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Edema

  • Most common ddx

    • local inflammation, nephrotic syndrome, minimal change, CHF, lymphedema, baker cyst, drug side effect, allergies
  • Serious ddx

    • DVT, tamponade, anaphylaxis
  • Labs

    • doppler US if suspect DVT
    • BNP if suspect CHF
    • if suspect cardio: EKG, CXR, echo
    • UA, albumin
    • TSH
    • CMP
  • Cardio ddx

    • CHF, pericarditis, tamponade
  • Vascular

    • SVC syndrome, lymphedema (firm, nonpitting, localized), DVT
  • Endo

    • myxedema, hypothyroidism (nonpitting)
  • Renal (generalized edema)

    • nephrotic syndrome, glomerulonephritis
  • GI

    • liver failure
  • MSK (localized edema)

    • arthritis, tenosynovitis, Baker's cyst, osteomyelitis (fever), trauma (strain, sprain, muscle tears)
  • Derm (localized edema)

    • insect bites, cellulitis
  • Drugs

    • steroids, hormones (estrogen, progesterone, testosterone), antihypertensives
  • HPI

    • onset, acute vs chronic, sudden vs gradual onset, triggering events
    • aggravating, alleviating factors
    • location, associated pain, erythema, rash
  • ROS

    • fever
    • trauma
    • exertional dyspnea
    • new meds
    • hematuria, foamy urine
  • PMH

    • cancers, breast cancer, thyroid disease, arthritis, diabetes
  • PSH

    • past surgeries
  • SH

    • EtOH, tob, hiking trips, exposure to ivy, allergens, new lotions
  • FH

  • Meds

    • new meds, steroids, hormones
  • Allergies

  • Px

    • vitals
    • inspection: erythema, rash
    • generalized vs localized
    • periorbital vs distal limbs
    • palpation: warmth, pitting vs nonpitting
    • abd: hepatomegaly
    • goiter
  • Tx

    • heparin if DVT
    • diuretic if CHF

  • Print | Citations

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