Edema

Question 1

General Mech of Generalized Edema

Answer 1

HYPOPROTEINEMIA

Question 2

2 Main Types of Edema

Def’n (2)?
THINK: Is / isn’t LYMPHATIC SYS functioning

Answer 2

1. Pitting Edema (Transudate): Properly functioning lymphatic system = what leaks into interstitium can be recovered.
   - ↑Hydrostatic P
   - ↓Oncotic P
2. Non-Pitting Edema (Exudate): Dysfunctional lymphatic system (ie blockage)

Question 2

Conseq of Edema (5 steps)

Answer 2

HYPOVOLEMIA ->
↓Renal perfusion ->
Activation of RAA System -> Na + H20 reabs ->
Na + H20 CAN’T be held in circ (due to hypoproteinemia) ->
Na + H20 enter tissues.

Question 3

Peripheral Edema

Mech (2 steps), Seen In?

Answer 3

↑venous pressure -> TRANSUDATION of fluid.

SEEN IN:
- RHF

Question 4

Myxedema

Def’n, Causes (2), Mech of Pres, Pres (2)?

Answer 4

Dermal edema due to accumulation of GAGs in skin and soft tis.

CAUSES:

• Hypothyroidism (Severe. Older Children + Adults)
• Graves disease

MECH = ↓SNS activity +↓BMR.

PRES:

• Large tongue
• Deepening of voice

Question 5

Lymphedema

Seen In (2)?

Answer 5

SEEN IN:

• Post Radical Mastectomy
• Infl Carcinoma (“peau d’orange”) of breast

Question 6

Pretibial Myxedema / Thyroid Dermopathy

Def’n, Mech (4 steps), Seen In, Pres?

Answer 6

Localized skin lesions resulting from deposition of Hyaluronic acid.

MECH:
Skin Fibroblasts express TSH receptor ->
TSH activation ->
GAG buildup ->
Edema, fibrosis + infl.

SEEN IN:
- Graves’ Dz

PRES:
- “Peau d’Orange” (discolored, waxy, indured skin) on ant aspect of lower legs

Question 7

Cerebral Edema

Seen In (3)?

Answer 7

SEEN IN:

• DKA
• SIADH
• Ammonia toxicity

Question 8

Papilledema

Mech (4 steps), Pres (2)?

Answer 8

MECH: Fluid in Retina
↑Intracranial P -> Resistance to Venous Return from eye -> Fluid collection in Retina -> Swollen Optic Disk w blurred margins.

PRES:

• Optic Disk with blurred margins
• LARGER blind spot

Question 9

Acute Cerebral Edema

Seen In (2), RX?

Answer 9

SEEN IN:

• Stroke
• Trauma

RX = Therapeutic Hyperventilation

Question 10

Pulmonary Edema

Mech (2 steps), Micro Findings, Seen In?

Answer 10

↑venous pressure -> TRANSUDATION of fluid.

FINDINGS:
- ‘Heart Failure’ cells in lungs

SEEN IN:
- LHF

Question 11

Edema of Upper Extremities

Causes?

Answer 11

CAUSES:

- SVC Sx

Question 12

Ankle Edema

Causes?

Answer 12

CAUSES:

- Cirrhosis / Portal Htn