Acute tubular necrosis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
On [[physical examination]], [[Patient|patients]] with acute tubular necrosis may show the findings of [[Hypovolemia|volume depletion]]. They usually appear [[Ill feeling|ill]], [[Dehydration|dehydrated]], and [[Fatigue|lethargic]]. Common [[physical examination]] findings of acute tubular necrosis include [[orthostatic hypotension]] and other signs of [[hypovolemia]] (dry [[mucous membranes]], sunken [[Eye|eyes]], poor skin turgor and [[Capillary refill time|delayed capillary refill]], and decreased [[jugular venous pressure]]). | |||
Common physical examination findings of [ | |||
==Physical Examination<ref name="pmid14760871">{{cite journal |vauthors=Anderson RJ, Barry DW |title=Clinical and laboratory diagnosis of acute renal failure |journal=Best Pract Res Clin Anaesthesiol |volume=18 |issue=1 |pages=1–20 |date=March 2004 |pmid=14760871 |doi= |url=}}</ref><ref name="pmid18354074">{{cite journal |vauthors=Himmelfarb J, Joannidis M, Molitoris B, Schietz M, Okusa MD, Warnock D, Laghi F, Goldstein SL, Prielipp R, Parikh CR, Pannu N, Lobo SM, Shah S, D'Intini V, Kellum JA |title=Evaluation and initial management of acute kidney injury |journal=Clin J Am Soc Nephrol |volume=3 |issue=4 |pages=962–7 |date=July 2008 |pmid=18354074 |pmc=2440262 |doi=10.2215/CJN.04971107 |url=}}</ref>== | |||
===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=== | ||
| Line 36: | Line 18: | ||
===Skin=== | ===Skin=== | ||
[[Skin]] examination of patients with acute tubular necrosis may show following findings: | |||
* Diminished [[skin]] turgor | |||
*[[ | * Dry [[Mucous membrane|mucous membranes]] | ||
*[[ | * Delayed [[capillary refill]] | ||
* [[ | |||
===HEENT=== | ===HEENT=== | ||
* | * Sunken [[Eye|eyes]] | ||
* Facial [[edema]] | |||
* Facial | |||
===Lungs=== | ===Lungs=== | ||
* Pulmonary examination of patients with | * Pulmonary examination of patients with acute tubular necrosis is usually normal. Bilateral [[Rales|crackles]] may be found on auscultation due to [[pulmonary edema]]. | ||
*[[Tachypnea]] may be caused by [[metabolic acidosis]] as a result of severe [[Hypovolemia|volume depletion]]. | |||
*[[ | |||
===Heart=== | ===Heart=== | ||
*[[Hypotension]] | |||
*[[Tachycardia]]/ [[Bradycardia]] | |||
*Decreased [[jugular venous pressure]] | |||
*[[Cardiac arrhythmia|Arrhythmias]] | |||
*[[ | |||
*[[ | |||
*[[ | |||
*[[ | |||
===Abdomen=== | ===Abdomen=== | ||
Abdominal examination of patients with | Abdominal examination of patients with acute tubular necrosis may show following findings: | ||
*[[Abdominal distention]] | *[[Abdominal distention]] | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
* | *[[Muscle weakness]] and [[Seizure|convulsions]] because of moderate to severe [[Electrolyte disturbance|electrolyte imbalance]]. | ||
*Changes in [[sensorium]] | |||
*Muscle [[tenderness]] | |||
* | |||
* | |||
===Extremities=== | ===Extremities=== | ||
* | * [[Cool extremities]] | ||
* [[Edema|Pitting edema]] | |||
*[[ | |||
==References== | ==References== | ||
Latest revision as of 19:19, 15 June 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[1][2]
Appearance of the Patient
- Patients with acute tubular necrosis may appear ill, dehydrated, or lethargic depending on the severity of renal hypoperfusion and damage.
Vital Signs
Skin
Skin examination of patients with acute tubular necrosis may show following findings:
- Diminished skin turgor
- Dry mucous membranes
- Delayed capillary refill
HEENT
Lungs
- Pulmonary examination of patients with acute tubular necrosis is usually normal. Bilateral crackles may be found on auscultation due to pulmonary edema.
- Tachypnea may be caused by metabolic acidosis as a result of severe volume depletion.
Heart
Abdomen
Abdominal examination of patients with acute tubular necrosis may show following findings:
Neuromuscular
- Muscle weakness and convulsions because of moderate to severe electrolyte imbalance.
- Changes in sensorium
- Muscle tenderness
Extremities
References
- ↑ Anderson RJ, Barry DW (March 2004). "Clinical and laboratory diagnosis of acute renal failure". Best Pract Res Clin Anaesthesiol. 18 (1): 1–20. PMID 14760871.
- ↑ Himmelfarb J, Joannidis M, Molitoris B, Schietz M, Okusa MD, Warnock D, Laghi F, Goldstein SL, Prielipp R, Parikh CR, Pannu N, Lobo SM, Shah S, D'Intini V, Kellum JA (July 2008). "Evaluation and initial management of acute kidney injury". Clin J Am Soc Nephrol. 3 (4): 962–7. doi:10.2215/CJN.04971107. PMC 2440262. PMID 18354074.