Edema

Question 1

Define edema

Answer 1

• Accumulation of excess fluids in interstitial space & serous cavities
• when net movement of fluid into tissues exceeds lymphatic drainage

Question 2

compare between Exudate & Transudate

Answer 2

• Exudate has inflammatory fluid #️⃣ transudate has Normal tissue fluid
• Exudate has inflammatory cells #️⃣ transudate has more fluid & less cells
• Exudate has specific gravity exceeding 1015 #️⃣ Transudate specific gravity is less than 1015
• Exudate is caused by inflammation or mild vascular injury #️⃣ Transudate is caused by an unbalance in tissue fluid (increase in hydrostatic pressure)
• Exudate appears cloudy due to WBCs #️⃣ Transudated appears straw colored
• Exudate coagulates #️⃣ transudate doesnt

Question 3

enumerate Causes of Edema

Answer 3

• Increase in Capillary hydrostatic pressure
• Decrease in osmotic pressure of plasma
• Lymphatic obstruction
• Sodium retention
• Inflammation (acute inflammatory exudate)

Question 4

Causes of increased capillary hydrostatic pressure

Answer 4

• Congestive heart failure (decreases venous return)
• Pressure on veins (due to pregnency or thrombus) causing obstruction

venous congestion/ obstruction

Question 5

Causes of decreased plasma osmotic pressure

Answer 5

Hypoproteinemia, caused by:
* kidney disease (nephrotic syndrome)
* Liver disease
* Malnutrition
* Protein losing enteropathy (GIT)

decreased protein

Question 6

Causes of lymphatic obstruction

Answer 6

• Milory disease (hypoplasia of lymphatics)
• Inflammation: lymphadenitis, flariasis
• Neoplastic/ cancer: causes permeation (solid columns obstructing lymph nodes)
• post-surgical: after radical mastectomy
• Post-irradiation: fibrosis

Question 7

Causes of sodium retention

Answer 7

• Excess sodium intake
• renal hypo-perfusion

Question 8

Types of generalised edema

Answer 8

• Cardiac edema
• Nutritional Edema
• Renal Edema
• Angioedema
• Hepatic Edema

Question 9

Renal edema is divided into:

Answer 9

• Nephritic edema: glomerulonephritis –> periorbital edema which then becomes generalised
• Nephrotic edema: loss of protein in urine

Question 10

Worst type of generalised edema

Answer 10

Anasarca: caused by hypoproteinemia

Question 11

Describe morphology of edema

Answer 11

• Subcutaneous –> gravitational, dependent –> at legs when standing or sacrum when recumbent
• if finger leaves a depression when pressure is added –> pitting edema
• Renal edema –> periorbital
• Chylous effusion: due to presence of lipids absorbed from the gut