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Exam questionKROK 2Medicine · 2023

A 3-ycar-old child was brought to the hospital by the mother with complaints of leg edema, dyspnea, cough, and abdominal pain. Heart murmurs were detected in the child at the early age, but back then the parents declined further examination. After a case of acute viral respiratory infection one month ago, the mother noticed that the child had become inert and periodically fussy and started developing edema of the shins. The child’s condition is severe. Respirations are 40/min. Foot and shin edema is observed. There are wet crackles in the lower posterior segments of the lungs. The left border of the relative cardiac dullness is located along the left anterior axillary line. Heart sounds are muffled and arrhythmic. The child’s heart rate is 120/min. The liver is +5 cm. Diuresis is decreased. Name the pathogenesis of the edema in this child:

Answer options

  1. Protein loss in stool
  2. Reduced cardiac ejection fraction and venous congestion
  3. Disturbed renal hemodynamics
  4. Increased vascular permeability
  5. Reduced protein synthesis function of the liver
Correct answer

Reduced cardiac ejection fraction and venous congestion

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