Abdo (Renal) Examination

Question 1

Clinical signs that may be present on general inspection of the patient during a renal examination?

Answer 1

Decreased conciousness - endstage renal failure?
Scars - previous abdo surgery
Pallor - anemia (EPO def)
SOB - pulmonary odema (RF)
Odema (nephoritc syndrome, ESRD (anuria)
Cachexia (protein-energy wasting)
Uraemic complexion (yellow colour of the skin by uraemia in advanced CKD)
Cushingoid appearance (secondary to high dose corticosteroids for glomerulonephritis or post renal transplant)

Question 2

Potential hand signs on renal examination?

Answer 2

Pallor - anaemia
Fingerprix marks (cbg)
Gouty tophi (advanced CKD)
Tremor (immunusupressive medications)

Question 3

Potential nail signs on renal examination?

Answer 3

Kolionychia - spoon shaped nails (iron/EPO def)
Leukonychia - whitening of the rain bed (hypoalbuminaemia)
Splinter haemorrhage (dialysis catheter associatied infections)
Beau’s lines -palpable transverse lines (malnutrition)
Muehrke’s lines - pale non-palpable transverse lines (hypoalbuminaemia)
Lindsay’s half and half nails - white discolouration at proximal portion of the nail and a red/brown discolouration of the distal portion with a sharp line of demarcation between the halves - commonly present in haemodialysis pts