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BIMONTHLY ASSESSMENT SEPTEMBER 2020

Q1  1)Anatomical diagnosis - pedal edema causes  1) increased hydrostatic pressure  2) decreased oncotic pressure   3) lymphatic obstruction  ?kidney  ?cardiac  ?liver.  Etiological diagnosis - ?long standing CKD ( 6months history of pedal edema) sr creatine and blood urea levels are high ?diabetic nephropathy ? nephrotic pattern hypoalbuminemia ? abdomen distension ? right heart failure  2)Reasons for  i) azotemia - ?increased nitrogen in blood ? renal excretion is impaired ?CKD or renal AKI   ii) anemia - ?CKD - decreased EPO   iii)hypoalbunemia - diabetic nephropathy glomerural disease ? loss of albumin   iv) acidosis - acidification of urine is lost H+ is accumulated in CKD   3)replacement of bicarbonates to counter metabolic acidosis as it is useful in normal anion gap metabolic acidosis IV BICARBONATE for fast replacement of bicarbonate deficit https://www.ncbi.nlm.nih.gov/pmc/articles...