Edema and Dyspnea Flashcards by DJ Reloj

Function of arteriolar pressure

hydrostatic pressure

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Function of serum albumin

oncotic pressure

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Painless Edema causes can include:

Venous insufficiency
Lymphedema
Malignancy
Heart, liver, kidney disease

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Painful Edema (inflammatory)

DVT
Lipedema
Cellulits
Compartment syndrome
Reflex sympathetic dystrophy

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Common drug causing leg edema

CCBs
Steroid
Anti-inflammatory drugs

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Less common drugs causing leg edema

Androgens
Clonidine
Danazol
Diazoxide
Estrogens
Glucocorticoids
Oral Contraceptives

ACDDEGO

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Bilateral or generalized edema – organ of systemic disease?

heart, CVD

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Decreased albumin occurs in disease of what organ (decreased oncotic)

Liver

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In chronic disease this organ is responsible for volume overload –> increased hydrostatic pressure

kidney

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Type of edema improving overnight

venous edema

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Type of edema not improving overnight

lymphedema

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Malignancy causing leg edema

prostate (men)

pelvic (women)

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Pitting edema is due to

Venous insufficiency
DVT
early lymphedema

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Hall mark of lymphedema

Stemmer’s sign

Kaposi-Stemmer

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Varicose veins with bipedal edema indicates

chronic venous insufficiency

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When 2nd toe skin is pinched it cannot be lifted with two fingers

positive Stemmer’s

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Causes wart texture with papilllmatosis

Filariasis; prostate/ovarian cancer

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Scarring of the skin and fat above the ankle, usually inside surface, resulting from high venous pressure in subcut veins in lower leg

lipodermatosclerosis

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Causes warm tender skin and increased sweating in edema

hyperthyroid

lymphangitis, cellulitis (unilateral)

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Distal thigh spared in unilateral edema

abscess

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popliteal cyst aka

Baker’s cyst

used in diagnosis of DVT

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S3, orthopnea, easy fatiguability, dyspnea

CHF

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peri-orbital edema

bilateral leg edema

thyroid disease

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peri-orbital edema

bilateral pitting edema

kidney disease

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Lipedema or lymphedema: tenderness

lipedema

Lipedema or lymphedema: thick, firm skin

lympedema

Lipedema or lymphedema: swollen feet

lympedema

Lipedema or lymphedema: assymetrical

lipedema (usually symetrical but lymphedema is always)

Lipedema or lymphedema: edema stops at ankles

lipedema

Increased pressure within a confined area affecting blood supply post-surgery

compartment syndrome Treatment: fasciotomy

non-pitting bilateral edema due to chronic accumunlation of mucopolysaccharides

pretibial myxedema treatment: thyroid hormones

Features a congentital asymmetry of lower extremities

Klippel-Trenaunay syndrome

Dyspnea --> Cough

CV dyspnea

Cough --> Dyspnea

Pulmo Dyspnea

Secondary to interstitial lung edema

CV dyspnea

secondary to secretions in the airways

Pulmo dyspnea

Cardiac meds that can cause dyspnea

diuretics B blockers CCBs

pursed-lip breathing

asthma

pathognomonic for lymphedema

stemmer's sign

Kussmaul breathing presence in

COPD and asthma

breathing in CHF

cheyne-stokes respiration | regularly irregular

breathing associated with meningitis

biot's respiration | irregularly irregular

On percussion: hyperresonanec

COPD and asthma

On percussion: dullness

consolidation (atelectasis, plueral effusion, diaphragmatic paralysis)

vesicular breath sounds heard in:

normal lungs

bronchial breath sounds heard in:

normal in upper airway consolidation anywhere else

rales or crackles heard in

atelectasis, pneumonia, CHF, interstitial lung disease, alverolar hemorrhage

rales/crackles + dyspnea

pneumonia, CHF, ILD

rhonchi originate in

larger airways due to accumulation of mucus in UPPER airways (low pitched snoring quality)

wheezes heard in

COPD, asthma

Cardiac examination in dyspnea: observe for what?

jugular venous distention ascites (umbilicus is everted) pedal edema (RVH signs)

Cardiac palpation: thrills (vibratory sensations)

systolic and diastolic murmurs secondary to severe valvular HD

Cardiac palpation: parasternal lifts

indicate enlargement of RV with possible pulmo HTN

Cardiac percussion used to detect

cardiomegaly or pericardial effusion

Valvular defect that can cause dyspnea

murmur of mitral stenosis

Dyspnea + cough

``` pneumonia asthma CHF COPD ILD ```

Dyspnea + chest pain (pleuritic)

pulmonary embolism pneumonia pneumothorax

Dyspnea + angina

Dyspnea + chest pain relieved WITH exertion

anxiety

Dyspnea + syncope

``` pulmonary htn pulmonary embolism idiopathic hypertrophic subaortic stenosis aortic stenosis dysrhythmia ```

Dyspnea + smoker + sputum wheezing

COPD

Dyspnea + cough + fever

pneumonia

Dyspnea + pleuritic chest pian + prolonged immobilization

pulmonary embolization

Dyspnea + HTN/DM or other risk factors for atherosclerosis

Dyspnea + young student

anxiety

Dyspnea + syncope

if cardiac in origin think: | valvular heart disease (aortic stenosis)