Approach to a Child with Generalized Edema

Question 1

What is edema?

Answer 1

abnormal fluid accumulation in the interstitium due to an imbalance in fluid homeostasis

Question 2

Factors affecting development of edema?

Answer 2

1. Hydrostatic Pressure
2. Oncotic pressure (colloid osmotic pressure)
3. Vascular permeability
4. Lymphatic System

Question 3

Pathophysiology of edema?

Answer 3

1. increased capillary hydrostatic pressure
2. decreased plasma oncotic pressure
3. enhanced permeability of the capillaries
4. lymphatic obstruction

Question 4

How is edema classified?

Answer 4

1. According to pathophysiological mechanism
   - Transudate (low protein content)
   - Exudate ( high protein content)
2. According to location
   - Localized
   - Generalized
3. according to clinical finding
   - Pitting
   - Non pitting

Question 5

Describe non-pitting edema?

Answer 5

feels form and indentation does not form

Question 6

Describe pitting edema?

Answer 6

indentation appears and persists when pressure is applied

Question 7

Disorders with normal serum albumin?

Answer 7

1. increased capillary permeability
2. increased lymphatic pressure (obstruction)
3. increased hydrostatic pressure
4. increased venous pressure

Question 8

Disorders with decreased serum albumin?

Answer 8

Nephrotic syndrome
Glomerulonephritis
HUS
Acute and chronic renal failure

Question 9

Disorders with decreased serum protein without proteinuria?

Answer 9

1. food protein allergies
2. liver disease
3. protein losing enteropathies