mahoney

Question 1

etiologies of Systemic peripheral edema

Answer 1

• CHF
• Cirrhosis of liver
• nephrotic syndrome
• Hypothydroidism
• idiopathic cyclic edema (menstruation)
• pregnancy

Question 2

How does CHF, cirrhosis of liver and nephrotic syndrome cause edema

Answer 2

• DECREASED RENAL PERFUSION leads to acivaiton of renin-angiotension-aldosterone system
  
  • leads to iINCREASED SODIUM AND WATER RETNETION TO MAINTAIN EFFECTIVE BLOOD VOLUME
• Renal –> direct damage to glomeruli
• Liver –> cirrhosis leads to increased production of vasodilators which increases splanchnic circualtion and STEALS blood flow from kidney
  
  • hypoalbuminemia (LOW PROTEIN) and portal hypertension
• Cardiac –> decreased cardiac output

Question 3

Nephrotic syndrome

Answer 3

• Nocturia and FOAMY URINE SUGGESTS PROTEINURIA
• PAIRED WHITE LINES (MUEHRCKE’s LINES) are seen in HYPOALBUMINEMIA
• Glomerular defect –> massive proteinuria –> hypoalbuminemia –> edema –> decreased renal blood flow –> renal retention of salt and water –> more edema

Question 4

Lab work for nephrotic sydrome

Answer 4

• 2 hPPG is 98mg/dL for diabetes
• ANA is absent for lupus
• Serum complement is normal

THESE TEST ARE ORDER TO SEEK A CAUSE FOR THE NEPHROTIC SYNDROME

Question 5

Complement levels in nephrotic syndrome

Answer 5

• C3 decrease but C4 is normal = MPGN and post-infectious glomerulonephritis
• CS and C4 decreased = lupus nephritis and cryoglobulinemia

Question 6

C CHIP ‘N DALE

Answer 6

CHF

Cirrhosis

Hypothyroidism

Intermittent cyclical edema

Pregnancy

Nephrotic syndrome

Decreased renal perfusion

Alcohol

Liver

Edema