Genito-Urinary Examination

Rapport with patient

  • Introductions
  • Position to 45 degrees first
  • Expose neck
  • Inspection of patient & surroundings (Note Mental State)
    • Diagnostic Facies
    • Pigmentation
    • IV access
    • Vascath
    • AV Fistula
    • IDC
    • Dialysis bag

Ask for relevant Vitals

  • Postural BP
  • Temperature

Examination of Hands

  • Arthropathy
  • Assessing for renal flap
  • Nails
  • Brown lines
  • Distal arc
  • Leuconychia
  • Palms
  • Polycythaemia
  • Vasculitis

Examination of Arms

  • Bruising
  • Scratch marks
  • Wasting

Assess AV fistula

  • Thrill
  • Bruit

Examination of Eyes

  • Jaundice
  • Conjuncitval Pallor
  • Iritis /Scleritis
  • Band keratopathy

Examination of Mouth

  • Stomatitis
  • Foetor
  • Ulceration
  • Mucosal moisture

Assess JVP

Reposition supine on 1 pillow

Exposure of Abdomen ‘nipples to knees’

Inspection of Abdomen

  • Distension
  • Tenchkoff
  • Scars
  • Masses
  • Kidney Transplant

Palpation

  • Superficial Palpation
  • Outline masses
  • Ask if any area tender first
  • Deep Palpation
  • Palpate for AAA
  • Ballot kidneys
  • Palpate and percuss bladder
  • Palpate Liver and Spleen if PCKD
  • Liver edge
  • Liver height
  • Spleen
  • Ascites
  • Shifting dullness
  • Fluid thrill

Groin Examination

  • Auscultation
  • Renal Bruits
  • Ask to perform rectal examination
  • Prostatomegaly
  • Ask for pelvic examination if female
  • Examine Groin (Repeat examination standing)
  • Testicles
  • Epididymis
  • Cremasteric ref
  • Inguinal nodes
  • Herniae
  • Urethra
  • Reposition sitting on edge of bed

Examine Back

  • Flank tenderness
  • Oedema
  • Bruising
  • Examination of Lower Limbs
  • Oedema
  • Bruising

Ask for Adjuncts

  • Urinalysis 
- Weight
  • Fluid balance

Ask to examine other systems

  • Cardiovascular for CCF
  • Neurological for peripheral neuropathy
  • Fundoscopy for retinopathy

Summary & Interpretation

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