Hepatorenal syndrome physical examination: Difference between revisions
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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> | 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: ==== | ==== Constitutional disturbances: ==== | ||
* Weakness | * [[Weakness]] | ||
* Fatigue | * [[Fatigue]] | ||
* Anorexia | * [[Anorexia]] | ||
* Poor nutritional status | * Poor nutritional status | ||
| Line 24: | 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]]: | ||
* Hepatomegaly | ** Dull sound in the belly area when tapped with the tips of the fingers - indicates presence of fluid | ||
* Stigmata of portal hypertension | * [[Hepatomegaly]] | ||
* Gynaecomastia | * Stigmata of [[portal hypertension]] (gastroesophageal varices, caput medusa, hepatic encephalopathy) | ||
* Spider naevi | * [[Gynecomastia|Gynaecomastia]] | ||
* [[Spider naevi]] | |||
====Genitals==== | ====Genitals==== | ||
| Line 37: | Line 38: | ||
* [[Pedal edema]] | * [[Pedal edema]] | ||
* [[Involuntary jerky movements]] | * [[Involuntary jerky movements]] | ||
* Finger clubbing | * Finger [[clubbing]] | ||
* Palmar erythema | * [[Palmar erythema]] | ||
====Neurologic==== | ====Neurologic==== | ||
* Abnormal reflexes | * Abnormal reflexes | ||
| Line 45: | Line 45: | ||
==== Cariovascular: ==== | ==== Cariovascular: ==== | ||
* Hyperdynamic circulation | * Hyperdynamic [[circulation]] | ||
* Reduced systemic vascular resistance | * Reduced [[systemic vascular resistance]] | ||
* Low | * Low [[mean arterial pressure]] | ||
* Low jugular venous pressure | * Low [[jugular venous pressure]] | ||
* Tachycardia | * [[Tachycardia]] | ||
* Bounding pulse | * Bounding pulse | ||
* Wide pulse pressure | * Wide pulse pressure | ||
Revision as of 14:19, 12 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Hepatorenal syndromeHRS 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.