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Nephrology > Edema Lecture Powerpoint > Flashcards

Edema Lecture Powerpoint Flashcards

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1
Q

Edema definition

A

Palpable swelling produced by expansion of insterstitial fluid volume in the tissue itself

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2
Q

Pitting vs nonpitting edema

A

Pitting edema leaves an indentation when pressed with a finger and indicates less severe fluid buildup, nonpitting edema bounces back from indentation when pressed with a finger and indicates severe fluid buildup

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3
Q

Anasarca definition

A

Massive and generalized fluid build up, extreme edema

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4
Q

Capillary hydrostatic pressure definition

A

Pressure pushed on the capillary walls due to blood pressure to release fluid into the tissue bed, increased in cases of inflammation and venous congestion

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5
Q

Capillary osmotic pressure definition

A

The pressure pulling water back into the capillary vessel due to plasma proteins within the vessel

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6
Q

Lymphatic obstruction and it generally manifests ___laterally

A

Tumors, parasites, fibrosis, or removal of lymph nodes that cause obstruction of the flow and edema, generally manifests unilaterally

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7
Q

Interstitial osmotic pressure definition

A

The pressure Inward pulling force of fluid from the capillary into the interstitial space where proteins drive the fluid

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8
Q

Interstitial hydrostatic pressure

A

The pressure pushing fluid out of the interstitial space and back into the capillaries

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9
Q

___ of total body water is confined to extracellular space, generalized edema requires ___ of excess fluid before even being noticable

A

1/3, 2.5 to 3 L

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10
Q

Cardiac signs of generalized edema (5)

A
  • dyspnea upon exertion
  • paroxysmal nocturnal dyspnea
  • JVD
  • displaced apical pulse
  • cool extremities
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11
Q

Cardiac labs of generalized edema, how is BUN/Cr ratio? How is sodium level? How is BNP level?

A

Elevated BUN/Cr ratio

  • Decreased Na+
  • Elevated BNP
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12
Q

Brain natriuretic peptide (BNP) definition

A

A protein released in the body when the heart is working very hard and failing

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13
Q

Often a patient with paroxysmal nocturnal dispnea will have to do this to sleep

A

Prop pillows underneath them

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14
Q

Hepatic signs of generalized edema (4)

A
  • history of alcohol abuse
  • ascites
  • jaundice
  • asterixis
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15
Q

Ascites definition

A

Excessive fluid retention in peritoneal space, often resulting from portal hypertension, has large tortuous veins called caput medusa

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16
Q

Asterixis definition

A

Flapping fingers when holding hand outright due to nervous system effect

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17
Q

Hepatic Labs of generalized edema, how are liver enzymes?

A

Elevated

18
Q

Renal signs of generalized edema (4)

A
  • Uremia
  • metalic or fishy taste
  • uremic frost
  • elevated BP
  • periorbital edema
19
Q

Uremic frost definition

A

Uremic crystal formation on skin due to renal failure, smells foul

20
Q

Renal labs of generalized edema, how is albuminuria? RBC count? K+ levels?

A
  • Positive for albuminuria
  • Normocytic anemiaRBC count
  • Hyperkalemic
21
Q

Edema can be caused by increased hydrostatic pressure caused by these 2 mechanisms

A

1) impaired venous return

2) arteriolar dilation

22
Q

Edema can be caused by reduced plasma osmotic pressure caused by these 3 mechanisms

A

1) protein losing gastroenteropathy or glomerulopathy
2) liver cirrhosis
3) Malnutrition

23
Q

Edema can be caused by lymphatic obstruction caused by these 3 mechanims

A

1) inflammation
2) post surgical
3) post irradiation

24
Q

Edema can be caused by increased capillary permeability or sodium retention caused by these 2 mechanisms

A

1) exccess salt intake or reabsorption

2) inflammation/immune rxn

25
Q

Hydrothorax definition

A

A type of edema with accumulation of excess fluid in chest cavity

26
Q

Hydropericardium definition

A

A type of edema with fluid in the pericardial sac that can lead to compression of heart

27
Q

Exudate definition

A

A type of edema with inflammatory fluid spilling out of skin

28
Q

Some common causes of anasarca (4)

A
  • nephrotic syndrome
  • cirrhosis
  • myxedema (hypothyroidism)
  • anaphylaxis
29
Q

Nephrotic syndrome can cause edema because of the…

A

….massive proteinuria diminishing the colloid oncotic pressure

30
Q

An early and a late finding in cirrhosis

A

Early - telangiectasias, broken sensitive vessels seen on face
Late - jaundice

31
Q

A left sided congestive heart failure sees back up in the ___ while a right sided sees backup in the _____

A

lungs, extremities

32
Q

Dependent edema definition

A

Edema that works with gravity via venous insufficiency and failure of valves causing blood to pool in veins increasing venous pressure and leading to edema that usually resovles when legs are elevated

33
Q

Dependent edema treatment (3)

A
  • restricted sodium intake
  • stockings
  • weight loss
34
Q

Brawny edema definition

A

Edema caused by chronic venous insufficiency causing thickened, dark colored skin with pectachiae and ulcerations

35
Q

Idiopathic cyclic edema definition and treatment

A

Edema that occurs on a predictable cycle possibly related to hormones, normally seen in female menstrual cycle with weight change during day around period
Treated with sodium restriction or diuretics with caution

36
Q

Drug class known to be a source of edema

A

Calcium channel blockers

37
Q

If edema is worse in the morning, think of ___ edema origin

A

Renal

38
Q

Facial involvement of edema, think of one of these 3 types involvement

A
  • renal
  • myxedema
  • allergic
39
Q

Increased edema at end of day improving at night think of ___ edema origin

A

Cardiac

40
Q

What type of edema is often treated with stockings?

A

Dependent edema

41
Q

How does cirrhosis of liver progress regarding edema?

A

To ascites then to generalized edema

Nephrology (14 decks)

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