Edema
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This document discusses various causes of localized generalized edema including cardiac, hepatic, renal, and nephrotic syndrome. It provides tables comparing the major findings and complications of cardiac, hepatic and renal edema. Other forms of generalized edema are described such as cyclic, myxedema, and those caused by vasodilators. Treatment options include general measures like sodium restriction and diuretics as well as more specific measures such as fluid removal procedures, plasma volume expansion, and various pharmacologic therapies.
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Approach to edema
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Atherosclerosis is a disease where plaque builds up in the arteries, making them harder and narrower. It is caused by inflammation over time from risk factors like age, family history, obesity, lack of exercise, smoking, high blood pressure, and high cholesterol. Doctors use tests like angiograms to see blockages. Treatment focuses on managing contributing conditions with drugs or procedures like angioplasty and bypass surgery to reopen arteries. Prevention emphasizes lifestyle changes like a healthy diet, exercise, quitting smoking, and stress reduction.
Pathophysiology of edema
This document discusses the pathophysiology of edema. It defines edema as swelling caused by excess fluid in the interstitial spaces between tissues. Edema can be classified as transudate or exudate based on protein content, and as localized or generalized based on location. The key mechanisms that can cause edema are increased hydrostatic pressure, reduced plasma oncotic pressure, lymphatic obstruction, and sodium and water retention. The movement of fluid between blood vessels and tissues is normally regulated by the balance of hydrostatic and oncotic pressures according to Starling's forces, but imbalances in these forces can result in excess fluid accumulation in the tissues and cause edema.
Mechanism of edema
Oedema is caused by mechanisms that interfere with normal fluid balance between plasma, interstitial fluid, and lymph flow. Fluid movement is controlled by opposing effects of vascular hydrostatic pressure and colloid osmotic pressure, where excess interstitial fluid is normally drained by lymphatics. Oedema can result from increased capillary hydrostatic pressure, reduced plasma oncotic pressure due to low albumin, lymphatic obstruction impairing drainage, sodium and water retention in the kidneys, or inflammation causing capillary leakage.
Edema
CONTENTS:
GENERAL
NORMAL FLUID CIRCULATION
EDEMA- INTRODUCTION
CAUSES
CLASSIFICATION
MAJOR TYPES
NOTE- Fonts may appear weird because the original fonts are different from the ones visible here.
Atherosclerosis - Pathogenesis
A brief powerpoint presentation on one of the most talked about health concerns today- Atherosclerosis
Neoplasia Etiology and pathogenesis of cancer
Cancer is a major cause of death worldwide. The document discusses the etiology and pathogenesis of various cancers. It provides data on the most common cancers globally and lists lifestyle risk factors. The key mechanisms of carcinogenesis include chemical, physical, and infectious causes. Chemical carcinogens can be direct or require metabolic activation. Various epidemiological factors influence cancer risk such as genetics, environment, age, and hormones. Physical carcinogens like radiation and asbestos can also cause cancer development. Certain viruses are associated with different cancer types.
Edema
Edema can be caused by increased hydrostatic pressure, decreased plasma oncotic pressure, or lymphatic obstruction. Increased hydrostatic pressure can result from heart failure, liver cirrhosis, or venous obstruction. Decreased plasma oncotic pressure occurs when albumin is lost, such as in nephrotic syndrome, or not produced sufficiently, as in liver disease or malnutrition. Lymphatic obstruction leads to localized edema and can be caused by infection, cancer, or surgery. Edema fluid accumulation in tissues can impair function and be life-threatening in the lungs or brain.
Clinical features of edema
Cardiac, renal, liver disease and hypoproteinemia can cause generalized edema. Cardiac edema presents as pitting edema in the legs, ankles and feet that worsens at the end of the day. Renal edema in nephrotic syndrome causes severe generalized edema involving the face, legs and ascites with massive proteinuria and hypoalbuminemia. Liver cirrhosis causes edema in the legs and face due to decreased protein synthesis. Localized edemas include cellulitis, DVT, lymphedema and angioneurotic edema. Certain endocrine conditions like hypothyroidism and Cushing's disease can also cause edema.
