Unilateral Edema — r/o Deep Venous Thrombosis (DVT)
BILATERAL EDEMA — TARGET ORGANS FOR WORK-UP
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DIAGNOSTIC WORK-UP
1. History & Physical for clues to: 2. Order — CBC, Chemistry Panel, BNP, TSH, U/A, EKG- CBC — for Anemia (also ↓ Platelets in Cirrhosis)
- B-Type Natriuretic Peptide (BNP) — for CHF
- Creatinine & BUN — for Nephrotic Syndrome / Renal Failure
- LFTs — for Cirrhosis / Liver Failure (may be deceptively normal)
- Serum Albumin — for Cirrhosis and Nephrotic Syndrome
- TSH — for Hypothyroidism
- Urinalysis — for Nephrotic Proteinuria (causing hypoalbuminemia)
- EKG — for recent MI, a possible cause of new CHF
- Echocardiogram (consider) — if reasonable suspicion of CHF (right- or left-sided)
- Chronic Venous Insufficiency
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Medications:
- Ca++ Channel Blockers, Thioglitazones, NSAIDs, Estrogens
- Diuretic Dependence (surreptitious use w/ rebound)
- Persistent Immobile Upright Posture (e.g. sleeps sitting)
- Late Pregnancy (usually obvious)
- Severe Malnutrition (usually obvious)
- “Idiopathic edema”
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