Edema Flashcards
GI causes bilateral leg edema
- nutritional deficiency or malabsorption –> hypoalbuminemia
- refeeding edema
lymphedema
impaired lymph return due to hereditary or secondary causes
- crush injuries
- tropical infections
- axillary LN dissection during mastectomy
anascara
massive generalized edema
1 cause worldwide of lymphedema
filarial infection
hematologic causes leg edema
anemia
edema vs swelling
edema: fluid in intercellular sapce
swelling: transient abnormal enlargement/increased volume of body part, or transient eminence or elevation (bug bites)
hepatic causes bilateral leg edema
cirrhosis
cardiovascular causes of bilateral leg edema
- systolic or diastolic HF
- constrictive pericarditis
- pulm HTN
extrinsic factors causing edema
- Na+ intake
- sedentary lifestyle
- increased calorie intake
- NSAID use
- alcohol intake
tx for lymphedema
elevation and compression (support/compression sleeves/hose/wraps)
lipidema
fat cell growth and proliferation and subsequent fluid retention around the cells
meds that cause bilateral leg edema
- antidepressants (MAO inhibitors)
- antihypertensives (CCB, BB, direct vasodilators)
- hormones
- NSAIDs
- thiazolidinediones
venous causes of bilateral leg edema
- DVT
- venous insufficiency
endocrine causes bilateral leg edema
myxedema (severe hypothyroidism)
what causes generalized edema
HF, renal disease
non lymph causes of unilateral limb edema
- cellulitis
- baker cyst
diagnostic testing to evaluate edema
- CBC
- TSH
- CBC
- CXR PA and LAT
- EKC
- Echo
- BNP
- ANP
sx nephrotic syndrome
- puffy eyes w/ puffy ankles
- puffy skin
- abd distention
- weakness
- anorexia
- feeling sick
- high cholesterol
pitting vs non-pitting edema
pitting: indentation w/ pressure, associated w/ underlying organ dysfunction
non-pitting: no indentation, due to underlying metabolic dz (thyroid, lymphatic system dz, can be associated w/ warm weather)
lymphatic causes of unilateral limb edema
secondary to:
- neoplasm
- surgery
- radiation
- TB
- filariasis
what causes localized edema
lymphatic or venous obstruction
renal causes bilateral leg edema
- advanced kidney dz
- nephrotic syndrome
if diagnostics inconclusive, what additional testing can be ordered
- antinuclear antibody
- Hep B and C serology
- serum and urine protein electrophoresis
- renal US
- renal biopsy
lymphatic causes bilateral leg edema
- pelvic or retroperitoneal lymphadenopathy or mass
- lymphatic obstruction (lymphedema)
should you use diuretics w/ lymphedema or lipedema
NO they will not help
edema + dyspnea might be
PE or pneumonia
tx for lipedema
weight loss
what direct vasodilators cause bilateral leg edema
hydralazine and minoxidil
