Case 55: Physical Exam

Case 55 Index

Vital Signs: Temperature 100.7℉, Blood Pressure 90/50 mm Hg on norepinephrine, Heart Rate 112 beats/min, SpO2 94% (FiO2 70%), Respiratory Rate 22 breaths/min on ventilator
General Appearance: critically ill
HEENT: positive scleral icterus, endotracheal tube in place
Lymph: No cervical lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallopsstethoscope
Pulmonary: mechanical breath sounds bilaterally
Abdominal: Soft, distended, positive fluid wave, sluggish bowel sounds
Extremities: 2+ pitting edema, cool clammy extremities
Genitourinary: foley catheter in place with minimal urine output
Skin: +jaundice

What’s on your differential diagnosis for acute kidney injury (AKI) in this patient? Pick your top 3!
Cardiorenal Syndrome
Hepatorenal Syndrome
Acute Interstitial Nephritis (AIN)
Acute Tubular Necrosis (ATN)
Obstructive Nephropathy
Volume Depletion

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Case 55 Index
Case 55 Introduction