Edema

cardiomyopathy

both right and left ventricles are affected causing swelling of both lungs and peripheral edema

fluid increase caused by heart disease usually

builds up in the lungs causing shortness of breath

left sided heart failure is caused by

coronary heart disease, hypertension or diseases of heart valves

the increased back pressure of the veins in varicose veins or thrombophlebitis forces

fluid to stay in the extremities

nephrotic syndrome

heavy loss of protein in the urine reducing albumin which triggers kidney the blood volume is low and to retain fluid

the fluid of ascites can be removed from the abdominal cavity by using syringe and a long needle called

paracentesis

non pitting edema usually effects

the legs or arms and does not result in persist indentation

anasarca is

the severe widespread accumulation of fluid in all the tissues and cavities at the same time

Acteazolamide

contracts the development of alkalosis

the lose of protein in the urine may be reduced by

ACE inhibitors and angiotensin receptor blockers both prompt kidneys to reduce the loss of proteins in urine

hypotension may be seen with the use of

ACE inhibitors especially if the patients is also taking diuretics

when pulmonary edema starts it also causes

accusation of fluid in legs causing pitting edema

Pitting edema

an indention that persist for some time after the release of pressure like elastic socks on the legs

diseases that impair kidney function the ability to excrete salt is limited conditions like this and heart failure

cause salt and water retention developing pitting edema

right sided heart failure is most often due to

chronic lung diseases which in severe cases cause ascites and hepatomegaly

with liver disease scaring of the liver occurs when scarring becomes advanced the condition is called

cirrhosis

chronic diuretic uses may develop

defenciacy in K. depletion of blood volume in BV kidney insufficiency or failure

In idiopathic edema giving diuretics does what

develop fluid retention as a rebound each time they discontinue diuretics

small side effects of chronic dirucetc use

diabetes, high uric acid(gout muscle crams and enlarged breast gynecomastia pancreatitis

venous insufficiency is incompetence because of

dilation or enlargement of the veins and dysfunction of their valves such as varicose veins

lymphedema

disturbance of the lymphatic circulation that may occur after mastectomy, lymph node surgery or congenitally

In patients with ascites without edema in cirrhosis

diuretics must be given with caution because if its too aggressive or rapid can lead to low blood volume

patients with impaired kidney function

do not require K supplements because damaged kidneys retain K

what is effective for non pitting edema of legs

elevation and compressive devices

ascites

excessive fluid that accumulates in the abdominal(peritoneal) cavity, it is a complication of cirrhosis

non pitting edema can be secondary to

increase in albumin content of the interstitial fluids

ascites develop because

increased pressure in the vein system that carries blood to stomach intestines, liver (portal hypertension) and because a low level of the protein albumin in the blood

Idiopathic edema

is pitting edema of unknown cause primarily in pre-menopausal women who do not have heart liver or kidney disease

albumin

is the predominant protein in the blood helping maintain blood volume is reduced in cirrhosis

idiopathic edema appear with

leaks in capillaries so fluid passes BV to the interstitial spaces which causes kidney to increase salt retention

people with idiopathic edema experience

leg edema exaggerated in standing position edema around the series periorbital emedam in the morning

impaired renal function

limitation of the kidney to excrete sodium into urine

Most potent directs are

loop diuretics furosemide tosemide bumetanide

accumulation of glycosaminoglycans with water retention cause what

non pitting edema

Diuretics used for non pitting edema of the legs are

not effective

Doctor looking at patient who has congestive heart failure with fluid retention look for

peripheral pitting edema, rale in the lungs moist crackle sounds, gallop rhythm three heart sounds, distended neck veins

why with venous insufficiency does diuretics usually not work

pooling of fluid in lower extremities make it difficult for diruetic to mobilize edema fluid

by adding a k sparing diuretic spironolactone, triamterene and amiloride may

preclude the patients need to take K supplements

the accumulation of solid materials is secondary to the

primary pathology

thiazide prevent the formation of kidney stones by

reducing urinary excretion of calcium

if blood flow to kidneys is decreased by conditions such as heart failure what do the kidneys do

retain salt

most medications that dilate blood vessels and reduce blood pressure except ace inhibitors and angiotensin receptor blockers lead to

secondary sat region by the kidneys

patients with left sided heart failure present to the doctor with

shortness of breath with exertion and when laying down Orthopnea which are caused by pulmonary edema

pretibal myxedema

swollen g over the shin in some patients with hyperthyroidism

when on loop and thiazide patients are advised to

take potassium supplements because the diuretics deplete K

edema most commonly occurs in

the feet and legs referred to as peripheral edema

people with impaired kidney function get edema when

the intake of sodium exceed the ability of the kidney

edema around the eyes does not tend to developing cardiac patients because

they keep their heads elevated at night because of shortness of breath when they lie flat

if one loop is not effective may be given with another that works more distal in tubule like

thiazide(hydrocholorthiazide) or metolazone

1+ for pitting edema

trace/ barley able to be seen 4+ when tissues are visibly swollen

patients with both edema and ascites

using diuretics is fine because the edema fluid in interstitial space serve as a buffer against low blood volume

the most common local conditions that cause pitting edema are

varicose veins and thrombophlebitis of the deep veins of the legs