History & examination of edema
-
Upload
abino-david -
Category
Health & Medicine
-
view
6.712 -
download
4
description
Transcript of History & examination of edema
![Page 1: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/1.jpg)
History And Clinical Examination
CLINICAL APPROACH TO OEDEMA
![Page 2: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/2.jpg)
HOW TO TAKE A HISTORY????
LOCALISED
CELLULITIS LYMPHANGITIS VENOUS OBS.
I. APPEARANCE
GENERALISED
CARDIAC RENAL LIVER D/S HYPOALBUMINEMIA HYPOTHYROIDISM
![Page 3: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/3.jpg)
II.ONSET
SUDDEN INSIDIOUS
A/C NEPHRITIS A/C ANAPHYLAXIS
![Page 4: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/4.jpg)
III.FIRST SITE OF APPEARANCE
PERIORBITAL AREA RENAL CAUSE
![Page 5: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/5.jpg)
DEPENDANT PART CARDIAC OEDEMA
LEG
SACRUM
Cont…….
![Page 6: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/6.jpg)
IV.OTHER SYMPTOMS
1. CONSTIPATION COLD INTOLERANCE FEELING SLEEPY
HYPOTHYROIDISM
![Page 7: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/7.jpg)
2.ARE THERE ANY FEATURES OF NUTRITIONAL DEFECIENCY
STARVATION/MALNUTRITION
HYPOROTEINEMIA
Cont…….
![Page 8: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/8.jpg)
4.R/C ATTACKS OF FEVER + RIGOR
H/O FEVER + SIGNS OF INFLAMMATION
FILARIASIS/ CELLULITIS/LYMPHANGITIS
Cont…….
![Page 9: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/9.jpg)
5.DOES THE PAT. HAVE HEMIPLEGIA AND IS THE OEDEMA ON PARALYSED SIDE?
PARALYSIS DEC. LYMPHATIC N VENOUS DRAINAGE
U/L OEDEMA OCCURS DUE TO LESIONS IN CNS WHICH AFFECTS THE VASOMOTOR FIBRES ON ONE SIDE….
Cont…….
![Page 10: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/10.jpg)
V. ASSOCIATED FEATURES
OLIGURIA & SMOKY URINE NEPHRITIS
ORTHOPNOEA & PND CARDIAC CAUSE
URTICARIA & MANI. OF ALLERGY ANGIODEMA
![Page 11: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/11.jpg)
GI SYMP. CIRRHOSIS OF LIVER ASCITES
CHEST PAIN & COUGH/
DYSPNOEA
MEDIASTINAL OBS. DUE TO TUMOUR
SIGNS OF INFLAMMATION OVER AREA
INFLAMMATORY CAUSE
Cont…….
![Page 12: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/12.jpg)
VI. PAST, PRESENT & FAMILY HISTORY
PAST H/O CARDIAC,RENAL OR LIVER D/Sa
FAMILY H/O OEDEMA MILROY’S OEDEMA
![Page 13: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/13.jpg)
DRUG HISTORY NIFEDIPINE,ESTROGEN,STEROIDS,NSAID
IS THE PAT. PREGNANT U/L PEDAL OEDEMA
Cont…….
![Page 14: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/14.jpg)
RELATION SHIP TO MENSTRUAL PERIODS
CYCLICAL OEDEMA(PERIODICAL)
H/O SURGERY & PROLONGED TRAVEL DVT
Cont…….
![Page 15: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/15.jpg)
EXAMINATION OF PATIENT
1.BUILT & NOURISHMENT
POORLY NOURISHED IF OEDEMA IS DUE TO ANY NUTRITIONAL DEF….
2.PALLOR
CARDIAC/GI CAUSES
GENERAL EXAMINATION
![Page 16: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/16.jpg)
3.ICTERUS
CIRRHOSIS OF LIVER
4.CYANOSIS & CLUBBING CARDIAC OEDEMA
Cont…….
![Page 17: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/17.jpg)
6.LYMPHADENOPATHY
FILARIASIS
7.OEDEMA
8.VITALS
Cont…….
![Page 18: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/18.jpg)
HOW TO DEMONSTRATE OEDEMA CLINICALLY?????
1. SITTING PATIENT
OVER MEDIAL MALLEOLUS OR 5cm ABOVE IT……….WITH RIGHT THUMB………APPLY PRESSURE FOR MINIMUM 30 SEC…..
ALMOST ALLWAYS LOOK FOR DIMPLE…..AFTER APPLYING PRESSURE….OTHERWISE WE CAN MISS A CASE OF MINIMAL OEDEMA….
![Page 19: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/19.jpg)
Cont…….
![Page 20: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/20.jpg)
2.AMBULATORY PATIENT……
APPLY PRESSURE OVER SACRUM WITH RIGHT THUMB FOR 30 sec…….AND LOOK FOR DIMPLE……
Cont…….
![Page 21: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/21.jpg)
EXAMINATION OF PATIENT WITH CARDIAC OEDEMA………….
1.INSPECTION DYSPNOEIC ENGORGED OR PULSATILE VEINS IN
NECK……
2.PALPATION PITTING OEDEMA, SOFT TENDER
HEPATOMEGALY APEX OUTSIDE MCL CARDIOMEGALY
![Page 22: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/22.jpg)
3.AUSCULTATION
MAY BE ASSO. WITH RV GALLOP RHYTHM…..
EXAMINATION OF PATIENT WITH RENAL OEDEMA………..
1.INSPECTION
PERI ORBITAL OEDEMA
SWELLING OF SCROTAL SACS
Cont…….
![Page 23: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/23.jpg)
2.PALPATION
PITTING OEDEMA
3.PERCUSSION & AUSCULTATION ARE LESS SIGNIFICANT………
EXAMINATION OF PATIENT WITH ASCITES………………….
1.INSPECTION
GENERALISED SWELLING OF ABD….FLANKS USUALLY FULL….UMBILICUS EVERTED…….
Cont…….
![Page 24: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/24.jpg)
Cont…….
![Page 25: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/25.jpg)
2.PERCUSSION PUDDLE SIGN -120 ml FLUID THRILL SHIFTING DULLNESS – 1000-1500 ml
(CONFIRM DIAGNOSIS)
Cont…….
![Page 26: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/26.jpg)
PUDDLE SIGN…
![Page 27: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/27.jpg)
FLUID THRILL…….
![Page 28: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/28.jpg)
SHIFTING DULLNESS……..
![Page 29: History & examination of edema](https://reader033.fdocuments.in/reader033/viewer/2022052621/557d768dd8b42a75548b4876/html5/thumbnails/29.jpg)