causes of pure transudates

Answer 9

1. hypoalbuminaemia (serum albumin <10-15g/L)

2. pre-hepatic portal hypertension (rare)