Edema Case Study Questions The following four patients all have severe edema for

Question

Edema Case Study Questions The following four patients all have severe edema for different reasons. Your challenge is to explain the cause of the edema. In each case, try to explain the edema in terms of either an increase or a decrease in one of the four pressures that cause bulk flow at capillaries. A picture may be useful. Patient 1: Mr. Taylor Mr. Taylor is a 66 year old alcoholic who has been drinking for years. During the past month he has gained over 25 pounds due to water retention. He exhibits swelling in all areas of the body.He has recently been admitted to the hospital and diagnosed with end stage liver failure. What is the connection between the liver failure and his edema? Which capillary pressure is altered and how does it cause edema? Hint: consider the functions of the liver, particularly the ones that affect blood composition. Patient 2: Mrs. So Mrs. So is a 28 year old visiting her OB in the 26th week of her pregnancy. She is experiencing varicose veins and swelling in her lower extremities. Her doctor explains that this is caused by the expanded uterus pressing on the large veins that run through the abdomen on their way up to the heart. Which pressure is altered in this case, and how is it causing edema? Patient 3: Mr. Herrera Mr. Herrera is arriving in an ambulance in anaphylactic shock due to a bee sting. During anaphylactic shock, the capillaries become leaky, and plasma proteins that normally stay inside the blood vessels “escape” into the interstitial fluid. Which pressure is altered in this case, and how is it causing edema? Patient 4: Mrs. O’Leary Mrs. O’Leary is recovering in the oncology ward. She was diagnosed with advanced breast cancer that had infiltrated her right breast and axillary lymph nodes. All of her axillary lymph nodes were surgically removed, which severed most of the lymphatic vessels draining her right arm. Mrs. O’Leary’s right arm is very swollen, and she is wearing a compression sleeve to wear on her right arm to help relieve the edema. What is causing her edema? Which pressure is altered by the compression sleeve, and how will this relieve her edema?

Explanation / Answer

In liver failure, hypoalbumenia will be developed as damaged liver cannot produce albumin qhich is important for maintaining blood and fluid volume. As a result, kidneys retain salt and water leading to edema. A fall in osmotic pressure occurs in this case.

The pressure could cause a reduced filtration rate and cause water retention. The expanded uterus could also be compressing the iliac veins which reduces blood flow returning to the heart.

Anaphylactic shock causes edema because of low osmotic pressure in the body tissue and high osmotic pressure in the capillaries. It occurs because the high osmotic pressure prevents the blood from re-entering the capillaries, causing the edema.

Fluid pools in her arm because her lymphatic vessels can no longer drain. A compression sleeve would increase the interstitual fluids hydrostatic pressure, decreasing the amount of fluid leaking from the capillaries into her right arm.

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