Case 53: Physical Exam

Case 53 Index

Vital Signs: Temperature 97.1℉, Blood Pressure 175/100 mm Hg, Heart Rate 93 beats/min, SpO2 98% (room air), Respiratory Rate 15 breaths/min, Weight 100 kg
General Appearance: no acute distress
HEENT: Normal conjunctiva, no scleral icterus, moist mucous membranes
Lymph: No cervical lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallopsstethoscope
Pulmonary: clear to auscultation bilaterally; no crackles, wheezes, or rhonchi
Abdominal: Soft, nontender, nondistended, normoactive bowel sounds, no hepatosplenomegaly
Extremities: +2 pitting edema in lower extremities bilaterally to shin, warm, well-perfused
Skin: no rash, warm, and dry

What’s on your differential diagnosis for acute kidney injury (AKI in this patient? Pick your top 3!
Contrast-induced nephropathy (CIN)
Volume depletion
Obstructive nephropathy
Acute tubular necrosis (ATN)  
Acute interstitial nephritis (AIN)
Hypertensive sclerosis
Pigment-induced nephropathy
Membranous nephropathy
Post-infectious glomerulonephritis
Diabetic nephroapthy

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