Hypertensive nephropathy physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Physical Examination

Cardiovascular examination

• Signs of left ventricular hypertrophy
  • Palpation
    • Left ventricular heave.
    • Shifting of apex towards the left.
  • Ausculatation
    • Loud S2
• Signs of congestive cardiac failure
  • Appearannce
    • Increased weight
    • Ankle edema
    • Dyspnea
  • Neck examination
    • Raised jugular venous pressure
  • Abdominal examination
    • Ascites
    • Hepatojugular reflux
    • Hepatomegaly
  • Cardiac ausculatation
    • S3 and gallop rhythm
  • Pulmonary examination
    • Rales from pulmonary edema on auscultation
    • Decreased breath sounds and dullness to percuss.

Ophthalmoscopy

• May show hypertensive retinal changes.

Neurologic examination

• Paralysis from stroke secondary to hypertension