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Flashcards in Oedema Deck (17):
1

What are some important cardinal features to ask about regarding oedema?

- Site
- Quality
- Onset/Time
- Severity
- Context
- R/A Factors
- Associated features

2

What are some considerations when looking at oedema for Site?

- where?
- One limb/two?
- moving?
- Changing?
- use a pen to demarkate borders?

3

What are some considerations when looking at oedema for Quality?

- pitting?

4

What are some considerations when looking at oedema for Onset?

Fast/slow?

5

What are some considerations when looking at oedema for Time Course?

- sudden: could be DVT, anaphylaxis
- Slow: could be HF; renal failure

6

What are some considerations when looking at oedema for Severity?

- how much?
- how bad is it?

7

What are some considerations when looking at oedema for Relieving/Aggravating factors?

- putting it up? lying down?
- Standing?

8

What are some considerations when looking at oedema for Context?

- could indicate MI? anaphylaxis? HF? etc.

9

What are some considerations when looking at oedema for Associated Features?

HF: dyspnoea, fatigue, orthopnoea, paoxysmal nocturnal dyspnoea
DVT: pain (chest pain) - one leg not two

10

What are some of the mechanisms of oedema?

- increased hydrostatic pressure due to extra fluid/no venous return --> HF
- decreased oncotic pressure because of decreased blood proteins --> cirrhosis
- increased capillary permeability --> allergy, anaphylaxis, septic shock
- obstruction of lypahtics --> lymphoedema (can be caused by lymph removal or parasitic infiltration)

11

What are some typical locations of oedema?

- lower limbs --> volume overload ie. HF
- unilateral leg --> DVT
- generalised --> increased capillary permeability

12

Explain the water within the body?

- the body's water is comaprtmentalised into intracellular water (2/3 total) and extracellular water (1/3)
- extracellular water is then compartmentalised into plasma and interstitial fluid.
- capillary walls allow small amounts of fluid to cross from plasma to interstitium so that oxygen and nutrients can be transported for metabolism.
- the lymphatic system then returns that water.

13

What elements control the distribution of fluid between the plasma and interstitium?

- permeability of capillary walls
- balance between osmotic and hydrostatic pressure (Starling)

14

What is oedema?

- accumulation of fluid in the interstitial space between cells.

15

What is oedema?

- accumulation of fluid in the interstitial space between cells.

16

What does pitting generally suggest about oedema?

Pitting suggests that increased capillary permeability

17

What strategy should you employ if a patient reports two symptoms with their presenting problem?

Characterise each symptom separately but be sure to find out how they relate to each other