Renal Exam Flashcards
1
Q
General inspection
A
- Hyperventilation - Metabolic acidosis
- Hiccups - advanced uraemia
- Fishy breath/uraemic fetor - kidney failure
- Sallow complexion/uraemic tinge - impaired excretion of urinary pigment combined with anaemia/iron deposition due to transfusions
- Impaired mental state (drowsy/confused) - late-stage renal failure
- Dehydration (dry mucous membranes, sunken eyes, decreased skin turgor)
2
Q
Hands
A
- Leukonychia
- Muehrcke’s nails
- Lee’s lines
- Half and half nails
- Pallor of palmar creases
- Asterixis
3
Q
Arms
A
- Assess BP for HTN
- AV fistula
- Bruising (CKD - nitrogen retention –> platelet fill defect –> abnormal aggregation)
- Scratch marks (uraemic pruritus)
4
Q
Face
A
Eyes: anaemia + jaundice
Uraemic fetor
Mucosal ulcers
5
Q
Neck
A
JVP
Carotid bruits
6
Q
Chest
A
Pulmonary oedema
Pericarditis
7
Q
Abdominal inspection
A
- Scars (renal calculi, transplant, peritoneal dialysis)
- Bulge (transplanted kidney)
- Distension
8
Q
Palpation
A
- Ballot the kidneys
- Palpate bladder
9
Q
Percussion
A
- Liver
- Spleen
- Bladder (if full = dull, otherwise resonant)
- Shifting dullness
- Murphy’s kidney punch (pyelonephritis, perinephric abscess, renal colic)
10
Q
Auscultation
A
Renal + Aortic bruits
11
Q
Legs
A
Pitting oedema
12
Q
Spine
A
Palpate for bony tenderness (hypocalcaemia + Vit D deficiency)
13
Q
Additional
A
Examine genital/urethral openings + PR exam (in males)
14
Q
A
Mee’s lines
- Arsenic poisoning
- Renal failure
- Chemotherapy
15
Q
A
Half and half nails
CKD
16
Q
A
Muehrcke’s nails
- Post chemotherapy
- Hypoalbuminaemia due to nephrotic syndrome
