...
Is there associated dyspnea? If there is associated dyspnea, one should look for congestive heart failure, pulmonary emphysema, and other cardiopulmonary conditions.
Is there ... DIAGNOSTIC WORKUP
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Is it in the right upper quadrant? A mass in the right upper quadrant is most often an enlarged liver. However, the liver may be pushed down by a subphrenic abscess, and there may be ... DIAGNOSTIC WORKUP
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Is there hepatomegaly? If there is hepatomegaly, one should suspect congestive heart failure, emphysema, constrictive pericarditis, hepatic vein thrombosis, and cirrhosis of the liver.
Is ... DIAGNOSTIC WORKUP
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Is there a family history of migraine or epilepsy? Migraine and epilepsy both present with abdominal pain.
Is the pain colicky or persistent? Chronic colicky abdominal pain may be ... DIAGNOSTIC WORKUP
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Does the edema pit on pressure? Edema that pits on pressure is more likely to be due to heart, liver, or kidney disease. Edema that does not pit on pressure is more ... DIAGNOSTIC WORKUP
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Is the edema acute or chronic? Acute edema, if it is localized, should always bring to mind a deep vein thrombophlebitis. It also should ... DIAGNOSTIC WORKUP
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Is there a periorbital or facial rash? The presence of a periorbital or facial rash should suggest contact dermatitis, angioneurotic ... DIAGNOSTIC WORKUP
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Where is the pain located? If it is diffuse, one should consider pancreatitis, mesenteric artery occlusion, or ruptured peptic ulcer. In addition, another viscus may be perforated, such as a ... DIAGNOSTIC WORKUP
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Abdominal distension is a common complaint that must be evaluated carefully and systematically to expediently rule out serious and life-threatening diagnoses and evaluate for mundane diagnoses, such as swallowing air or overeating,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Lower abdominal pain is a common complaint that must be evaluated carefully and systematically to reach the appropriate diagnosis in timely manner. All diagnoses must be considered, with the most emergent... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Upper abdominal pain is a common presenting symptom. A complete differential diagnosis should be developed based on the organs in the upper abdomen in addition to the associated... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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In evaluating an acute abdomen, rebound tenderness is one of the most important signs of peritonitis. It is elicited by pressing deeply on the abdomen and then suddenly releasing pressure, which stretches the peritoneum and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Periorbital or eyelid edema has many possible etiologies, including mechanical, hemodynamic, infectious, inflammatory, and neoplastic causes. A careful history and physical examination are necessary... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Chronic venous insufficiency affects up to 25% of the general population and is the most common cause of edema or swelling of the lower extremities. Normal venous blood return to the heart requires competent venous... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Many disease processes, including malignancies, infections, and bowel obstruction, present with abdominal masses. The most serious and dramatic etiology is an abdominal aortic aneurysm, which is responsible for 15,000 deaths per year. More... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Examination of the jugular venous pulse for abnormalities of the wave form or level of venous pressure is a critical component of the cardiovascular exam and can aid in the diagnosis... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Abdominal pain is a frequent complaint and associated with an enormous number of causes. Many causes of acute abdominal pain require surgical intervention, so a prompt diagnosis is needed. Diagnostic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Ascites, the accumulation of serous fluid within the peritoneal cavity, may be caused by a combination of factors, including hypoalbuminemia, portal hypertension, increased aldosterone and antidiuretic hormone... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Edema is defined as the accumulation of excessive amounts of fluid in the cells and tissues of the body and is relatively rare in children. It is usually generalized and dependent (i.e., fluid tends to accumulate... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A prominent “potbelly” contour is normal in infants and young children. Pathologic enlargement of the abdomen is a fairly common problem that can result from reduced tone of the wall musculature or from... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Periorbital edema is frequently reported by parents via telephone. Unless the cause is obvious and benign, an immediate evaluation is warranted.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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Abdominal masses are common presenting signs of malignant solid tumors in children and should be presumed to be such. They require urgent evaluation to rule out compression of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The mechanism for periorbital and facial edema is similar to that for edema of the extremities. Thus, increased backpressure of the veins will cause periorbital edema in right heart failure, constrictive pericarditis,
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... As the physician examines the abdomen, how can he or she recall all of the causes of a mass or swelling? The physician should consider the possibilities for the mass’s composition. It may be air, in which case the physician would
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... The GI tract is the only “organ” that really covers the abdomen from one end to the other. Anything that causes an irritation of all or a large portion of this “tube” may
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... Edema of the extremities is a common symptom. Most physicians, therefore, have an immediate working diagnosis when the patient walks into the office: congestive heart failure if the edema is bilateral and deep vein phlebitis if it is unilateral
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... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a neoplasm, an abscess, a vascular defect... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening... Emergency interventions
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... Dyspepsia refers to an uncomfortable fullness after meals that's associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy, fatty, or high-fiber foods and by excess caffeine... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... The result of excess interstitial fluid in the arm, arm edema may be unilateral or bilateral and may develop gradually or abruptly. It may be aggravated by immobility and alleviated by arm elevation and exercise.