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Nephrotic Syndrome .pdf
A 7-year-old boy was admitted with facial puffiness, passing smoky urine, and decreased urine output for 1 week. Examination showed pallor, high blood pressure, and a skin lesion on his elbow. Tests found protein and red blood cells in his urine, and raised blood urea. An ultrasound showed enlarged pale kidneys. The document discusses nephrotic syndrome, including its definition, causes, presentation, diagnosis, management, and nursing care. Nephrotic syndrome results from kidney damage that allows protein to leak into the urine, lowering blood protein levels and causing edema. Management focuses on fluid control, diuretics, ACE inhibitors, and sometimes steroids to preserve kidney function.
Glomerular diseases
This document discusses the classification and approach to diagnosing glomerular diseases. Glomerular diseases present with various combinations of proteinuria, hematuria, pyuria, reduced glomerular filtration rate, and reduced sodium excretion. They are classified into syndromes like nephrotic syndrome, acute nephritic syndrome, and chronic glomerulonephritis. The diagnosis involves categorizing the clinical presentation, characterizing the etiology through investigations, and completing the diagnostic workup which may involve renal biopsy. Treatment depends on the specific glomerular disease and syndrome but generally includes managing symptoms like edema, diet modifications, treating hypertension, and using immunosuppression or immunomodulation if indicated.
Glomerular diseases
This document discusses the classification and approach to diagnosis and treatment of glomerular diseases. Glomerular diseases present with various combinations of proteinuria, hematuria, pyuria, reduced glomerular filtration rate, and reduced sodium excretion. They are classified into syndromes like nephrotic syndrome, acute nephritic syndrome, and chronic glomerulonephritis. The approach involves categorizing the clinical presentation, characterizing the disease etiology through investigations, and completing the diagnosis with a renal biopsy. Treatment depends on the specific glomerular disease but may include immunosuppression, management of symptoms like edema, and preserving renal function through dialysis or transplantation if needed.
Nephrotic syndrome
Nephrotic syndrome is a kidney disorder that causes your body to excrete too much protein in your urine.
Glomerulonephritis
Acute glomerulonephritis is inflammation of the glomeruli caused by streptococcal infection that presents as acute nephritic syndrome with hematuria, hypertension, edema, and decreased kidney function. It is self-limiting in most cases, but 10% of patients may progress to rapidly progressive glomerulonephritis with renal failure if left untreated. Antibiotics are given to treat the streptococcal infection causing the condition.
Liver Cirrhosis
Liver cirrhosis is a chronic liver disease characterized by the replacement of liver tissue with fibrosis and the formation of regenerative nodules, leading to loss of liver function. It is commonly caused by alcoholism, viral hepatitis, and fatty liver disease. While generally irreversible, treatment focuses on preventing progression and complications like ascites, bleeding from esophageal varices, hepatic encephalopathy, and liver cancer. A diagnosis involves blood tests, imaging, and potentially a liver biopsy. Management includes medications to prevent complications and address underlying causes, with liver transplantation as a potential surgical option for end-stage disease.
Acute pancreatitis kollol
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Heart Failure
Heart failure is a condition where the heart cannot pump enough blood to meet the body's needs. It is usually caused by problems with the structure or function of the heart muscles. Common symptoms include fatigue, shortness of breath, and fluid retention leading to swelling. Treatment focuses on managing symptoms through lifestyle changes, medications, and addressing the underlying heart condition. Nursing care aims to promote rest, fluid balance, nutrition, oxygenation, and self-care education for managing the condition.
Gastroenterology
This document provides an overview of gastroenterology, including general pathophysiology, risk factors, emergencies, abdominal pain, assessment, and treatment approaches. It then discusses specific illnesses affecting the upper and lower gastrointestinal tract, liver, gallbladder, pancreas, and appendix. Conditions covered include bleeding, ulcers, varices, gastroenteritis, peptic ulcers, inflammatory bowel disease, hemorrhoids, bowel obstructions, appendicitis, cholecystitis, pancreatitis, and hepatitis.
