The Case of the Swollen Belly Flashcards
(52 cards)
5 F’s of enlarged abdomen
fluid flatus (obstruction) faeces fat foetus
caput medusae
swollen abdo wall veins due to portal hypertension
abdominal paracentesis
puncture of the abdomen for aspiration of fluid in the peritoneal cavity
how much fluid filtered into large body cavities per day?
how much fluid filtered into large body cavities per day?
20L
how much fluid is reabsorbed back into circulation?
how much fluid is reabsorbed back into circulation?
90%, rest returns as lymph fluid
why does fluid leave capillaries?
high pressure pushes fluid into interstitial space
why does fluid reenter venous circulation?
low pressure causes reabsorption
what 4 things affect Qf/filtration/reabsorption rate of fluid?
change in hydrostatic pressure
change in oncotic pressure
change in permeability
change in exchange area
Where are serous membranes located?
pericardium
pleura
peritoneum
tunica vaginalis of testis
are effusions always pathological?
yes, but only clinically detectable once a certain size
transudate
plasma filtrate forced into tissues, low protein content
what causes transudate?
↑ Hydrostatic pressure
or
↓ Oncotic pressure
what causes exudate?
increased vascular permeability, change in exchange area
exudate
unfiltered plasma with high protein content
what causes hydrostatic pressure change?
portal hypertension
what causes 80% of portal hypertension?
liver cirrhosis
Other causes of portal hypertension (aside from liver cirrhosis)
alcoholic hepatitis
chronic cardiac failure
what causes oncotic pressure change?
hypoalbuminuria (caused by nephrotic syndrome, malnutrition, protein losing enteropathy)
what affects exchange area or vascular permeability?
malignancy, infection
Serum Albumin Ascites Gradient (SAAG)
a value which suggests portal hypertension if >1.1g/dl, if lower not portal hypertension
diagnostic technique for ascites
ascitic aspiration
risk of ascitic drainage (5)
bleeding infection pain leakage at drainage site procedure failure
Seldinger technique
A technique that involves inserting a needle with a syringe, then inserting a guide wire into the needle, removing the needle, making an incision, and inserting a catheter over the guide wire; the guide wire is then removed
what does pale yellow watery fluid aspirated suggest?
transudate
Low protein