Arm edema... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... Leg edema is a common sign that results when excess interstitial fluid accumulates in one or both legs. It may affect just the foot and ankle or extend to the thigh, and may be slight or dramatic, pitting or... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... A common sign in severely ill patients, generalized edema is the excessive accumulation of interstitial fluid throughout the body. Its severity varies widely; slight edema may be difficult to detect, especially if the... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Mechanical Bowel Obstruction
Extraluminal compression
Congenital abnormalities
Annular pancreas
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... Without Peritoneal Disease
Portal hypertension
Cirrhosis
Alcoholic hepatitis
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... Localized
Venous or lymphatic obstruction and/or insufficiency
Venous thrombosis
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... Diffuse
Gastroenteritis
Peritonitis
Pancreatitis
Leukemia
Sickle cell
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... Elevated Microvascular Pressure
Cardiogenic
Volume overload (especially when associated with low plasma oncotic pressure)
Neurogenic
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... Abdominal Disorders
Inflammatory disorders
Peritoneum
Peritonitis (chemical or
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... Signs and Symptoms Dyspnea; orthopnea; coughing; tachycardia; tachypnea; crackles; jugular vein distention; diastolic gallop; cyanosis; confusion; frothy, bloody sputum; cold, clammy... Treatment (Tx)
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... Pulmonary edema is the accumulation of fluid in the extravascular spaces of the lung. In cardiogenic pulmonary edema, fluid accumulation results from elevations in pulmonary venous and capillary... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can also be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Dyspepsia
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Dyspepsia refers to an uncomfortable fullness after meals that’s associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy, fatty, or high-fiber... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... The result of excess interstitial fluid in the arm, this type of edema may be unilateral or bilateral and may develop gradually or abruptly. It may be aggravated by immobility and alleviated by arm... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... Facial edema refers to either localized swelling—around the eyes, for example—or more generalized facial swelling that may extend to the neck and upper arms. Occasionally painful, this... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Leg edema is a common sign that results when excess interstitial fluid accumulates in one or both legs. It may affect just the foot and ankle or extend to the thigh, and may be slight or dramatic and pitting... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... A common sign in severely ill patients, generalized edema is the excessive accumulation of interstitial fluid throughout the body. Its severity varies widely; slight edema may be difficult to detect,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Abdominal Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Richard W. Emerine
Abdominal pain of varying causes, ranging from the functional to the organic, is one of the top ten outpatient complaints; it is the chief complaint... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Ascites
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... C. Randall Clinch
Ascites, the accumulation of fluid within the abdominal cavity, is the most common major complication of cirrhosis; it is present in 50... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Edema
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Paul Evans and Michael P. Rowane
Edema is defined as a clinically apparent increase in interstitial fluid volume (1–3). A number of possible factors cause edema.
Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Congestive heart failure
❑ Venous insufficiency
❑ Hypoalbuminemia
❑ Drugs ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Ascites
❑ Right-sided heart failure
❑ Cirrhosis
&... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Irritable bowel syndrome
❑ Peptic ulcer disease
❑ Cholecystitis
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Abdominal Mass
❑ Liver enlargement
❑ Spleen enlargement
... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Generalized/Periumbilical
❑ Gastroenteritis
❑ Obstipation
❑ Small bowel... Diagnostic Approach ... Clinical Findings ... Pictures
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... With pulmonary edema, fluid accumulates in the extravascular spaces of the lung. With cardiogenic pulmonary edema, fluid accumulation results from elevations in pulmonary venous and capillary hydrostatic pressures. A common complication of... Causes ... Signs and symptoms ... Diagnosis ... Treatment
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Abdominal pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Abdominal pain usually results from a GI disorder, but can also be caused by drug use, ingestion of toxins, or disorders of the reproductive, genitourinary (GU), musculoskeletal, or... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Edema, facial
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Facial edema refers to either localized swelling — around the eyes, for example — or more generalized facial swelling that may extend to the neck and upper arms. Occasionally painful, this sign... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Edema, generalized
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common sign in severely ill patients, generalized edema is the excessive accumulation of interstitial fluid throughout the body. Its severity varies widely; slight edema may be difficult to detect, especially if the patient is obese,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Dyspepsia refers to an uncomfortable fullness after meals that’s associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... The result of excess interstitial fluid in the arm, arm edema may be unilateral or bilateral and may develop gradually or abruptly. It may be aggravated by immobility and alleviated by arm elevation and exercise. ... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Facial edema refers to either localized swelling — around the eyes, for example — or more generalized facial swelling that may extend to the neck and upper arms. Occasionally painful, this sign... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Leg edema is a common sign that results when excess interstitial fluid accumulates in one or both legs. It may affect just the foot and ankle or extend to the thigh and may be slight... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common sign in severely ill patients, generalized edema is the excessive accumulation of interstitial fluid throughout the body. Its severity varies widely; slight edema may be difficult to detect, especially if the patient is... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Many diseasescause abdominal pain, and clinical dilemma is to distinguish life-threateningones from those that are mild and self-limited. Best way to approach diagnosis... Principal Causes of Acute Abdominal Pain ... Clinical Features and Diagnosis: Acute Abdominal Pain ... Diagnostic Approach: Acute Abdominal Pain ... Principal Causes of Chronic or Recurrent Abdominal Pain ... Diagnostic Approach: Chronic or Recurrent Abdominal Pain ... References
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Edema
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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...Generalized edema—excessive accumulationof fluid in interstitial space—is usually obvious first inankles, lower legs, and eyelids. Principal Causes of Edema Disorderswith normal serum albumin ... Clinical Features and Diagnosis ... Table 17.1. Principal Causes of Hydrops Fetalis ... Diagnostic Approach ... References
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...Although vomiting, abdominal pain, GI bleeding,hematuria, and fever accompany some types of abdominal mass lesions,other types occur without any associated signs and symptoms. Thus,it is... Principal Causes of Abdominal Masses ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe,... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Dyspepsia refers to an uncomfortable fullness after meals that's associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... The result of excess interstitial fluid in the arm, arm edema may be unilateral or bilateral and may develop gradually or abruptly. It may be aggravated by immobility and alleviated... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Facial edema refers to either localized swelling—around the eyes, for example—or more generalized facial swelling that may extend to the neck and upper arms. Occasionally painful, this sign may develop gradually... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Leg edema is a common sign that results when excess interstitial fluid accumulates in one or both legs. It may affect just the foot and ankle or extend to the thigh, and may be slight or dramatic, pitting or nonpitting. ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... A common sign in severely ill patients, generalized edema is the excessive accumulation of interstitial fluid throughout the body. Its severity varies widely; slight edema may be difficult to detect, especially if the patient is obese,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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...
The mechanism for periorbital and facial edema is similar to that for
edema of the extremities. Thus, increased backpressure of the veins will
cause periorbital edema in right heart failure, constrictive pericarditis, ... Pictures
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...
As the physician examines the abdomen, how can he or she recall all of
the causes of a mass or swelling? The physician should consider the
possibilities for the mass&... Pictures
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...
The GI tract is the only “organ” that really covers the abdomen
from one end to the other. Anything that causes an irritation of all or a
large portion of this “tube&... Pictures
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...
Edema of the extremities is a common symptom. Most physicians,
therefore, have an immediate working diagnosis when the patient walks into
the office: Congestive heart... Pictures
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