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Symptoms and Signs – Differential Diagnosis of Decreased Salivary Gland Secretion,
• Amyloidosis
• Anxiety
• CNS disorders
• Dehydration
• Head and neck irradiation
• Medications (antihistamines, antidepressants, neuroleptics, antihypertensives)
• Mumps
• Sarcoidosis
• Sjögren’s syndrome
• Amyloidosis
• Anxiety
• CNS disorders
• Dehydration
• Head and neck irradiation
• Medications (antihistamines, antidepressants, neuroleptics, antihypertensives)
• Mumps
• Sarcoidosis
• Sjögren’s syndrome
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Symptoms and Signs – Differential Diagnosis of Renal Artery Occlusion, Causes
• Abdominal aortic surgery
• Angiography or stent placement
• Atherosclerosis
• Atrial fibrillation
• Atrial myxoma thromboembolism
• Mitral stenosis thromboembolism
• Mural thrombus thromboembolism
• Prosthetic valve thromboembolism
• Renal artery aneurysm/dissection
• Renal cell carcinoma
• Septic embolism
• Thrombosis in patient with fibromuscular dysplasia
• Trauma
• Vasculitis
• Abdominal aortic surgery
• Angiography or stent placement
• Atherosclerosis
• Atrial fibrillation
• Atrial myxoma thromboembolism
• Mitral stenosis thromboembolism
• Mural thrombus thromboembolism
• Prosthetic valve thromboembolism
• Renal artery aneurysm/dissection
• Renal cell carcinoma
• Septic embolism
• Thrombosis in patient with fibromuscular dysplasia
• Trauma
• Vasculitis
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Symptoms and Signs – Differential Diagnosis of Renal Cell Adenocarcinoma
• Other rare primary renal carcinomas and sarcomas
• Renal cysts
• Retroperitoneal tumors
• Transitional cell carcinomas of the renal pelvis (8% of all renal cancers)
• Wilms’ tumor
• Other rare primary renal carcinomas and sarcomas
• Renal cysts
• Retroperitoneal tumors
• Transitional cell carcinomas of the renal pelvis (8% of all renal cancers)
• Wilms’ tumor
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Symptoms and Signs – Differential Diagnosis of Renal Cystic Disorders
• Acquired cystic kidney disease
• Autosomal dominant polycystic kidney disease
• Autosomal recessive polycystic kidney disease
• Medullary cystic disease
• Medullary sponge kidney
• Simple cysts
• Acquired cystic kidney disease
• Autosomal dominant polycystic kidney disease
• Autosomal recessive polycystic kidney disease
• Medullary cystic disease
• Medullary sponge kidney
• Simple cysts
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Symptoms and Signs – Differential Diagnosis of Renal Failure, Intrinsic or Parenchymal Causes
ABNORMALITIES OF THE VASCULATURE
• Renal arteries: atherosclerosis, thromboembolism, arteritis
• Renal veins: thrombosis
• Microvasculature: vasculitis, thrombotic microangiopathy
ABNORMALITIES OF GLOMERULI (ACUTE
GLOMERULONEPHRITIS)
• Anti–glomerular membrane disease (Goodpasture’s syndrome)
• Immune complex glomerulonephritis: SLE, postinfectious, idiopathic, membranoproliferative
ABNORMALITIES OF INTERSTITIUM (ACUTE
INTERSTITIAL NEPHRITIS)
• Drugs (e.g., antibiotics, NSAIDs, diuretics, anticonvulsants, allopurinol)
• Infectious pyelonephritis
• Infiltrative: lymphoma, leukemia, sarcoidosis
ABNORMALITIES OF TUBULES
• Physical obstruction (uric acid, oxalate, light chains)
• Acute tubular necrosis
• Ischemic
• Toxic (antibiotics, chemotherapy, immunosuppressives, radiocontrast dyes, heavy metals, myoglobin, hemolyzed RBCs)
ABNORMALITIES OF THE VASCULATURE
