We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byMoriah Saxton
Modified over 2 years ago
Mrs. EB Mesangiocapillary Glomerulonephritis
Pt Background Mrs. EB is a 62 yo female currently experiencing end stage renal failure (ESRF) 2 ⁰ to Mesangiocapillary Glomerulonephritis which she was diagnosed with 16 years ago.
Hx of presenting complaint Pt presented with ▫Pyrexia ▫Aches ▫Swollen hands and feet
Renal History Change in colour/smell of urine ▫Haematuria Dysuria Change in volume and stream ▫Nocturia, polyurua, anuria Fever/loin pain Bruising/itching Oedema Prostatism ▫Poor stream, difficulty starting, dribbling
Examination General appearance ▫Colour, swelling, AV fistula, catheter Hands ▫Leukonychia, anaemia, asterixis Arm ▫BP (lying then standing) Face ▫Anaemia, jaundice, uraemic fetor, skin colour Neck ▫JVP, auscaltate carotid arteries
Examination ctd. Chest ▫Praecordium, auscultate lung bases Abdomen ▫Palpate & percuss liver & spleen, kidney punch, ballot kidneys, auscultate for renal bruits, palpate and auscultate a.aorta, examine fermoral pulse & radio- femoral delay, rectal exam Back ▫Vertebral tenderness, sacral oedema Lower limbs ▫Oedema, inspect skin, capillary refill,
Urinalysis Specific gravity pH Protein Blood ▫WBC ▫RBC Microscopy ▫Casts (damage to the glom basement mem or tubules)
Mx Dx with Mesangiocapillary Glomerulonephritis by biopsy. Did not respond to corticosteriods (as expected). Started on diuretics and an ACE inhibitors
16 yrs later Presented with malaise, weight increase and oedema. Creatinine was above 500 (70-150) umol/L Kidney function 5-10% Corticosteroids failed again Started on haemodialysis due to ESRF
Mesangiocapillary GN There is no proven treatment 50% of pts develop ESRF Oxford Handbook of Clinical Medicine
Assessing Renal Patients SHARONDEEP GILL. Overview Chronic Kidney Disease History Examination Fistula Cases Clinical Topics Summary.
Adult Medical-Surgical Nursing Renal Module: Clinical Manifestations Diagnostic Tests.
Abdominal Exam Course.
Dept of Internal Medicine
Head & Neck Examination of A SURGICAL PATIENT
Renal Pathology Lab November 4, Renal Pathology Lab Case 1.
Case Study 31: Chronic Renal Failure
CVS Physical Examination
Introduction to nephrology for dentist students 2015 Judit Nagy.
CVS Examination done by Fahad Gadi 6th year medical student-2007
Urological History & Examination Dr. Abdelmoniem ElTraifi.
ABDOMEN. Examination of the Abdomen Ensure the patient is lying flat (remove any extra pillows,if present,with the permission of the patient);the hands.
Urinary System 1 Introduction Prof John Simpson University of Aberdeen.
Case 1 Urology Clinical Interactive Teaching Session.
BY: TESSA HAYMAN AND MADISON CHARRON CHAPTER 18 DIAGNOSIS OF DISEASE.
Nursing Urinary Assessment Heather Nelson, RN. Nursing History The nurse determines: Normal voiding pattern and frequency Appearance of the urine and.
ENDOCRINE EXAMINATION: THYROID Wimpie de Lange Div. of Endocrinology Dept. of Internal Medicine October 23, 2015.
Some cases 55 yr male, presents with back pain. –Dipstick detects blood in urine –Pain localised to below right 12 th rib just medial to erector spinae.
© 2017 SlidePlayer.com Inc. All rights reserved.