Case 54: Physical Exam

Case 54 Index

Vital Signs: Temperature 98.6℉, Blood Pressure 164/92 mm Hg, Heart Rate 88 beats/min, SpO2 99% (room air), Respiratory Rate 16 breaths/min
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, well-healed abdominal scar
Extremities: no pitting edema, 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!
Non-steroidal anti-inflammatory drug (NSAID) induced injury
Volume depletion
Calcium channel blocker toxicity
Steroid toxicity
Trimethoprim-sulfamethoxazole nephrotoxicity
Calcineurin inhibitor toxicity 
Obstructive nephropathy
Transplant renal artery stenosis (TRAS) 
Kidney Transplant Pyelonephritis
Rejection of pancreas allograft
Rejection of kidney allograft

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Case 54 Index
Case 54 Introduction