oedema and congestion

Question 1

what is congestion ?

Answer 1

this is relative excessive blood in vessels in the tissue or organs

Question 2

examples of congestion

Answer 2

deep vein thrombosis
hepatic cirrhosis
generalised acute congestion
congestive cardiac failure

Question 3

what causes hepatic cirrhosis

Answer 3

liver damage from alcohol and hepatitis virus

Question 4

congestive heart failure

Answer 4

stenosis or ischemia may cause reduced pumping capacity of the heart there is decreased cardiac output and raas system is activated to increase retention leading to fluid overload

Question 5

effects of cardiac congestion

Answer 5

raised JVP
pulmonary oedema
peripheral oedema
liver congestion tachycardia
hepatomegaly

Question 6

presentation of hepatic central venous congestion

Answer 6

there is stasis of blood which is poorly oxygenated that is the pericentral hepatocytes

Question 7

periportal hepatocytes

Answer 7

relatively better oxygenated due to proximity of hepatic arterioles

Question 8

what is oedema

Answer 8

Accumulation of abnormal amounts of fluid in the extravascular compartment ​

intercellular tissue compartment (extracellular fluid) ​ body cavities ​

Question 9

peripheral oedema

Answer 9

increased interstitial fluid in tissues

Question 10

what is an exudate

Answer 10

Part of inflammatory process* due to  vascular permeability​

Tumour, inflammation, allergy​

Higher protein/albumin content (cells)​

H2O & electrolytes​

High specific gravity​

Question 11

pathophysiology of oedema

Answer 11

there is increased hydrostatic pressure which leads to transudate

Question 12

pathophysiology of peripheral oedema

Answer 12

right side failure , hypertrophy of the right ventricle means high pressure difficult for the return of blood, blood retention in systemic veins .

there is increased blood pressure in capillaries and increased filtration rate

Question 13

pathophysiology of lymphatic blockage

Answer 13

lymphatic Obstruction – hydrostatic pressure upset​

Lymphatic drainage is required for normal flow​

If lymphatic system blocked  lymphoedema​

Question 14

pathophysiology of oedema in abnormal renal function

Answer 14

Abnormal renal function results in Salt (NaCl) and H2O retention​

Secondary in heart failure - reduced renal blood flow​

Primary: acute tubular damage eg hypotension​

 renal function is the result of both​

  salt and H2O ​

 intravascular fluid volume ​

 secondary  PC ​

 oedema​

Question 15

pathophysiology of low protein oedema

Answer 15

due to the insufficient proteins in the body there is decreased oncotic pressure and therefore increased filtration levels

Question 16

causes of low protein levels

Answer 16

e.g. nephrotic syndrome  leaky renal glomerular basement membrane; lose protein; generalised oedema​

e.g. hepatic cirrhosis  diffuse nodules and fibrosis in liver; liver unable to synthesise enough protein ​

e.g. malnutrition  insufficient intake of protein​

LP.S[(PC-Pi)-(C-i)] =JV​

Question 17

pathophysiology of permeability oedema

Answer 17

there is increased endothelial permeability causes exudate.

Question 18

examples of pathophysiology of permeability oedema

Answer 18

burns
acute inflammation such as pneumonia