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Renal Exam
 
 

Arm Inspection

November 28th, 2019
 
 
 
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Purpura

  • Look For

  • Red / purple lesions that do not blanch with pressure. May be present over the head, arms, legs, chest or abdomen.
  • Causes of Purpura

  • Trauma

  • Platelet Disorders

  • Idiopathic thrombocytopaenic purpura (ITP)
  • Thrombotic thrombocytopaenic purpura (TTP)
  • Disseminated intravascular coagulation (DIC)
  • Bone marrow failure - aplastic anaemia, leukaemia, chemotherapy
  • Platelet sequestration - splenomegaly, haemangioma
  • Haemolytic-uraemic syndrome
  • Inherited disorders of platelet function
  • Disorders of Coagulation

  • Factor deficiencies - haemophilia, Von Willebrand disease
  • Vitamin K deficiency - malabsorption, poor diet
  • Anticoagulants
  • Disseminated intravascular coagulation (DIC)
  • Vascular Disorders

  • Connective tissue diseases - Ehlers-Danlos, scurvy
  • Infection - mengingococcal, streptococcal, viral
  • Henoch-Schönlein purpura
  • Senile purpura
  • Steroids

Scratch Marks

  • Look For

  • Scratch marks over the skin of the face, arms, chest or abdomen.
  • Significance

  • An indicator that the patient has been pruritic.
  • Causes of Pruritis

  • Obstructive jaundice (bile acid deposition)
  • Chronic kidney disease (urea deposition)
  • Skin conditions - dry skin, atopic eczema, psoriasis, lichen planus, ichthyosis
  • Infection - herpes zoster, scabies, fungal infections
  • Myeloproliferative disorders
  • Hyperthyroidism
  • Pregnancy
  • Neuropathic itch
  • Psychogenic itch
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