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Flashcards in FN: Leg swelling Deck (17):
1

Differential bilateral

1. Raised venous pressure
2. reduced oncotic pressure
3. Lymphoedema
4. Myxoedema

2

Raised venous pressure

RHF
Venous insufficiency
Drugs: e.g. nifedipine

3

Reduced oncotic pressure

Nephrotic syndrome
Hepatic failure
Protein losing enteropathy

4

Myxoedema

Hyper/Hypo thyroidism

5

Unilateral differentials

Venous insufficiency
DVT
Infection or inflammation
Lymphoedema

6

Lymphoedema

Collection of interstitial fluid due to blockage or absence of lymphatics

7

Lymphoedema Primary

congenital absence of lymphatics
May or may not be familial

8

Lymphoedema primary: presentation

Congenital: evidence from birth
Praecox: after birth but 35yrs

9

Milroys syndrome

Familiar AD subtype of congenital lymphoedema
F>M

10

Secondary Lymphoedema: FIIT

Fibrosis
Infiltration
Infection
Trauma

11

Fibrosis

e.g. post-radiotherapy

12

Infiltration

Ca: prostate, lymphoma
Filariasis: Wuchereria bancrofti

13

Infection:

TB

14

Trauma

Block dissection of lymphatics

15

Investigations Lymphoedema

Doppler Us
Lymphoscintigraphy
CT/MRI

16

Management Conservative

Skin care
compression stocking
Physio
Treat or prevent comorbid infections

17

Mx surgical

debulking operation

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