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Biochem. and Medical Genetics
BGEN 3020
Jason Leboe- Mcgowan

Lec 11 Edema – excess fluid in the interstitial space, which is extracellular fluid (ECF); this is outside the vessel Types of Edema 1. Non-Pitting edema – increased vessel permeability with pus in the interstial space (pus=exudates). Lymphatic fluid is another type of non-pitting edema. Blockage of lymphatics leads to lymphatic fluid in the interstial space. Pits early, but eventually becomes nonpitting. Exudates and lymphatic fluid does not pit. 2. Pitting edema – transudate with right heart failure, swelling of the lower extremities, fluid in the interstial space. Transudate does pit. 3. So there are three things that cause edema: exudates, lymphedema, and transudate, and transudates are the only one that has pitting edema. Transudate/Pitting Edema Transudate deals with starling forces: 1. What keeps fluid in our blood vessels? Albumin, and this is called oncotic pressure. 80% of our oncotic pressure is related to the serum albumin levels. Anytime there is hypoalbuminemia then we will have a leaking of a transudate (protein of less than 3 g/dL) leaking into interstial space via capillaries and venules (pitting edema); 2. Normally, hydrostatic pressure is trying to push fluid out. Therefore, in a normal person, oncotic pressure is winning. Therefore, a decrease in oncotic pressure and an increase in hydrostatic pressure will lead to transudate (pitting edema). 3. Albumin is made in the liver. With chronic liver dz (cirrhosis), have a decreased albumin level. Can you vomit it out? No. Can crap it out (malabsorption syndrome), or can pee it out (nephrotic syndrome), can come off our skin (3 degree burn b/c losing plasma), another possibility of low protein ct (low-intake) is seen in kids – Kwashiorkor – kid has fatty liver and decreased protein intake, leading to low albumin level. 4. Examples: a. Person with MI 24 hrs ago and he died and he has fluid coming out– transudate b/c
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