EDEMA

Question 1

Pitting edema

tipico da ICC ma anche da insufficienza venosa, cirrosi e sdr. nefrosica

Answer 1

1. Fluid retention
   
   • Reduced cardiac stroke volume in cardiac failure → impaired renal perfusion → activation of renin-angiotensin system → increased renal fluid retention → increased hydrostatic pressure → secretion of fluid into the interstitium (edema formation)
   • Pharmaceutical side effects (e.g., calcium channel blockers) (A decrease in arteriolar resistance increases the hydrostatic pressure in the precapillary circulation, which causes fluid to shift into the interstitium.)
2. Protein deficiency (mainly hypoalbuminemia) : nephrotic syndrome, liver cirrhosis, malnutrition, protein-losing enteropathy
3. Hydrostatic: chronic venous insufficiency , pregnancy, deep vein thrombosis, post-thrombotic syndrome
4. Increased capillary permeability: inflammation, burns, allergic reactions, trauma

Question 2

Nonpitting edema

Gli edemi da tireopatie non sono improntabili

Answer 2

-Lymphedema: due to lymphatic obstruction. Lipid-rich, protein-rich fluid in the interstitial space that has high viscosity. Characteristic finding in Turner syndrome.
-Secondary lymphedema
Tumors, operations , inflammation, trauma, radiation
therapy, Infections ,Recurrent erysipelas, leprosy,
syphilis, granuloma inguinale
Lymphatic filariasis (elephantiasis)
1.Manual compression therapy and compression garments
2.Elevation of the involved limb
3.Exercise
4.Management of underlying disease
5.Surgical resection of lymphatic vessels

-Myxedema: hypothyreosis (generalized), hyperthyreosis (typically pretibial)