Answer 14

Where is the problem?

 

Discussions conducted by internal medicine residents:

 -An answer from Dr. Ali (hoping you're ok Ali):

"......a case of hormonal disturbance, Cushing's syndrome, causing salt and water retention due to increase cortisone."

-Well, there are no other clinical features mentioned in the case supporting this diagnosis, so further investigations regarding this diagnosis is not justified.

 -Dr. Amira postulated:

"......this may be renal affection and in particular glomerular damage."

-This possibility was excluded from the start clinically and by investigations.

N.B. if investigations details were not mentioned, we can consider them normal as shown by the phrase " Investigations showed normal liver, renal and thyroid functions".

  

To remove this confusion, remember this: when there is no cause to explain the occurrence of edema, do not forget the psychogenic origin.

So this is a case of psychogenic edema that gave good response to psychic help