Urinary disorders watson
This document provides information on acute and chronic renal failure, including causes, pathophysiology, assessment, diagnosis, complications, nursing diagnoses, and nursing care. Acute renal failure can be pre-renal, intra-renal, or post-renal and is caused by decreased blood flow or obstruction. Chronic renal failure is a progressive loss of kidney function over time due to various injuries and diseases. Common complications include fluid imbalance, electrolyte abnormalities, nutritional deficits, and increased risk of infection or cardiovascular issues. Nursing focuses on monitoring fluid status, diet, nutrition, and treating related symptoms and complications.
Oliguria and anuria
Oliguria is a low urine output defined as less than 1 mL/kg/hr in infants, less than 0.5 mL/kg/hr in children, and less than 300 mL daily in adults. It indicates an underlying disorder and can lead to acute renal failure if left untreated. Anuria is even less urine output at less than 50 mL/day. Causes of oliguria and anuria include pre-renal (low blood volume), renal (kidney damage), and post-renal (urinary tract obstruction). Evaluation and management depends on determining the cause through history, physical exam, urinalysis, and blood tests to guide volume replacement or other interventions to prevent further kidney injury.
Periarticular Disorders
This document discusses various peri-articular disorders including crystal deposition diseases like gout and pseudogout. It defines these conditions, describes their signs and symptoms, risk factors, diagnosis, and treatment options. It also covers non-crystal peri-articular disorders like bursitis, tendinitis, and rotator cuff injuries of the shoulder, explaining their causes, presentations, and management approaches.
edemabyahammednaseem-210628024050.pdf
Edema is the accumulation of excess fluid in body tissues. It can be caused by increased hydrostatic pressure, reduced plasma oncotic pressure, inflammation, lymphatic obstruction, or sodium/water retention. Edema is classified as generalized, localized, pitting or non-pitting depending on location and indentation. Signs include weight gain, swelling, and distended veins. Treatment focuses on managing the underlying cause, restricting salt intake, using diuretics and antibiotics, and preventing complications through positioning, skin care, and monitoring for worsening symptoms.
Renal failure
Acute renal failure can be prerenal, intrarenal, or postrenal in origin and progresses through onset, diuretic, oliguric, and recovery phases which may be reversible with treatment. Chronic renal failure is progressive and irreversible, leading to azotemia, uremia, and electrolyte imbalances. Treatment options include diet therapy, dialysis like hemodialysis and peritoneal dialysis, and renal transplantation. Nursing care focuses on managing complications and symptoms of renal failure like fluid imbalance, infection risk, fatigue, and anxiety.
Nephortic syndrome
Nephrotic syndrome may be caused by primary (idiopathic) renal disease or by a variety of secondary causes. Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia.
Nephrotic syndrome is a primary glomerular disease characterized by the following:
Marked increase in protein in the urine (proteinuria)
Decrease in albumin in the blood (hypoalbuminemia)
Edema (The swelling (edema), can be most noticeable on the face, around the eyes, around the feet and ankles, and in the belly area (or the abdomen).
High serum cholesterol and low-density lipoproteins (hyperlipidemia)
Nephrotic syndrome is a clinical disorder characterized by marked increase of protein in the urine ( proteinuria ), decrease in albumin in the blood (hypoalbuminemia ),edema, & excess lipids in the blood ( hyperlipidemia )
Pathophysiology
Nephrotic syndrome can occur with almost any intrinsic renal disease or systemic disease that affects the glomerulus.
Although generally considered a disorder of childhood, nephrotic syndrome does occur in adults, including the elderly. Causes include:
Chronic glomerulonephritis
Diabetes mellitus with intercapillary glomerulosclerosis
Amyloidosis of the kidney
Systemic lupus erythematosus
Multiple myeloma and renal vein thrombosis.
