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A patient who has gained 21 pounds and has severe edema after stopping diuretics is experiencing:

  1. Nephrotic syndrome

  2. Syndrome of inappropriate antidiuretic hormone (SAIDH)

  3. Ascites

  4. Anasarca

The correct answer is: Anasarca

The correct answer is associated with the systemic manifestation of widespread edema. Anasarca refers to severe, generalized edema that affects the entire body, and it often surfaces when there is significant fluid accumulation due to various underlying health conditions. In this scenario, the patient has experienced a substantial weight gain and severe edema following the discontinuation of diuretics, which are medications commonly used to manage fluid retention. The abrupt stop of diuretics can lead to fluid overload, causing the body to retain excess fluid. While nephrotic syndrome can lead to edema due to protein loss, it’s characterized more specifically by a combination of edema, proteinuria, and hypoalbuminemia, rather than just generalized swelling. The syndrome of inappropriate antidiuretic hormone (SIADH) typically results in water retention resulting in dilutional hyponatremia rather than generalized swelling. Ascites specifically refers to fluid accumulation in the abdominal cavity, which does not capture the full body edema implied by the term anasarca. Thus, the manifestations of severe, total body swelling are best described by anasarca in this context.