F00574 017 g001
Fundoscopy
Hypertensive changesA
Jugular vcnous pressure
Elevated in fluid overload
Blood pressure
Often elevated
Skin
Yellow complexion* Bruising*
Excoriation of pruritus* Reduced skin turgor in fluid depletion
Hands
Heart
Extra heart sounds in fluid overload
Pericardial friction rub*
3 Sacral oedema
Ankle oedema
Peripheral neuropathy*
Urine microscopy
Abdomen
Enlarged kidneys Local tenderness Renal or other arterial bruits in renal vascular disease Rectal examination-prostatę
Urinalysis for blood and protein
'Brown lina pigmentation A of naiis
Obscrvation
1 Tiredness
Respiratory ratę and depth increased in metabolic acidosis Pallor*
Genitalia
A Phimosis
* Features of advanced chronię renal failure (see also Fig. 17.20)
© Elsevier. Boon et al.: Davidson's Principles and Practice of Medicine 20e - www.studentconsult.com
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