NSAIDs
Pre eclampsia
Nephritis
Nephritis refers to inflammation of the kidneys that can be caused by various factors like infection, autoimmune disease, or kidney disease. It affects the glomeruli, tubules, or surrounding tissue and can lead to impaired kidney function. Symptoms vary depending on the specific type and cause of nephritis but may include blood or protein in the urine, high blood pressure, swelling, and changes in kidney function test results. Treatment involves addressing the underlying cause, managing complications, and potentially using medications, dietary changes, or dialysis.
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This document discusses gastrointestinal and hepatobiliary problems that are common in patients with chronic kidney disease. It outlines several conditions that occur more frequently or are specific to renal patients, such as gastroparesis, peptic ulcers, acute pancreatitis, and gastrointestinal bleeding. It also notes that concurrent gut and kidney disease can be seen in disorders like polycystic kidney disease, vasculitis, diabetes, and amyloidosis. Finally, it mentions several drugs used to treat chronic kidney disease that can cause gastrointestinal side effects.
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Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
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Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
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Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
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Structure and Function of Taste Buds:
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Location of Taste Buds:
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Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
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Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Edema
- 2. LOCALIZED GENERALIZED EDEMA Cardiac Hepatic Renal Nephrotic syndrome Acute glomerulonephritis Chronic renal insufficiency Idiopathic edema Other forms Inflammation Lymphatic obstruction Venous obstruction thrombophlebitis
- 3. Table 01. diagnosis of hepatic edema evidence of chronic liver disease Spider angiomata Palmar erythema jaundice Presence of portal hypertension and ascites Prominent venous pattern on abdominal wall Esophageal varies Peripheral edema (usually, but not always, present)
- 4. Table 02. major findings in three forms of edema CARDIAC HEPATIC RENAL Dependent edema ++++ +++ ++ Facial edema - - Present Ascites + ++++ + Hypoalbuminemia - ++ ++++ proteinuria 0- trace 0- trace ++++
- 5. Table 03. other forms of generalized edema Type Comments Cyclic edema Can develop in women of childbearing age just before the monthly menstrual period; is self-limited and does not require treatment other than counseling; can be confused with idiopathic edema myxedema Is the characteristic brawny edema that resists pitting; develops in patients with hypothyroidism Edema due to the use of vasodilators Resullts from sodium retention (with agents such as minoxidil and hydralazine) and may also result from altered capillary permeability (with nifedipine and possibly other calcium channel blockers of the dihydropyyridine class); usually requires the addition of a diuretic to the therapeutic regimen Edema of pregnancy Is rarely a problem for the general internist, but its treatment often benefits from a nephrology consultation Capillary leak syndrome Develops in critically ill patients who are usually septic Inferior vena cava obstruction Rarely causes generalized edema Protein – losing enteropathy Rarely causes generalized edema
- 6. Table 04. complications of edema and ascites Peripheral edema Cellulitis Venous thrombosis Impaired vision from periorbital edema Pain Unacceptable cosmetic impact Scrotal and penile edema Limitation of physical activity Pleural effusions
- 7. ascites Impaired intestinal absorption Esophageal reflux Dyspnea from impaired diaphragmatic excursion Umbilical or inguinal hernias Spontaneous bacterial peritonitis From genes et al. [1*]; with permission
- 8. Table 06. treatment of edema General measures Treatment of the primary disease Bed rest Sodium restriction Diuretic administration
- 9. specific measures Fluid removal Pleurocentesis (heart failure, cirrhosis, nephrosis) Paracentesis (heart failure, cirrhosis, nephrosis) Plasma volume expansion Infusion of plasma or hyperoncotic albumin solutions (cirrhosis, nephrosis) Ascitic fluid reinfusion (cirrhosis) Insertion of a peritoneovenous shunt (cirrhosis) Head – out water immersion (cirrhosis, nephrosis) Pharmacologic therapy Vasodilators (heart failure) Angiotensin – converting enzyme inhibitors (heart failure, nephrosis) Vasoconstrictors (cirrhosis) Continuous arteriovenous hemofiltration (heart failure, nephrosis) Adapted from Gines et al. [1*]; with permission.