Acute tubular necrosis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
On physical examination ,patients with acute tubular necrosis may show the findings of volume depletion. They usually appear ill, dehydrated and lethargic. Common physical examination findings of acute tubular necrosis include orthostatic hypotension and other signs of hypovolemia ( dry [[mucous membranes]], sunken eyes, poor skin turgor and [[Capillary refill time|delayed capillary refill]], and decreased [[jugular venous pressure]]).
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


==Physical Examination==
==Physical Examination==
* Physical examination of patients with [disease name] is usually normal.
OR
*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with acute tubular necrosis may appear ill, dehydrated, or lethargic depending on the severity of renal hypoperfusion and damage.
*[[Patient|Patients]] with acute tubular necrosis may appear [[Ill feeling|ill]], [[Dehydration|dehydrated]], or [[Fatigue|lethargic]] depending on the severity of [[Kidney|renal]] hypoperfusion and damage.


===Vital Signs===
===Vital Signs===
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===Skin===
===Skin===
* Skin examination of patients with acute tubular necrosis may show following findings:  
* [[Skin]] examination of patients with acute tubular necrosis may show following findings:  
** Diminished skin turgor
** Diminished [[skin]] turgor
** Dry mucous membranes
** Dry [[Mucous membrane|mucous membranes]]
** Delayed capillary refill
** Delayed [[capillary refill]]


===HEENT===
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
* Sunken [[Eye|eyes]]
OR
* Facial [[edema]]
* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
===Neck===
* Neck examination of patients with [disease name] is usually normal.
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]
 
===Lungs===
===Lungs===
* Pulmonary examination of patients with acute tubular necrosis  is usually normal.
* Pulmonary examination of patients with acute tubular necrosis  is usually normal.
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===Abdomen===
===Abdomen===
Abdominal examination of patients with [disease name] is usually normal.
Abdominal examination of patients with acute tubular necrosis may show following findings:
 
OR
*[[Abdominal distention]]  
*[[Abdominal distention]]  
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
===Back===
* Back examination of patients with [disease name] is usually normal.
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
OR
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge


===Neuromuscular===
===Neuromuscular===
*[[Muscle weakness]] and [[Seizure|convulsions]] because of moderate to severe [[Electrolyte disturbance|electrolyte imbalance]]
*[[Muscle weakness]] and [[Seizure|convulsions]] because of moderate to severe [[Electrolyte disturbance|electrolyte imbalance]].
*Muscle [[tenderness]]


===Extremities===
===Extremities===
* Cool extremities
* [[Cool extremities]]
* [[Edema|Pitting edema]]


==References==
==References==

Revision as of 15:39, 2 May 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

On physical examination ,patients with acute tubular necrosis may show the findings of volume depletion. They usually appear ill, dehydrated and lethargic. Common physical examination findings of acute tubular necrosis include orthostatic hypotension and other signs of hypovolemia ( dry mucous membranes, sunken eyes, poor skin turgor and delayed capillary refill, and decreased jugular venous pressure).

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Lungs

Heart

Abdomen

Abdominal examination of patients with acute tubular necrosis may show following findings:

Neuromuscular

Extremities

References

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