Membranoproliferative glomerulonephritis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with MPGN usually appear normal but may develop signs and symptoms of [[Chronic renal failure|end stage renal disease]]. Signs of volume overload maybe present.
==Physical Examination==
==Physical Examination==
Physical examination of patients with membranoproliferative glomerulonephritis is usually normal except there are signs of fluid overload if the disease progress to end-stage renal failure.<ref name="pmid22187987">{{cite journal |vauthors=D'Agati VD, Kaskel FJ, Falk RJ |title=Focal segmental glomerulosclerosis |journal=N. Engl. J. Med. |volume=365 |issue=25 |pages=2398–411 |date=December 2011 |pmid=22187987 |doi=10.1056/NEJMra1106556 |url=}}</ref>
===Appearance of the Patient===
*Patients with  membranoproliferative glomerulonephritis  usually appear [[Fatigue|lethargic]]
===Vital Signs===
*Afebrile
*[[Hypertension|High blood pressure]] with normal [[pulse pressure]]
===Skin===
*Skin examination of patients with  membranoproliferative glomerulonephritis is usually normal
===HEENT===
*HEENT examination of patients with membranoproliferative glomerulonephritis  is usually normal
*[[Periorbital edema|Swelling of periorbital]] sometimes resulting in swollen-shut eyelids
===Neck===
*Neck examination of patients with membranoproliferative glomerulonephritis  is usually normal
*[[Jugular venous distension]] is seen in fluid overload
===Lungs===
* Pulmonary examination of patients with  membranoproliferative glomerulonephritis  is usually normal, however, if there is fluid overload, following signs are seen:
*Lungs are hyporesonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases bilaterally
===Heart===
*Cardiovascular examination of patients with membranoproliferative glomerulonephritis  is usually normal
===Abdomen===
*[[Abdominal distention]]
===Back===
*Back examination of patients with  membranoproliferative glomerulonephritis is usually normal
===Genitourinary===
*Signs of fluid overload can be seen which includes:
**Scrotal edema
**Vulvar edema
===Neuromuscular===
*Neuromuscular examination of patients with  membranoproliferative glomerulonephritis is usually normal
===Extremities===
*Pitting/non-pitting [[edema]] of the upper and lower extremitiesdue to fluid overload


* Hypertension is present in approximately 80% of patients at initial presentation. Hypertension typically is mild, although an occasional patient with dense deposit disease may present with severe hypertension.
* Conjunctival pallor indicative of anemia
* Periorbital or dependent edema may occur in patients with a nephritic or nephrotic presentation. Anasarca is present in a few patients.
* A strong association is present between partial lipodystrophy and dense deposit disease. Fat atrophy usually affects the upper limbs, trunk, and face.
* Retinal changes: A finding of drusen in a patient with chronic glomerulonephritis suggests MPGN type II. Drusen are yellowish deposits of extracellular material that are found between the basement membrane of the retinal pigment epithelium and the inner collagenous zone of the Bruch membrane. Choroidal neovascularization, macular degeneration, and visual loss also may develop in dense deposit disease.


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Nephrology]]
[[Category:Nephrology]]

Latest revision as of 17:19, 30 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Patients with MPGN usually appear normal but may develop signs and symptoms of end stage renal disease. Signs of volume overload maybe present.

Physical Examination

Physical examination of patients with membranoproliferative glomerulonephritis is usually normal except there are signs of fluid overload if the disease progress to end-stage renal failure.[1]

Appearance of the Patient

  • Patients with membranoproliferative glomerulonephritis usually appear lethargic

Vital Signs

Skin

  • Skin examination of patients with membranoproliferative glomerulonephritis is usually normal

HEENT

  • HEENT examination of patients with membranoproliferative glomerulonephritis is usually normal
  • Swelling of periorbital sometimes resulting in swollen-shut eyelids

Neck

  • Neck examination of patients with membranoproliferative glomerulonephritis is usually normal
  • Jugular venous distension is seen in fluid overload

Lungs

  • Pulmonary examination of patients with membranoproliferative glomerulonephritis is usually normal, however, if there is fluid overload, following signs are seen:
  • Lungs are hyporesonant
  • Fine/coarse crackles upon auscultation of the lung bases bilaterally

Heart

  • Cardiovascular examination of patients with membranoproliferative glomerulonephritis is usually normal

Abdomen

Back

  • Back examination of patients with membranoproliferative glomerulonephritis is usually normal

Genitourinary

  • Signs of fluid overload can be seen which includes:
    • Scrotal edema
    • Vulvar edema

Neuromuscular

  • Neuromuscular examination of patients with membranoproliferative glomerulonephritis is usually normal

Extremities

  • Pitting/non-pitting edema of the upper and lower extremitiesdue to fluid overload


References

  1. D'Agati VD, Kaskel FJ, Falk RJ (December 2011). "Focal segmental glomerulosclerosis". N. Engl. J. Med. 365 (25): 2398–411. doi:10.1056/NEJMra1106556. PMID 22187987.

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