• Renal arteries: atherosclerosis, thromboembolism, arteritis
• Renal veins: thrombosis
• Microvasculature: vasculitis, thrombotic microangiopathy
ABNORMALITIES OF GLOMERULI (ACUTE
GLOMERULONEPHRITIS)
• Anti–glomerular membrane disease (Goodpasture’s syndrome)
• Immune complex glomerulonephritis: SLE, postinfectious, idiopathic, membranoproliferative
ABNORMALITIES OF INTERSTITIUM (ACUTE
INTERSTITIAL NEPHRITIS)
• Drugs (e.g., antibiotics, NSAIDs, diuretics, anticonvulsants, allopurinol)
• Infectious pyelonephritis
• Infiltrative: lymphoma, leukemia, sarcoidosis
ABNORMALITIES OF TUBULES
• Physical obstruction (uric acid, oxalate, light chains)
• Acute tubular necrosis
• Ischemic
• Toxic (antibiotics, chemotherapy, immunosuppressives, radiocontrast dyes, heavy metals, myoglobin, hemolyzed RBCs)
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Symptoms and Signs – Differential Diagnosis of Renal Failure, Postrenal Causes
URETER AND RENAL PELVIS
• Intrinsic obstruction: blood clots; stones; sloughed papillae:
diabetes, sickle cell disease, analgesic nephropathy; inflammatory:
fungus ball
• Extrinsic obstruction: malignant neoplasm, retroperitoneal
fibrosis; iatrogenic: inadvertent ligation of ureters
BLADDER
• Prostatic hypertrophy or malignant neoplasm
• Neuropathic bladder
• Blood clots
• Bladder cancer
• Stones
URETHRAL
• Strictures
• Congenital valves
URETER AND RENAL PELVIS
• Intrinsic obstruction: blood clots; stones; sloughed papillae:
diabetes, sickle cell disease, analgesic nephropathy; inflammatory:
fungus ball
• Extrinsic obstruction: malignant neoplasm, retroperitoneal
fibrosis; iatrogenic: inadvertent ligation of ureters
BLADDER
• Prostatic hypertrophy or malignant neoplasm
• Neuropathic bladder
• Blood clots
• Bladder cancer
• Stones
URETHRAL
• Strictures
• Congenital valves
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Symptoms and Signs – Differential Diagnosis of Renal Failure, Prerenal Causes
DECREASED CARDIAC OUTPUT
• Congestive heart failure (CHF)
• Arrhythmias
• Pericardial constriction or tamponade
• Pulmonary embolism
HYPOVOLEMIA
• GI tract loss (vomiting, diarrhea, nasogastric suction)
• Blood losses (trauma, GI tract surgery)
• Renal losses (diuretics, mineralocorticoid deficiency, postobstructive diuresis)
• Skin losses (burns)
VOLUME REDISTRIBUTION
• Decrease in effective blood volume
• Hypoalbuminemic states (cirrhosis, nephrosis)
• Sequestration of fluid in “third” space (ischemic bowel, peritonitis, pancreatitis)
• Peripheral vasodilation (sepsis, vasodilators, anaphylaxis)
ALTERED RENAL VASCULAR RESISTANCE
• Increase in afferent vascular resistance (nonsteroidal anti-inflammatory drugs [NSAIDs], liver disease, sepsis, hypercalcemia, cyclosporine)
• Decrease in efferent arteriolar tone (angiotensin-converting enzyme [ACE] inhibitors)
DECREASED CARDIAC OUTPUT
• Congestive heart failure (CHF)
• Arrhythmias
• Pericardial constriction or tamponade
• Pulmonary embolism
HYPOVOLEMIA
• GI tract loss (vomiting, diarrhea, nasogastric suction)
• Blood losses (trauma, GI tract surgery)
• Renal losses (diuretics, mineralocorticoid deficiency, postobstructive diuresis)
• Skin losses (burns)
VOLUME REDISTRIBUTION
• Decrease in effective blood volume
• Hypoalbuminemic states (cirrhosis, nephrosis)
• Sequestration of fluid in “third” space (ischemic bowel, peritonitis, pancreatitis)
• Peripheral vasodilation (sepsis, vasodilators, anaphylaxis)
ALTERED RENAL VASCULAR RESISTANCE
