Edema

Question 1

Edema

Answer 1

Excessive fluid accumulation between cells

Palpable swelling

Or within cavities (acities)

Question 2

Why is edema bad

Answer 2

inc diff distance for O2 and nutrients

Dec removal of toxic byproducts of metabolism

Lungs - limit O2 diffusion

Damage to cerebral edema/compartment syndrome

Intestinal - limit absorption

Ascites - predispose to infection

Question 3

Kidney to the resuce

Answer 3

Dec in ECV sauses sodium retention

But alterations of capillary hemodynamics allow fluid to enter the interstitium and produces more edema

Kindey retians more fluid

Trying to maintain normal PV

Question 4

Kdieny as a cause

Answer 4

INapproprtiate fluid retention

Alteration of cap HD byu inc VP

Question 5

Inappropriate fluid rentention

Answer 5

Causes - excessive IV fluids or renal dz, CHF

Alters cap HD by inc VP

Question 6

Local factors agaist edema

Answer 6

Lympatics - inc flow and contractility

Fluid entry into interstitium will raise interstitial HS presudre

Question 7

Inc cap HS presure

Answer 7

Venous obstruction
Cirrhosis
HF
Constriction.restriction
CKD 
Pregnancy

Question 8

Inc VP and inc arteriolar dilation

Answer 8

VP - expanded BV (CHF), venous obstruction, peripheral venous dz (venous valvular insuff)

Dilation - acute infalmation or allergic rxns, CCBs

Question 9

IMpediemnt to venous flow

Answer 9

SVC syndrome or DVT

Question 10

CHF

Answer 10

Inc CVP and dec renal perfsuon…leads t orelease of more renini

Question 11

Venous valvular insuff

Answer 11

Inc venous pressure

Prolonged venous HTN leads to edema, inflammation, and hypoxia

In addition, inc pressure transmitted to tissue leading to skin issues

Question 12

Stasis dermatitis

Answer 12

Erythema, scaling, weeping and crusting from chronic venous stasis

Could also get hyperpigmentation

Question 13

Early venous stasis ulcer

Answer 13

LIchenification and hyperpigmentation

Ulcer atm medial malleolus

Develop from inadequatly tx stasis dermattiis

Question 14

Dec plasma oncotic pressure

Answer 14

Malabsorption
Neprhotic
Liver failure
Mlanutrtion

Question 15

Dec plasma oncotic pressure mechs

Answer 15

Loss of plasma albumin - burn/neprhotic

Inc protein consumption - tumors or inflammation

Dec synthesis of albumin - hepatic dysfunction and starvation

Dilution of serump rotein - over infusion of H2O and sodium

Question 16

Inc capillary perm

Answer 16

Burns and angioedema

INfection, hypoxia, acidosis, radiation damage, trauama, burns

Inflamm mediators

Question 17

Lymphedema

Answer 17

Obstruction or

Increase in interstitial colloid oncotic pressure - abnormal accumulation of interstitial fluid resulting from inury, infection, or congenital abnormality of the lymphatic systerm

Question 18

Mech of lymphedema

Answer 18

Obstructed lymphatics—–backflow of protein in interstitial fluid blocker—-interstitial COP rises—-effective COP dec—–effective FP increases—-more fluid in interstitum

Question 19

Signs and sx of lymphedema

Answer 19

Chronic swelling

Mostly lower

Recurrent infections

Cellulitis, lymphagitis fissuring, ulcerations

Question 20

Exam of lymphedema

Answer 20

Nontender, pitting edema erythema and thicking ofskin

Elephantiass - cobble-stoned hyperkeratotic, papillomatous plaques on the shins

FIssuring, ulcerations, skin breakdown

Superinfection - impetigo

Positive stemmer sign

Question 21

Myxedema

Answer 21

Inc interstitial oncotic pressure

Hypothyrodiism characterize by hard edema of subq tissue - with inc content of mucins (proteoglycans) in the IS fluid