Paediatric-History taking & Physical examination of a patient with Nephritic Syndrome and Hematuria

Paediatric-History taking & Physical examination of a patient with Nephritic Syndrome and HematuriaCreated OnApril 28, 2020Last Updated OnApril 28, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & Physical examination of a patient with Nephritic Syndrome and Hematuria < All Topics Table of Contents History taking: Ask about identification of patient – age, gender. Usually aged 2-14 years with male predominance. Ask about chief complaint and history of presenting illness: Urine colour – dark / tea coloured (hematuria). Gross hematuria present in 30 – 50% of patients. Reduced urine output – Oliguria Symptoms of raised blood pressure (headache, vision problems, chest pain, hypertensive encephalopathy) Edema – ranges from mild to severe. Puffiness around eyelids and facial edema (not as prominent as nephrotic syndrome) History of recent skin infection or pharyngitis: Recent fever, sore throat, joint pain, skin infection Identify a possible streptococcal infection. Typically 1-2 weeks for postpharyngitis cases 2-4 weeks for postdermal infection Weakness, fever, abdominal pain and malaise are common. Assess the complications such as uremic symptoms: Loss of appetite Tiredness and lethargy Generalized itch Nausea, vomiting Easy bruising, nose bleed Shortness of breath or dyspnea (due to pulmonary edema) Flank pain due to renal capsule stretching Identification of an underlying systemic disease: Triad of sinusitis, pulmonary infiltrates, and nephritis, suggesting granulomatosis with polyangiitis (Wegener granulomatosis) Nausea and vomiting, abdominal pain, and purpura, observed with Henoch-Schönlein purpura Joint pain, photosensitivity rash, oral ulcer, hair loss aree associated with SLE. Hemoptysis, occurring with Goodpasture syndrome or idiopathic progressive glomerulonephritis Ask about past medical history – previously known renal diseases, similar illness, hospitalization, infections, cardiovascular diseases. Ask about drug history – any traditional medications or nephrotoxic drugs Ask about family history – renal disease, genetic disorders and autoimmune diseases. Ask about other history as indicated – Birth history, Immunization history, Nutrition history and Developmental history. Physical examination: General wellbeing – well or ill-looking child, pallor, jaundice, cyanosis or...

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