• Increase in afferent vascular resistance (nonsteroidal anti-inflammatory drugs [NSAIDs], liver disease, sepsis, hypercalcemia, cyclosporine)
• Decrease in efferent arteriolar tone (angiotensin-converting enzyme [ACE] inhibitors)
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Symptoms and Signs – Differential Diagnosis of Renal Tubular Acidosis
• Diarrhea with significant bicarbonate loss
• Other causes of metabolic acidosis
• Respiratory acidosis
• Diarrhea with significant bicarbonate loss
• Other causes of metabolic acidosis
• Respiratory acidosis
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Symptoms and Signs – Differential Diagnosis of Renal Vein Thrombosis, Causes
• Aortic aneurysm causing compression
• Estrogen therapy
• Lymphadenopathy
• Nephrotic syndrome
• Pregnancy
• Renal cell carcinoma
• Renal cell carcinoma with vein invasion
• Retroperitoneal fibrosis
• Severe dehydration
• Aortic aneurysm causing compression
• Estrogen therapy
• Lymphadenopathy
• Nephrotic syndrome
• Pregnancy
• Renal cell carcinoma
• Renal cell carcinoma with vein invasion
• Retroperitoneal fibrosis
• Severe dehydration
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Symptoms and Signs – Differential Diagnosis of Respiratory Failure, Hypoventilatory
ABNORMAL RESPIRATORY CAPACITY, NORMAL
RESPIRATORY WORKLOADS
• Acute depression of CNS: various causes
• Chronic central hypoventilation syndromes: obesityhypoventilation syndrome, sleep apnea syndrome, hypothyroidism, Shy-Drager syndrome (multisystem atrophy syndrome)
• Acute toxic paralysis syndromes: botulism, tetanus, toxic ingestion or bites, organophosphate poisoning
• Neuromuscular disorders (acute and chronic): myasthenia gravis, Guillain-Barré syndrome, drugs, amyotrophic lateral sclerosis (ALS), muscular dystrophies, polymyositis, spinal cord injury, traumatic phrenic nerve paralysis
ABNORMAL PULMONARY WORKLOADS
• Chronic obstructive pulmonary disease (COPD): chronic bronchitis, asthmatic bronchitis, emphysema
• Asthma and acute bronchial hyperreactivity syndromes
• Upper airway obstruction
• Interstitial lung diseases
ABNORMAL EXTRAPULMONARY WORKLOADS
• Chronic thoracic cage disorders: severe kyphoscoliosis, after thoracoplasty, after thoracic cage injury
• Acute thoracic cage trauma and burns
• Pneumothorax
• Pleural fibrosis and effusions
• Abdominal processes
ABNORMAL RESPIRATORY CAPACITY, NORMAL
RESPIRATORY WORKLOADS
• Acute depression of CNS: various causes
• Chronic central hypoventilation syndromes: obesityhypoventilation syndrome, sleep apnea syndrome, hypothyroidism, Shy-Drager syndrome (multisystem atrophy syndrome)
• Acute toxic paralysis syndromes: botulism, tetanus, toxic ingestion or bites, organophosphate poisoning
• Neuromuscular disorders (acute and chronic): myasthenia gravis, Guillain-Barré syndrome, drugs, amyotrophic lateral sclerosis (ALS), muscular dystrophies, polymyositis, spinal cord injury, traumatic phrenic nerve paralysis
ABNORMAL PULMONARY WORKLOADS
• Chronic obstructive pulmonary disease (COPD): chronic bronchitis, asthmatic bronchitis, emphysema
• Asthma and acute bronchial hyperreactivity syndromes
• Upper airway obstruction
• Interstitial lung diseases
ABNORMAL EXTRAPULMONARY WORKLOADS
• Chronic thoracic cage disorders: severe kyphoscoliosis, after thoracoplasty, after thoracic cage injury
• Acute thoracic cage trauma and burns
• Pneumothorax
• Pleural fibrosis and effusions
• Abdominal processes
