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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 likely due to myxedema or lymphedema.
Is there ... 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 edema, trichinosis, and herpes zoster. Remember, herpes zoster is usually ... 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 bring to mind acute lymphangitis, particularly if there is erythema in the area. Finally, it should also ... DIAGNOSTIC WORKUP
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Is it focal or diffuse? Focal rashes suggest the dermatophytoses, scabies, actinic dermatitis, herpes zoster, warts, contact dermatitis, erythema nodosum, actinic dermatosis, dyshidrosis, skin tumors, nummular eczema, stasis ... DIAGNOSTIC WORKUP
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Is the rash macular or papular? A macular or papular rash would suggest scarlet fever, measles, erythema multiforme, exfoliative dermatitis, pityriasis rosea, eczema, contact dermatitis, secondary syphilis, drug ... DIAGNOSTIC WORKUP
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Urticaria, also known as hives, is a very common clinical presentation characterized by transient (<12 hours), itchy dermal wheals. Angioedema is defined as subcutaneous or mucosal (often of the lips) swelling that is episodic and recurrent; it may occur>... 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 to determine whether the problem is localized or generalized, and treatment... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Pruritus, or itching, is the most common dermatologic complaint. When pruritus occurs without cutaneous findings, a thorough history, physical exam, and laboratory tests must be obtained to rule out a systemic disease as a cause of pruritus. The prevalence of an... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Pruritus, or itching, is the most common dermatologic complaint. When pruritus occurs with cutaneous findings, the clinician must carefully analyze the dermatologic findings to identify the underlying cause. Severe pruritus may lead to lifestyle disturbances by causing... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The etiologies of rash with fever are vast, but a systematic approach will help the clinician quickly narrow the differential. Patients who appear “toxic” with fever and prostration must be rapidly and thoroughly evaluated to rule out life... 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 valves, intermittent muscle contraction of the legs, and the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Scalp dermatitis or infection is easy to diagnose, but it can be challenging to treat. Topical therapy or topical plus systemic therapy for prolonged periods are often necessary to successfully control these disorders. Seborrheic dermatitis is a chronic condition that can... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Drug-induced urticaria is the most common form of urticaria in children; anaphylaxis and hereditary angioedema are life-threatening conditions; remember ABCs of resuscitation (airway, breathing, circulation); best treatment is prevention; that is, avoidance of causative agents.
... 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
Periorbital cellulitis
& ... 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 in the most dependent areas, such as the lower extremities)... 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, advanced pulmonary emphysema, and thrombosis or
... READ EXCERPTS »
... 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. Many times this is right. However, what if the
... READ EXCERPTS »
... The best way to recall the causes of a general rash while still examining the patient is to think of the mnemonic DERMATITIS. 4 (See figures on pages 447, 448, 449, and 450.)
D—Deficiency
... READ EXCERPTS »
... The differential diagnosis of a local rash is best approached with the mnemonic VINDICATE.
V—Vascular suggests livedo reticularis, acrocyanosis, gangrene of Raynaud syndrome, necrotic areas of periarteritis nodosa, and
... READ EXCERPTS »
... A pustular rash is made up of crops of pustules — a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Urticaria is a vascular skin reaction characterized by the eruption of transient pruritic wheals — smooth, slightly elevated patches with well-defined erythematous margins and pale centers of various shapes and sizes. It’s produced by... Emergency interventions ... History ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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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, whereas massive edema is immediately... Emergency interventions ... 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 signals a localized fluid... 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 nonpitting.
Leg edema may result from venous disorders, trauma, and... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... A papular rash consists of small, raised, circumscribed — and perhaps discolored (red to purple) — lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Specific antigen sensitivity (e.g., foods, food additives, Hymenoptera venom)
Physical agents
Pressure, mechanical irritation, vibratory, water (aquagenic)
... READ EXCERPTS »
... Elevated Microvascular Pressure
Cardiogenic
Volume overload (especially when associated with low plasma oncotic pressure)
Neurogenic
Head trauma
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... Localized
Venous or lymphatic obstruction and/or insufficiency
Venous thrombosis
Baker's cyst
Tumor
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... Urticaria, commonly known as hives, is an episodic, usually self-limited skin reaction characterized by local dermal wheals surrounded by an erythematous flare. Angioedema is a subcutaneous and dermal eruption that produces deeper, larger wheals (usually on the hands, feet,... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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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 skin
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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 hydrostatic pressures. A common complication of cardiac disorders, pulmonary edema can occur as... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... A pustular rash is made up of crops of pustules—a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Urticaria is a vascular skin reaction characterized by the eruption of transient pruritic wheals—smooth, slightly elevated patches with well-defined erythematous margins and pale centers of various shapes and sizes. This reaction is caused by... Emergency Interventions ... History ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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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, whereas massive edema is immediately apparent.... Emergency interventions ... 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 elevation and exercise.
Arm edema signals a... 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 sign may develop gradually or abruptly. Sometimes it precedes onset of peripheral or... 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 or nonpitting.
