Edema

Question 1

GI causes bilateral leg edema

Answer 1

• nutritional deficiency or malabsorption –> hypoalbuminemia
• refeeding edema

Question 2

lymphedema

Answer 2

impaired lymph return due to hereditary or secondary causes

• crush injuries
• tropical infections
• axillary LN dissection during mastectomy

Question 3

anascara

Answer 3

massive generalized edema

Question 4

1 cause worldwide of lymphedema

Answer 4

filarial infection

Question 5

hematologic causes leg edema

Answer 5

anemia

Question 6

edema vs swelling

Answer 6

edema: fluid in intercellular sapce
swelling: transient abnormal enlargement/increased volume of body part, or transient eminence or elevation (bug bites)

Question 7

hepatic causes bilateral leg edema

Answer 7

cirrhosis

Question 8

cardiovascular causes of bilateral leg edema

Answer 8

• systolic or diastolic HF
• constrictive pericarditis
• pulm HTN

Question 9

extrinsic factors causing edema

Answer 9

• Na+ intake
• sedentary lifestyle
• increased calorie intake
• NSAID use
• alcohol intake

Question 10

tx for lymphedema

Answer 10

elevation and compression (support/compression sleeves/hose/wraps)

Question 11

lipidema

Answer 11

fat cell growth and proliferation and subsequent fluid retention around the cells

Question 12

meds that cause bilateral leg edema

Answer 12

• antidepressants (MAO inhibitors)
• antihypertensives (CCB, BB, direct vasodilators)
• hormones
• NSAIDs
• thiazolidinediones

Question 13

venous causes of bilateral leg edema

Answer 13

• DVT

- venous insufficiency

Question 14

endocrine causes bilateral leg edema

Answer 14

myxedema (severe hypothyroidism)

Question 15

what causes generalized edema

Answer 15

HF, renal disease

Question 16

non lymph causes of unilateral limb edema

Answer 16

• cellulitis

- baker cyst

Question 17

diagnostic testing to evaluate edema

Answer 17

• CBC
• TSH
• CBC
• CXR PA and LAT
• EKC
• Echo
• BNP
• ANP

Question 18

sx nephrotic syndrome

Answer 18

• puffy eyes w/ puffy ankles
• puffy skin
• abd distention
• weakness
• anorexia
• feeling sick
• high cholesterol

Question 19

pitting vs non-pitting edema

Answer 19

pitting: indentation w/ pressure, associated w/ underlying organ dysfunction

non-pitting: no indentation, due to underlying metabolic dz (thyroid, lymphatic system dz, can be associated w/ warm weather)

Question 20

lymphatic causes of unilateral limb edema

Answer 20

secondary to:

• neoplasm
• surgery
• radiation
• TB
• filariasis

Question 21

what causes localized edema

Answer 21

lymphatic or venous obstruction

Question 22

renal causes bilateral leg edema

Answer 22

• advanced kidney dz

- nephrotic syndrome

Question 23

if diagnostics inconclusive, what additional testing can be ordered

Answer 23

• antinuclear antibody
• Hep B and C serology
• serum and urine protein electrophoresis
• renal US
• renal biopsy

Question 24

lymphatic causes bilateral leg edema

Answer 24

• pelvic or retroperitoneal lymphadenopathy or mass

- lymphatic obstruction (lymphedema)

Question 25

should you use diuretics w/ lymphedema or lipedema

Answer 25

NO they will not help

Question 26

edema + dyspnea might be

Answer 26

PE or pneumonia

Question 27

tx for lipedema

Answer 27

weight loss

Question 28

what direct vasodilators cause bilateral leg edema

Answer 28

hydralazine and minoxidil