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
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. A 54 year old Toddy tree climber came to opd with chief complaints of 1. Swelling of both the legs since 15 days 2. chest pain since 10days 3. Facial puffiness since 10days 4. Difficulty in breathing since 7days Patient was apparently asymptomatic 15days back then he developed bilateral pitting type of pedal edema extending Upto knees. He had on and off symptoms of Chest discomfort and pain since 10days. He also developed facial puffiness 10 days back which temporari
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