Bi monthly assessment
CASE 1: 1) Patient develops hypoalbuminemia due to liver pathology as liver helps in albumin synthesis. Oncotic pressure is reduced leading to accumulation of fluid. So patient developed Ascites due to loss of starling forces 2) a) The pedal edema may also be explained by the hypoalbunemia hypothesis. But it can also be explained in terms of increased pressure in the abdomen in gross ascitis which may have caused obstruction to the lymphatic vessels and causing pedal edema (this is mostly supported for unilateral pedal edema) b) in case of pedal edema there is stretching of skin and cracking up this may alter the defence mechanisms of skin. pathogens lodge and may develop infections, cellulitis of the leg. c) At the same time due to increased stretching of the skin the upper epidermis gets separated and leads to accumulation of fluid there, which is the reason for blebs. d) When there is excessive stretching there will be more pressure which may lead to pressure necrosis and caus
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