Hepatorenal syndrome physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hepatorenal syndrome}} | {{Hepatorenal syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{SKA}} | ||
==Overview== | ==Overview== | ||
Hepatorenal syndrome (HRS) does not have specific clinical findings.However patient has reflect the underlying advanced liver disease, renal impairment, and circulatory abnormalities present. | |||
==Physical Examination== | ==Physical Examination== | ||
Patients with type 1 HRS have worse clinical picture than patients with type 2 HRS..<ref name="pmid26445256">{{cite journal| author=Heemann U, Füeßl HS, Renders L| title=[The hepatorenal syndrome]. | journal=Dtsch Med Wochenschr | year= 2015 | volume= 140 | issue= 20 | pages= 1520-3 | pmid=26445256 | doi=10.1055/s-0041-105807 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26445256 }}</ref><ref name="pmid25856938">{{cite journal| author=Pandey CK, Karna ST, Singh A, Pandey VK, Tandon M, Saluja V| title=Hepatorenal syndrome: a decade later. | journal=J Assoc Physicians India | year= 2014 | volume= 62 | issue= 8 | pages= 696-702 | pmid=25856938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25856938 }}</ref><ref name="pmid26375691">{{cite journal| author=Hrabovský V, Mendlová A, Vavříčková T| title=[Hepatorenal syndrome - pathophysiology, diagnosis and treatment]. | journal=Vnitr Lek | year= 2015 | volume= 61 | issue= 7-8 | pages= 649-54 | pmid=26375691 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26375691 }}</ref> | |||
==== Constitutional disturbances: ==== | |||
* [[Weakness]] | |||
* [[Fatigue]] | |||
* [[Anorexia]] | |||
* Poor nutritional status | |||
====Skin==== | ====Skin==== | ||
* [[Pallor]] | * [[Pallor]] | ||
| Line 16: | Line 24: | ||
====Abdomen==== | ====Abdomen==== | ||
* [[Abdominal distension]] | * [[Abdominal distension]] | ||
* [[Shifting dullness]]: Dull sound in the belly area when tapped with the tips of the fingers - indicates presence of fluid | * [[Shifting dullness]]: | ||
** Dull sound in the belly area when tapped with the tips of the fingers - indicates presence of fluid | |||
* [[Hepatomegaly]] | |||
* Stigmata of [[portal hypertension]] (gastroesophageal varices, caput medusa, hepatic encephalopathy) | |||
* [[Gynecomastia|Gynaecomastia]] | |||
* [[Spider naevi]] | |||
====Genitals==== | ====Genitals==== | ||
* [[Small testicles]] | * [[Small testicles]] | ||
* Oliguria | |||
====Extremities==== | ====Extremities==== | ||
* [[Pedal edema]] | * [[Pedal edema]] | ||
* [[Involuntary jerky movements]] | * [[Involuntary jerky movements]] | ||
* Finger [[clubbing]] | |||
* [[Palmar erythema]] | |||
====Neurologic==== | ====Neurologic==== | ||
* Abnormal reflexes | * Abnormal reflexes | ||
* [[Confusion]] on neurologic testing | * [[Confusion]] on neurologic testing | ||
==== Cariovascular: ==== | |||
* Hyperdynamic [[circulation]] | |||
* Reduced [[systemic vascular resistance]] | |||
* Low [[mean arterial pressure]] | |||
* Low [[jugular venous pressure]] | |||
* [[Tachycardia]] | |||
* Bounding pulse | |||
* Wide pulse pressure | |||
==References== | ==References== | ||
Latest revision as of 20:59, 21 December 2017
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Hepatorenal syndrome physical examination On the Web |
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Risk calculators and risk factors for Hepatorenal syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Hepatorenal syndrome (HRS) does not have specific clinical findings.However patient has reflect the underlying advanced liver disease, renal impairment, and circulatory abnormalities present.
Physical Examination
Patients with type 1 HRS have worse clinical picture than patients with type 2 HRS..[1][2][3]
Constitutional disturbances:
Skin
Abdomen
- Abdominal distension
- Shifting dullness:
- Dull sound in the belly area when tapped with the tips of the fingers - indicates presence of fluid
- Hepatomegaly
- Stigmata of portal hypertension (gastroesophageal varices, caput medusa, hepatic encephalopathy)
- Gynaecomastia
- Spider naevi
Genitals
- Small testicles
- Oliguria
Extremities
Neurologic
- Abnormal reflexes
- Confusion on neurologic testing
Cariovascular:
- Hyperdynamic circulation
- Reduced systemic vascular resistance
- Low mean arterial pressure
- Low jugular venous pressure
- Tachycardia
- Bounding pulse
- Wide pulse pressure
References
- ↑ Heemann U, Füeßl HS, Renders L (2015). "[The hepatorenal syndrome]". Dtsch Med Wochenschr. 140 (20): 1520–3. doi:10.1055/s-0041-105807. PMID 26445256.
- ↑ Pandey CK, Karna ST, Singh A, Pandey VK, Tandon M, Saluja V (2014). "Hepatorenal syndrome: a decade later". J Assoc Physicians India. 62 (8): 696–702. PMID 25856938.
- ↑ Hrabovský V, Mendlová A, Vavříčková T (2015). "[Hepatorenal syndrome - pathophysiology, diagnosis and treatment]". Vnitr Lek. 61 (7–8): 649–54. PMID 26375691.