This document discusses different types of jaundice and edema. It defines jaundice as yellowish discoloration of the skin, sclera, or both. It then presents three clinical cases and asks the reader to identify the type of jaundice in each case. The types listed are hemolytic, hepatocellular, or obstructive jaundice. It also defines edema as abnormal accumulation of fluid in interstitial tissue due to disturbed fluid regulation. The types of edema listed are pitting and non-pitting edema. Factors that can cause edema include renal disease, liver disease, heart failure, and nutritional deficiencies.

1. Oedema
By: Alaa Mostafa
Assistant lecturer of internal medicine
Minia university

2. Revision

3. Jaundice is defined as
yellowish discoloration of:
O Skin only
O Sclera only
O Skin, Mucous membranes, and sclera

4. Jaundice is clinically visible when
bilirubin concentration is more than
O 5 gm/ dl
O 2.5 gm/dl
O 2.5-3 mg /dl

5. Case 1
O A 20 yrs old Female patient with history of
Thalassemia presented by mild
jaundice,anemia, with normal urine, dark
stool, Total bilirubin 4 mg/dl, direct bilirubin 0.3
mg /dl
What is the type of jaundice
O Hemolytic
O Hepatocellular
O obstructive

6. Case 2
A 60 yrs old male patient presented with
jaundice, Abdominal distension, Bilateral pitting
lower limb oedema, flapping tremors, bleeding
tendency. Lab shows total bilirubin 6 mg/dl,
direct bilirubin 2.5 mg/dl, Dark urine, clay stool
What is the type of jaundice
O Hemolytic
O Hepatocellular
O obstructive

7. Case 3
O A 45 yrs female patient presented by deep
jaundice, abdominal colic, dark urine, pale
stool, steatorrhea, itching, total bilirubin
15mg/dl, Direct bilirubin 14.5 mg/dl
What is the type of jaundice
O Hemolytic
O Hepatocellular
O obstructive

8. Carrotinemia is differentaited
from jaundice by

9. Body fluid Distribution

10. Factors affecting interstitial
fluid formation and drainage

11. Factors Causing oedema

12. Definition
O Abnormal accumulation of fluid in the
interstitial tissue due to disturbed
mechanisms of interstitial fluid regulation

14. Types
O Pitting
O Non pitting

17. How to examine?

18. Unilateral vs bilateral

19. Dependent or not?

20. Sacral oedema

21. Cardiac oedema
O Bilateral
O Painless
O Pitting
O Dependent
O Before ascitis

22. Ascitis precox
O Ascitis before onset of oedema
O In cases of
O Oericaerdial effusion
O Constrective pericarditis
O Tricuspid regergue or Tricaspid stenosis

24. Renal oedema
O Begin by eye lid buffness
O Generalized
O Pitting
O More at the morning

26. oliguria
Hypertension
hematuria
Smoky
urine(casts)
Heavy
proteinuria
Hypoproteinemi
a
Oedema
Hypercholesteroloemi
a

27. Hepatic oedema
O Associated with signs and symptoms of
LCF

28. Nutrional oedema

29. Angioneuretic oedema

30. Peri orbital oedema

31. Management

33. Localized oedema
O DVT
O Lymphoedema (eg; post mastectomy)
O Varicose veins
O Orthostatic oedema
O Angioneuretic oedema
O Cellulitis

34. Unilateral oedema
O DVT
O Cellulitis
O Lymphoedema
O trauma

35. Drugs causing oedema
O CCB
O Steroids
O OCPs
O NSAIDs

36. Occult oedema
O Up to 3 litres of excess interstitial fluid can
accumulate in the body before oedema is
clinically detectable