Case 7: Physical Exam

Case 7 Index

Vital Signs: Temperature 100.1°F, Blood Pressure 162/92 mmHg, Heart Rate 82 beats/min, Respiratory Rate 14 breaths/min
General Appearance: In no acute distress
HEENT: Normal conjunctiva, no scleral icterus, moist mucous membranes, clear oropharynx
Lymph: No lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallopsstethoscope
Pulmonary: Breath sounds normal bilaterally, no rales/rhonchi/wheezes
Abdominal: Soft, nontender, nondistended, normoactive bowel sounds, no hepatosplenomegaly
Extremities: warm and well perfused extremities, trace pitting edema of bilateral ankles. Mild swelling and tenderness of bilateral wrists and ankles
Neurologic: Alert, Oriented x3, no focal deficits
Psychiatric: Calm, pleasant
Skin: Warm, dry, no rashes

What’s at the top of your differential diagnosis? Choose 3 before moving on!
Membranous nephropathy
Post-infectious glomerulonephritis
Acute interstitial nephritis (AIN)
ANCA-associated glomerulonephritis
Systemic lupus erythematosus (SLE) nephritis
Minimal change disease
Acute tubular necrosis (ATN)
IgA nephropathy
Hepatitis C-related glomerulonephritis
Anti-glomerular basement membrane (GBM) disease

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Case 7 Index
Case 7 Introduction