Chronic renal failure physical examination: Difference between revisions
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===Cardiothoracic=== | ===Cardiothoracic=== | ||
*Left ventricular [[heave]] | *Left ventricular [[heave]] | ||
*[[Heart sounds#Fourth heart sound S4|S4]] | *Fourth heart sound [[Heart sounds#Fourth heart sound S4|S4]] | ||
*[[Pericardial friction rub]] ([[uremic pericarditis]]) | *[[Pericardial friction rub]] ([[uremic pericarditis]]) | ||
*[[Crackles]] ([[pulmonary edema]]) | *[[Crackles]] ([[pulmonary edema]]) | ||
Revision as of 14:59, 3 April 2015
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Chronic renal failure Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Chronic renal failure causes disturbances in not only the filtration function of the kidney, but also in the normal functioning of virtually every organ in the body. Symptoms and overt signs of kidney disease are often subtle or absent until renal failure ensues. Thus, the diagnosis of chronic renal failure often take the patient by surprise.
Physical Examination
General Appearance
- Malaise
- In distress
Vital signs
- Hypertension
- Tachycardia
- Reduced pulse pressure
- Tachypnea
- Hypothermia
Skin
- Uremic fetor (foul smell)
- Uremic frost on the face (deposits of tiny, white, friable, crystalline material)[1] [2]
- Poor skin turgor
- Excoriations (scratching)[3]
- Localized erythema
- Blisters[3]
- Bruises
HEENT
- Abnormal fundoscopic exam with evidence of diabetic retinopathy (among diabetic patients) or hypertensive retinopathy (among hypertensive patients)
- xerostomia (dry mucus membranes)
Neck
- Distended neck veins
- Carotid bruit (atherosclerosis)
Cardiothoracic
- Left ventricular heave
- Fourth heart sound S4
- Pericardial friction rub (uremic pericarditis)
- Crackles (pulmonary edema)
References
- ↑ Kuo CC, Hung JB, Tsai CW, Chen YM (2010). "Uremic frost". CMAJ. 182 (17): E800. doi:10.1503/cmaj.091779. PMC 2988568. PMID 20696798. Unknown parameter
|month=ignored (help) - ↑ Udayakumar P, Balasubramanian S, Ramalingam KS, Lakshmi C, Srinivas CR, Mathew AC (2006). "Cutaneous manifestations in patients with chronic renal failure on hemodialysis". Indian J Dermatol Venereol Leprol. 72 (2): 119–25. PMID 16707817.
- ↑ 3.0 3.1 Meyer TW, Hostetter TH (2007). "Uremia". N Engl J Med. 357 (13): 1316–25. doi:10.1056/NEJMra071313. PMID 17898101.