tough call, i think it’s appropriate. will let the community decide
amboss writes periorbital and peripheral edema - I see where amboss writes the “edema is typically milder than what is seen in nephrotic syndrome” - but not the comment about hypoalbuminemia
I personally am not a fan of this. Maybe you can add as periorbital/pedal edema. Periorbital edema is usually first thing that presents due to mild loss of protein and nephiritic is milder proteinuria therefore logically you would expect periorbital first. Nephrotic is more proteinuria therefore u would get periorbital edema + more edema in other places
From clinical features section of nephrotic syndrome (AMBOSS): Typically starts with periorbital edema - (hover text) - unlike edema related to heart failure, the edema in hypoalbuminemia does not follow gravity. Instead, it appears throughout the entire body. The area around the eyes is usually the first clinically apparent localization of edema because connective tissue in this area is particularly loose, making edema very noticeable."
Nephritic syndrome does not cause hypoalbuminemia unless it is a mixed-syndrome. Logically, it follows that the edema in pure nephritic syndrome (which is due to glomerular damage) would start as pedal and look similar to CHF (glomerular inflammation → low GFR → renin release → retention of H2O/Na). Across UW, AMBOSS, and FA2022 I cannot find anything supporting periorbital edema in nephritic syndrome. For some reason, this is the hill I have chosen to die on…
Should I resubmit (given the additional information that I provided)?