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 MALE QUESTIONNAIRE - PAGE 5(d) 

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This section deals with edema (swelling/puffiness caused by fluid retention).
526.  Do you have edema of the feet? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
527.  Do you have edema of the ankles or lower legs? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
528.  Do you have edema of the knees? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
529.  Do you have edema of the hands? To rate its severity, press firmly with a finger for 5 seconds and note the approximate depth of the indentation or length of time to return to normal.
No / don't know
Slight: 5mm (1/4 inch) depth, immediate return
Minor: 8-10mm (1/2 inch) depth, 10-15 seconds
Moderate: 11-20mm (3/4 inch) depth, 15-30 seconds
Severe: Over 20mm (1 inch) depth, over 30 seconds
530.  Do you have edema of the eyelids?
Don't know
No
Slightly
Very much
531.  Do you have edema of the scrotum?
Don't know
No
Slightly
Very much
532.  Do you have edema of the abdomen?
Don't know
No
Slightly
Very much

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GLOSSARY

Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.

Edema
Abnormal accumulation of fluids within tissues resulting in swelling.





























 
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