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Questions and Answers
In a patient with liver cirrhosis and ascites, what is the primary pathophysiologic mechanism contributing to the development of edema?
In a patient with liver cirrhosis and ascites, what is the primary pathophysiologic mechanism contributing to the development of edema?
- Reduced plasma osmotic pressure due to decreased protein production. (correct)
- Increased hydrostatic pressure due to arterial vasoconstriction.
- Elevated plasma osmotic pressure caused by increased protein synthesis.
- Increased lymphatic drainage due to inflammatory response.
A patient with a history of breast cancer presents with unilateral arm swelling following a mastectomy and axillary lymph node dissection. Which pathophysiologic mechanism is most likely responsible for the edema in this scenario?
A patient with a history of breast cancer presents with unilateral arm swelling following a mastectomy and axillary lymph node dissection. Which pathophysiologic mechanism is most likely responsible for the edema in this scenario?
- Increased venous return due to compensatory mechanisms.
- Lymphatic obstruction caused by surgical disruption and potential post-irradiation fibrosis. (correct)
- Reduced plasma protein concentration due to increased protein excretion.
- Arteriolar constriction, leading to decreased capillary hydrostatic pressure.
A patient with chronic kidney disease presents with generalized edema. Which of the following mechanisms contributes most significantly to the development of edema in this patient?
A patient with chronic kidney disease presents with generalized edema. Which of the following mechanisms contributes most significantly to the development of edema in this patient?
- Excessive salt intake combined with impaired renal sodium excretion. (correct)
- Decreased renin-angiotensin-aldosterone secretion, leading to increased sodium excretion.
- Increased plasma oncotic pressure due to protein retention.
- Lymphatic hyperproliferation, resulting in increased fluid absorption.
In the context of heart failure, which of the following best describes the sequence of events leading to pulmonary edema?
In the context of heart failure, which of the following best describes the sequence of events leading to pulmonary edema?
A patient presents with myxedema. Which of the following pathophysiologic mechanisms is most closely associated with the development of this specific type of edema?
A patient presents with myxedema. Which of the following pathophysiologic mechanisms is most closely associated with the development of this specific type of edema?
A researcher is studying the effects of a novel anti-inflammatory drug on edema formation. Which of the following mechanisms would be the most relevant target for reducing edema in the context of acute inflammation?
A researcher is studying the effects of a novel anti-inflammatory drug on edema formation. Which of the following mechanisms would be the most relevant target for reducing edema in the context of acute inflammation?
In a patient with nephrotic syndrome, which of the following is the primary sequence of events leading to edema?
In a patient with nephrotic syndrome, which of the following is the primary sequence of events leading to edema?
A patient with constrictive pericarditis develops edema. Which of the following best explains the underlying mechanism?
A patient with constrictive pericarditis develops edema. Which of the following best explains the underlying mechanism?
Microscopically, 'heart failure cells' observed in pulmonary edema are characterized by which of the following?
Microscopically, 'heart failure cells' observed in pulmonary edema are characterized by which of the following?
A patient with severe malnutrition develops edema. What is the primary mechanism by which malnutrition leads to edema?
A patient with severe malnutrition develops edema. What is the primary mechanism by which malnutrition leads to edema?
Flashcards
Edema and Effusions
Edema and Effusions
Accumulation of fluid in tissues (edema) or body cavities (effusions) due to perturbed cardiovascular, renal, or hepatic function.
Increased Hydrostatic Pressure
Increased Hydrostatic Pressure
Increased fluid pressure within blood vessels, forcing fluid into tissues.
Lymphatic Obstruction
Lymphatic Obstruction
Blockage of lymphatic vessels, preventing fluid drainage from tissues.
Sodium Retention
Sodium Retention
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Inflammation (as cause of edema)
Inflammation (as cause of edema)
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Reduced Plasma Osmotic Pressure (Hypoproteinemia)
Reduced Plasma Osmotic Pressure (Hypoproteinemia)
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Pitting Edema
Pitting Edema
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Periorbital Edema
Periorbital Edema
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Myxedema
Myxedema
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Pulmonary Edema
Pulmonary Edema
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Study Notes
- Edema refers to fluid accumulation in tissues
- Effusions refer to fluid accumulation in body cavities
- Perturbed cardiovascular, renal, or hepatic function can cause edema and effusions
Pathophysiologic Mechanisms of Edema
- Increased hydrostatic pressure can cause edema
- Impaired venous return is a cause (congestive heart failure, constrictive pericarditis, ascites, venous obstruction, lower extremity inactivity)
- Arteriolar dilation (heart or neural humoral dysregulation)
Lymphatic Obstruction
- Lymphatic obstruction can cause edema
- Inflammatory conditions
- Neoplastic conditions
- Post-surgical conditions
- Post-irradiation conditions
- Neoplastic obstruction is caused by carcinoma or malignancy in lymph nodes obstructing lymphatic flow
- Mastectomy or lumpectomy with lymph node dissection can lead to arm edema, exacerbated by post-irradiation effects
Sodium Retention
- Sodium retention can cause edema
- Excessive salt intake with renal insufficiency
- Increased tubular sodium reabsorption
- Renal hypoperfusion
- Increased renin-angiotensin-aldosterone secretion
- Patients with renal failure have impaired salt regulation, leading to edema
Inflammation
- Acute or chronic inflammation disrupts lymphatic flow and return to the heart
- Proliferation of blood vessels can contribute to edema
Reduced Plasma Osmotic Pressure (Hypoproteinemia)
- Hypoproteinemia can cause edema
- Protein-losing conditions
- Protein-losing enteropathy
- Liver cirrhosis
- Malnutrition
- Protein-losing gastroenteropathy
- Cirrhosis leads to fluid accumulation in the abdominal space (peritoneal edema)
Types and Morphology of Edema
- Subcutaneous edema is often seen in lower extremities and manifests as pitting edema
Periorbital Edema
- Swelling around the eyes
Myxedema
- Edema of the skin and subcutaneous tissues in hypothyroidism
- Common in the face, legs, and tongue with a waxy skin appearance
Pulmonary Edema
- Pink material is seen in histologic slides represents fluid and extracellular proteins
- Results from increased hydrostatic pressure or decreased colloid osmotic pressure
- Causes frothy, blood-tinged sputum (hemoptysis)
- Macrophages pick up red blood cells, degrading hemoglobin into hemosiderin, forming heart failure cells
Brain Edema
- Causes brain dysfunction
Effusions
- Fluid accumulation in body cavities, including:
- Pleural effusions (lungs)
- Pericardial effusions (heart)
- Peritoneal effusions (abdominal cavity)
Pulmonary Edema in Histology
- Congestive heart failure in lung
- Pulmonary edema showing pink fluid in alveolar spaces
- Chronic pulmonary edema leads to hemosiderin-laden macrophages (heart failure cells), indicating past edema or bleeding
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