Focal segmental glomerulosclerosis physical examination

Focal segmental glomerulosclerosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

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].

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 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].

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].

Appearance of the Patient

• Patients with focal segmental glomerulosclerosis usually appear lethargic

Vital Signs

• Afebrile
• High/low blood pressure with normal pulse pressure

Skin

• Skin examination of patients with focal segmental glomerulosclerosis is usually normal

HEENT

• HEENT examination of patients with focal segmental glomerulosclerosis is usually normal
• Swelling of periorbital sometimes resulting in swollen-shut eyelids

Neck

• Neck examination of patients with focal segmental glomerulosclerosis is usually normal
• Jugular venous distension is seen in fluid overload

Lungs

• Pulmonary examination of patients with focal segmental glomerulosclerosis 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 focal segmental glomerulosclerosis is usually normal

Abdomen

• Abdominal distention

Back

• Back examination of patients with focal segmental glomerulosclerosis is usually normal

Genitourinary

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

Neuromuscular

• Neuromuscular examination of patients with [disease name] is usually normal.

OR

• Patient is usually oriented to persons, place, and time
• Altered mental status
• Glasgow coma scale is ___ / 15
• Clonus may be present
• Hyperreflexia / hyporeflexia / areflexia
• Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
• Muscle rigidity
• Proximal/distal muscle weakness unilaterally/bilaterally
• ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
• Unilateral/bilateral upper/lower extremity weakness
• Unilateral/bilateral sensory loss in the upper/lower extremity
• Positive straight leg raise test
• Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
• Positive/negative Trendelenburg sign
• Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
• Normal finger-to-nose test / Dysmetria
• Absent/present dysdiadochokinesia (palm tapping test)

Extremities

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