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MD1 URO - EXAM 1 > Les états d’œdème > Flashcards

Les états d’œdème Flashcards

1
Q

What is oedème?

A

Accumulation anormale/excessive de liquide dans le milieu interstitiel…

eau intravasculaire —> interstitiel

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2
Q

How much liquid needs to have accumulated to be considered an oedème?

A

2L

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3
Q

What are the two forms of oedème?

A

Localisé

Généralisé

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4
Q

What are the necessary conditions to lead to the formation of a generalized edema?

A
  1. Perturbation of Starling Forces in capillaries which favours accumulation of interstitial fluid
  2. Rétention anormale hydrosodée par le rein
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5
Q

What are the 2 pathophysiologies that can lead to edema?

A

Sous and sur-remplissage

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6
Q

What is sous-remplissage?

A

Due to a “fuite intravasculaire”

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7
Q

What is sur-remplissage?

A

Overfilling little bucket due to problem with the kidneys

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8
Q

What is the difference when using diuretics in sur vs. sous-remplissage?

A

Sous-remplissage can be dangerous because there was already a drop in VCE compared to sur-remplissage where there is an already excess liquid intravascularly

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9
Q

What are the 5 things that can perturb Starling Forces?

A
  1. Increase in hydrostatic capillary pressure
  2. Decrease in plasma oncotic pressure
  3. Increase in capillary permeability
  4. Lymphatic obstruction
  5. Increase in interstitial oncotic pressure
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10
Q

Illnesses of which three organs have the ability to provoke an edema?

A

Heart

Liver

Kidneys

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11
Q

How does left heart failure cause edema?

A

ventricule défaillant —> dim. débit cardiaque —> activation des barorecepteurs du (VCE) (2) —> rétention hydrosodée par le rein (to aug. VCE) —> aug. volume sanguin —> aug. pression veineuse —> aug. pression veineuse (2) —> oedème (2 —> 1)

pas de sphincter du côté veineux des capillaires —> increase in volume in veins can easily go back to capillaries ​

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12
Q

How does right heart failure cause edema?

A

ventricule défaillant —> aug. pression veineuse —> transudation capillaire et rétention hydrosodée par le rein —> oedème (1+2)

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13
Q

What kind of diuretic is used to treat heart failure?

A

Furozemide (want to target Henle)

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14
Q

How does cirrhosis cause edema?

A

With heart/kidney insufficiency the abdomen is the last place to fill vs. liver failure the abdomen fills first and then the rest of the body

First it is sur-remplissage which over time becomes sous-remplissage

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15
Q

How does kidney failure cause edema?

A

incapacité rénale d’uriner le Na+ —> aug. volume plasmatique —> aug. pression hydrostatique capillaire —> oedème

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16
Q

What are three ways to treat edema due to kidney failure?

A
  1. Restrict sodium intake
  2. Diuretics
  3. Dialysis
17
Q

What is a syndrome néphrotique?

A

un trouble des glomérules (pelotes de microscopiques vaisseaux sanguins dans les reins ayant de petits pores à travers lesquels le sang est filtré) dans lequel des quantités excessives de protéines sont excrétées dans l’urine

18
Q

What are some things that indicate the presence of a syndrome néphrotique? (3+2)

A

protéinurie massive

Hypoalbuminémie

Oedème

** 4. Lipidurie

** 5. Hyperlipidémie

4 and 5 are consequences of increased albumin production not part of the disease itself

19
Q

How can a “glomérulonéphrite” cause edema? (2 mechanisms)

A

Light/moderate: albuminémie > 20g/L

Abnormal tubular retention of Na+ (sur-remplissage) —> edema

Severe: albuminémie ≤ 20 g/L

Loss of albumin in urine —> hypoalbuminémie —> fuite du liquide intravasculaires vers compartement interstitiel (sous-remplissage) —> edema

20
Q

What are four ways to treat edema due to a syndrome néphrotique?

A
  1. Traitement de la maladie glomérulaire
  2. Restriction de NaCl (remove from diet)
  3. Diurétique (sur-remplissage… Furosémide)
  4. Repos en position allongé
21
Q

What is oedème cyclique idiopathique?

A

Only in women… more of an inconvenience than anything else

Physiopathology unknown but thought that it is due to an accentuation of capillary permeability

How is it treated?

  • Oftentimes these women have an increased vascular reactivity and so for treatment rest is recommended…
  • AVOID DIURETICS —> will provoke rebound sodium retention when they’re stopped

MD1 URO - EXAM 1 (8 decks)

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