Edema - ANNA

Question 1

Edema

Answer 1

Palpable swelling secondary to expansion of volume within the interstitial fluid

Question 2

Anasarca

Answer 2

Edema affecting the whole body
-kidney/liver failure
-pregnancy
-protein deficiency
-burns
-malignancy

Question 3

Peripheral edema

Answer 3

edema affecting the hands and/or feet
-typically toes are spared

Question 4

Ascites

Answer 4

Edema of the abdomen
-can have protrusion of umbilicus
-dullness to percussion
-full/firm to palpation
-fluid wave test: tap on one side, hand on the other
-#1 cause is cirrhosis

Question 5

Pulmonary edema

Answer 5

Excess fluid in the lungs
-fuzzy on CXR
-chest pain, dyspnea, orthopnea, SOB

Question 6

What factors contribute to development of edema associated with pressures?

Answer 6

Increased hydrostatic pressures
Decreased oncotic pressure in BV
Increased oncotic pressure in tissue

Question 7

Other factors that contribute to development of edema associated with pressures?

Answer 7

Increased blood vessel wall permeability
Obstruction of fluid clearance by lymphatic system

Question 8

Conditions that increase hydrostatic pressure

Answer 8

Right heart failure
DVT
Iliac vein compression by fibroids or metastatic lymph node disease

Question 9

Conditions that decrease oncotic pressure

Answer 9

Liver cirrhosis
Nephrotic syndrome
Anything with protein loss

Question 10

Conditions that increase capillary permeability

Answer 10

Sepsis
Cellulitis
Vasculitis

Question 11

Conditions that decrease lymphatic drainage

Answer 11

Metastatic lymph node disease
elephantiasis
lyphangectasia

Question 12

What is localized edema?

Answer 12

limited to a single extremity or part of an extremity
-example: unilateral leg swelling

Question 13

What is generalized edema

Answer 13

Affects the whole body rather than one particular organ or body area
-bilateral leg and abdominal swelling
-CKD or cirrhosis
-need at minimum 3L additional fluid

Question 14

Examples of localized edema

Answer 14

Inflammatory causes
Venous obstruction
Lymphatic obstruction
Local trauma
Congenital

Question 15

Examples of generalized edema

Answer 15

Cardiac
GI
Renal
Poor nutrition
Endocrine
Misc. - medications

Question 16

What is pitting edema

Answer 16

swelling depresses to pressure
-press over boney surface
-scale is 1+ to 4+

Question 17

What could chronic pitting edema be a sign of?

Answer 17

Liver, heart, kidney problems or problems with nearly veins

Question 18

What is non-pitting edema often a sign of?

Answer 18

thyroid or lymphatic system issue
-chronic venous stasis
-chronic inflammation
-Grave’s dermopathy

Question 19

What is dependent edema

Answer 19

Swelling that falls to gravitational pull
-walking: lower extremities
-bed: back or buttocks or face
-pregnancy

Question 20

What medications can cause edema

Answer 20

CCBs - amlodipine
NSAIDs
Estrogens
TZDs
Steroids
Gabapentin
Trazadone

Question 21

What is cyanosis

Answer 21

Bluish coloration of the skin or mucous membranes due to poor circulation or inadequate oxygenation of blood
-Caused by disorders of deoxygenated hemoglobin and abnormal hgb
-can indicated medical emergency

Question 22

Peripheral cyanosis

Answer 22

Upper or lower extremities
secondary to significant difference in the saturation between the arterial and venous blood

Question 23

Central cyanosis

Answer 23

Occurs when oxygen sat drops <85%
Bluish hue to the entire body surface and mucosa

Question 24

Causes of peripheral cyanosis

Answer 24

-Acrocyanosis is bluish coloration of the hands and feet
-May occur when O2 stats are normal
-Caused by peripheral vasoconstriction when not hypoxic

Question 25

Causes of central cyanosis

Answer 25

Cardiac
Respiratory
Hemorrhage
Shock