Acute tubular necrosis physical examination
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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).
Appearance of the Patient
- Patients with acute tubular necrosis may appear ill, dehydrated, or lethargic depending on the severity of renal hypoperfusion and damage.
Skin examination of patients with acute tubular necrosis may show following findings:
- 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.
Abdominal examination of patients with acute tubular necrosis may show following findings:
- Muscle weakness and convulsions because of moderate to severe electrolyte imbalance.
- Changes in sensorium
- Muscle tenderness
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- 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.