|
|
| (106 intermediate revisions by the same user not shown) |
| Line 1: |
Line 1: |
| {{familytree/start}}
| | [[Syncope]] is classified into three types: |
| {{familytree | | | | | | | A01 | | A01= <div style="float: left; text-align: left; width: 28em; padding:1em;">'''History and Physical Eexamination'''<br>
| | * [[Cardiac]] |
| Ask for [[urinary]] [[symptoms]] such as:
| | * [[Neurogenic]] |
| ❑ [[Dysuria]]<br>
| | * [[Vasovagal syncope|vasovagal]] |
| ❑ [[Hematuria]]
| |
| Physical Examination should asses for the presence of:
| |
| ❑ [[Hypotension]]<br>
| |
| ❑ [[Pallor]]<br>
| |
| ❑ [[Edema]]<br>
| |
| ❑ Muffled [[heart sounds]]<br>
| |
| ❑ [[Swollen joints]]<br>
| |
| ❑ [[Organomaegally]]
| |
| ❑ [[Lymphadenopathy]]
| |
| ❑ Abdominal and pelvic examination
| |
| :❑ Digital rectal examination
| |
| :❑ [[Vaginal]] examination (in female)
| |
| </div>}}
| |
| {{familytree | | | | | | | |!| | | | | | | | | }}
| |
| {{family tree| | | | | | | B01 | | | | B01=<div style="float: left; text-align: left;width: 28em; padding:1em;"> '''Medical History and Risk Factors''' <div class="mw-collapsible mw-collapsed"><br>
| |
| ❑ inquire about previous similar episodes<br>
| |
| ❑ co-morbidities
| |
| :❑ [[Diabetes]]-long standing poorly controlled diabetes can precipitate ARF
| |
| :❑ [[Hypertension]]
| |
| :❑ [[Heart Failure]]
| |
| :❑ [[Vascular disease]] (such as renal artery stenosis
| |
| ❑ Inquire about medication history
| |
| :❑ [[ACE inhibitors]]- can precipitate ARF in [[renal artery stenosis]]
| |
| :❑ [[NSAIDs]]-associated with [[interstitial kidney disease]]
| |
| :❑ [[Penicillins]]-associated with [[renal papillary necrosis]] <br>
| |
| ❑ inquire about recent hospitalization-rule out [[ATN]]<br>
| |
| ❑ Inquire about recent trauma/surgery-rule out [[sepsis]]-look for [[fever]] and [[hypotension]]/rule out [[hemorrhage]] and [[hypovolemia]]<br>
| |
| ❑ Age factor-elderly people-rule out [[Benign Prostate hypertrophy]]/[[prostate cancer]]<br>
| |
| :❑ Elderly patient with bone pain-[[Multiple Myeloma]]?
| |
| ❑ History of [[kidney stones]]<br>
| |
| ❑ Associated symptoms
| |
| :❑ Nasal stuffiness/[[epistaxis]]-suggest [[Wagener's Granulomatosis]]?
| |
| :❑ recent [[sore throat]]-streptococcal [[Glomerulonephritis]]
| |
| ❑ Social history-[[Alcohol]] use/[[tobacco]] use/drug abuse<br>
| |
| ❑ history of [[autoimmune]] disorders- [[Systemic Lupus Erythromatosus]], [[Good Pasture syndrome]] <br>
| |
| </div> }}
| |
| {{familytree | | | | | | | |!| | | | | | | | | }}
| |
| {{family tree| | | | | | | C01 | | | | C01=<div style="float: left; text-align: left;width: 28em; padding:1em;"> '''Initial work-up''' <div class="mw-collapsible mw-collapsed"><br>
| |
| ❑ Basic Blood
| |
| :❑ [[Full blood count]] with differentials
| |
| :❑ [[Blood glucose]]
| |
| :❑ [[Urea]] and [[electrolytes]]
| |
| :❑ [[Coagulation]] screen
| |
| :❑ Inflammatory markers
| |
| :❑ Urea/electrolytes
| |
| :❑ [[Liver]] function test
| |
| :❑ [[Calcium]] and [[phosphate]]
| |
| :❑ Blood culture if infection suspected
| |
| :❑ Arterial blood gases or venous [[bicarbonate]]
| |
| ❑ [[Urine]] analysis<br>
| |
| ❑ Urine microscopy/urine sediment/[[culture]]<br>
| |
| ❑ Renal [[ultrasound]]<br>
| |
| ❑ Chest radiograph<br>
| |
| ❑ [[ECG]] <br>
| |
| ❑ [[Renal biopsy]] may be indicated if intrinsic cause is suspected <br>
| |
| </div> }}
| |
| {{familytree | | | | | | | |!| | | | | | | | | }}
| |
| {{family tree| | | | | | | B01 | | | | B01=<div style="float: left; text-align: left;width: 28em; padding:1em;"> '''Draw a conclusion''' <div class="mw-collapsible mw-collapsed"><br>
| |
| ❑ Treat any life threatening features first—[[shock]], [[respiratory failure]], [[hyperkalaemia]] <br>
| |
| ❑ Is this acute or chronic [[renal impairment]]?<br>
| |
| ❑ A full [[drug]] history (current, recent, and alternative medication) is vital<br>
| |
| ❑ Is there a pre‐renal cause? What is the patient's current fluid status?<br>
| |
| ❑ Could this be obstruction?<br>
| |
| ❑ Is [[intrinsic renal disease]] probable—what does [[urine]] analysis show? <br>
| |
| </div> }}
| |
| {{familytree/end}} <br>
| |