hydrocarbons surmarry

Apr 16th, 2015
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ASCITES=pathologic collection of free fluid in theperitoneal cavity.Abdominal distention is common in medicalpractice = initial px of systemic ds orunsuspected abdominal dsclinically: subjectively= sensation offullness/bloating (mostly fnxnal GITproblem..transient but R/o objective ^in girth or local swelling)Ascites usually insidious, Inspection= distention/ flank fullness/ movtwt inspiration/ cutaneous veins/ scars/marks***tight shiny skin + everted umbilicus +buldging flanks = ascites.Palpation= tense/ tender/ballotable masses/ vein flowPercussion=*shifting dullness*fluid thrillMildnil+Mod++Severenilnil**picked clinically with fluid >/= 1,000 mlsAspirate check colour, consistency, stand for 30 minpathophysiologySalt/ water retentionPortal HT increasing local hydrostatic pressure, ^ hepatic+ splanchnic lymph production>>transudationLow serum albumin>>decreased oncotic pressure inplasmaInflammatory>>exudate e.g. infection (TB), malignancy(GIT,ovary), pancreatic...DDxHypoalbuminemia= NS,protein loosinenteropathy, starvationCirrhosis (low protein,^portal pressure)Infection= TB, othr bactChylousBile leakageUrine=obstruction/leakageHepatic congestion=CCF, constrictivepericarditis, TR,IVC/hepatic vein/portalvein blockageNeoplasm=hepatic, livermets, peritoneal mets,lymphoma,leukemiaOvarian= MeigssyndromePacreatitis, pseu

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