Leg edema may result from venous... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... A papular rash consists of small, raised, circumscribed—and perhaps discolored (red to purple)—lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many cutaneous disorders; they may also... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Rachelle L. Cassity
Urticaria (hives) is a common condition. The lesions appear well circumscribed. Typically, they are first erythematous and subsequently develop a central wheal. They usually clear within 3 to 4 hours, and the skin appears normal. It is... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Michael L. O’Dell
Fever with an accompanying rash represents a diagnostic challenge for even the most experienced of clinicians, as this combination of signs can represent trivial or life-threatening illnesses.
Approach A... History ... Physical examination ... Testing ... Diagnostic assessment
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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 The diagnostic process begins by determining if edema is ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Ingestants
❑ Drugs
❑ Inhalants
❑ Hymenoptera venom
❑ Latex... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Congestive heart failure
❑ Venous insufficiency
❑ Hypoalbuminemia
❑ Drugs
❑ Cirrhosis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Eczema
❑ Atopic dermatitis
❑ Seborrheic dermatitis
❑ Tinea versicolor
&... Clinical Findings
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... Urticaria, commonly known as hives, is an episodic, usually self-limited skin reaction characterized by local dermal wheals surrounded by an erythematous flare. Angioedema, which can present either subcutaneously or dermally, produces deeper, larger wheals (usually on the hands, feet,... Causes ... Signs and symptoms ... Diagnosis ... Treatment
... READ EXCERPTS »
... 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 cardiac disorders,... Causes ... Signs and symptoms ... Diagnosis ... Treatment
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... Urticaria is a vascular skin reaction characterized by the eruption of transient pruritic wheals — smooth, slightly elevated patches with well-defined erythematous margins and pale centers of various shapes and sizes (hives). It’s produced by the local... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... 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 or abruptly. Sometimes it precedes onset of... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... 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, whereas massive edema is immediately apparent. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A pustular rash is made up of crops of pustules — visible collections of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Urticaria, also known as hives, is a vascular skin reaction characterized by the eruption of transient pruritic wheals — smooth, slightly elevated patches with well-defined erythematous margins and pale centers of various shapes and sizes. It... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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, whereas massive edema is... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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 signals a localized... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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 or abruptly. Sometimes it... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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.
Leg... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A papular rash consists of small, raised, circumscribed — and perhaps discolored (red to purple) — lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...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 Increased capillary permeability Skin ... Clinical Features and Diagnosis ... Table 17.1. Principal Causes of Hydrops Fetalis ... Diagnostic Approach ... References
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... A pustular rash is made up of crops of pustules—a visible collection of pus within or beneath the epidermis, commonly in a hair follicle or sweat pore. These lesions vary greatly in size and shape and can be generalized or localized to the hair follicles or sweat glands. (See ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Urticaria is a vascular skin reaction characterized by the eruption of transient pruritic wheals—smooth, slightly elevated patches with well-defined erythematous margins and pale centers of various shapes and sizes. It's produced by the local release of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... 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, whereas massive edema is... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... 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 signals a localized... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... 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 or abruptly. Sometimes it precedes the... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... 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.
Leg edema may result... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A papular rash consists of small, raised, circumscribed—and perhaps discolored (red to purple)—lesions known as papules. It may erupt anywhere on the body in various configurations and may be acute or chronic. Papular rashes characterize many cutaneous disorders; they may also... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
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,
advanced pulmonary emphysema, and... Pictures
... READ EXCERPTS »
...
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 (CHF) if the edema is bilateral and
deep vein phlebitis if it is unilateral. Many times this is... Pictures
... READ EXCERPTS »
...
The
best way to recall the causes of a general rash while still
examining the patient is to think of the mnemonic DERMATITIS.
D—Deficiency diseases include pellagra, scurvy, and vitamin A
deficiency.
E—Endocrine diseases... Pictures
... READ EXCERPTS »
...
The differential diagnosis of a local rash is best approached with the
mnemonic VINDICATE.
V—Vascular lesions suggest livedo
reticularis, acrocyanosis, gangrene of Raynaud syndrome, necrotic areas of
periarteritis nodosa, and... Pictures
... READ EXCERPTS »
... Heather C. Forkey
Approach to the Patient with Rash
I. Definition of the Complaint
Rash, a general term applied to any skin eruption, is the presenting problem or
secondary ... Pictures
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... I. History of Present Illness
A 7-week-old Caucasian girl had initially presented to a hematologist for
evaluation of bruising. Her mother had noted several small purple bruises on
her right arm and a linear bruise across her left ... Pictures
... READ EXCERPTS »
... Lawrence Copelovitch, MDMitchell Schwartz, MD (4th edition) Edema - BASICS Edema - description Presence of abnormal amount of fluid in the extracellular spaces of the body; usually secondary to low... Edema - DIAGNOSIS ... Edema - TREATMENT ... Edema - FOLLOW UP ... Edema - bibliography ... Edema - CODES ... Edema - FAQ
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... Christopher P. Raab, MD Urticaria - BASICS Urticaria - description Urticaria is best described as raised, pruritic circumscribed erythematous papules. Single lesions may coalesce as ... Urticaria - DIAGNOSIS ... Urticaria - TREATMENT ... Urticaria - FOLLOW UP ... Urticaria - bibliography ... Urticaria - CODES ... Urticaria - FAQ
... READ EXCERPTS »
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