Clinical Signs and Symptoms of Renal and Endocrine Pathology
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| Haematuria, dysuria, fever, suprapubic pain, moderate flank or back pain | Urinary tract infection
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| Fever | Prostatitis, pyelonephritis
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| Severe loin pain | Renal calculi
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| Yellow urine | Tetracycline
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| Red urine | Rifampicin, severe muscle breakdown
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| Brown urine | Nitrofurantoin
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| Orange urine | Danthron laxatives
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| Falsely negative urine blood test | Vitamin C intake
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| Nitrites in the urine specimen | Gram negative bacterial infection
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| Leucocytes in the urine specimen | Urine infection or contamination with vaginal secretion
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| Ketones in the urine specimen | DKA, starvation
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| Easily palpable bladder with dullness in suprapubic region | Bladder outlet obstruction
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| Hesitancy, dribbling, strangury and pis-en-deux | Prostatism
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| Leakage of urine during times of exertion | Stress incontinence
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| Overactivity of the detrusor muscle resulting in the intense urge to urinate and leakage of urine. | Urge incontinence
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| Increased frequency, nocturia and leaking of small amounts of urine | Underactivity of the detrusor muscle
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| GFR = 90-120ml/min | Normal GFR
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| GFR > 90ml/min | Stage 1 CKD - normal GFR but some kidney damage
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| GFR = 60-89ml/min | Stage 2 CKD - mild GFR reduction
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| GFR = 30-59ml/min | Stage 3 CKD - moderate GFR reduction
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| GFR = 15-29ml/min | Stage 4 CKD - severe GFR reduction
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| GFR = <15 ml/min | Stage 5 CKD - End stage renal failure
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| Hyperventilation | Metabolic acidosis in late renal failure
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| Hiccuping | Uraemia
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| Myoclonic jerks and tetany | Hypocalcaemia in late renal failure
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| Leuconychia | Hypoalbuminaemia
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| Ecchymoses | Nitrogen retention causing impaired prothrombin consumption.
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| Scratch marks and pruritis | Uraemia and hyperphosphataemia
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| Renal bruit | Renal artery stenosis
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| Carotid bruits | Generalised atherosclerotic disease
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| Costovertebral angle tenderness | Renal infection (perinephric abscess, pyelonephritis, renal calculi)
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| Resonant suprapubic area | Normal
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| 700-2500mls of urine per day | Normal adult urine output
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| Less than 400mls per day | Oliguria
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| Increased frequency with normal volume | High fluid intake, glycosuria, diuretics, defects in urinary concentration, renal disease, diabetes insipidus.
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| Increased frequency with reduced volume | Bladder outlet obstruction, small bladder, urinary tract infection.
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| Perineal pain | Prostatitis, prostadynia, urethral trauma
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| Dysuria | UTI or lower urinary tract trauma
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| Less than 50mls per day | Anuria
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| Abnormal smelling urine | UTI, antibiotics, asparagus
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| Urinary infections/enuresis as a child | Vesicoureteric reflux
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| Elevated JVP | Right sided heart failure caused by fluid overload from renal failure
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| Bilateral pitting oedema | Hypoalbuminaemia or cardiac disease
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| Capillary refill of 2-3 seconds in adults | Normal capillary refill
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| Capillary refill of 2-4 seconds in the elderly | Normal capillary refill
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| Sunken fontanelles | Dehydration
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| Increase of 8-12 bpm | Normal postural increase in heart rate
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| Increase of more than 30bpm | Hypovolaemia
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| A reduction of SBP of at least 20mmHg or diastolic of at least 10mmHg. | Orthostatic hypotension
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| A systolic reduction of 3-4mmHg when standing | Normal
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| A diastolic increase of 3-7mmHg when standing | Normal
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| Waist:hip of 1.0 | Increased risk for men
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| Waist:hip of 0.85 | Increased risk for women
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| Waist circumference of 94cm | Increased risk for men
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| Waist circumference of 80cm | Increased risk for women
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| Waist circumference of 102cm | Greatly increased risk for men
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| Waist circumference of 88cm | Greatly increased risk for women
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| Polyuria, polydipsia, hyperglycaemia, Kussmaul respiration (laboured and deep), abdominal pain, nausea and vomiting. | Diabetic ketoacidosis
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| Severe dehydration, decreased mental function, sensory or motor impairments, increased risk of thrombosis, highly elevated BG. | Hyperosmolar, Hypertonic State
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| Weakness, lethargy, tremors, morning headaches, irritability, dizziness, hunger, sweating, numbness around the lips and fingers. | Hypoglycaemia
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| Bronze diabetes and haemochromatosis | Deposition of iron in the pancreas
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| Charcot's joints | Diabetic neuropathic arthropathy
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| Symmetrical plaques on the shins with a yellow appearance and waxy feel in diabetic patients | Necrobiosis lipoidica
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| Increased appetite with weight loss | Hyperthyroidism or uncontrolled diabetes mellitus
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| Increased appetite with weight gain | Cushing's syndrome
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| Decreased appetite with weight loss | Adrenal insufficiency or Addison's disease
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| Decreased appetite with weight gain | Hypothyroidism
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| Constipation | Hypothyroidism, hypercalcaemia
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| Diarrhoea | Hyperthyroidism, adrenal insufficiency
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| Hirsutism | Excess androgens in females
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| Loss of axillary and pubic hair in females and males | Decrease in adrenal androgens caused by hypogonadism, hypopituitism or adrenal insufficiency
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| Lethargy | Hypothyroidism, Addison's disease, diabetes mellitus
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| Xanthelasma | Hypothyroidism, diabetes mellitus
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| Coarse,pale and dry skin | Hypothyroidism
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| Spontaneous ecchymoses and purple striae | Cushing's syndrome
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| Onycholysis and pretibial myxoedema | Graves' disease
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| Dry and scaly skin | Hyperparathyroidism
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| Acanthosis nigricans | Insulin resistant states - Cushing's syndrome, diabetes mellitus, acromegaly
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| Increased pigmentation | Adrenal insuffiency, acromegaly, cushing's disease (excess ACTH)
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| Decreased pigmentation | Hypopituitism
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| Vitligo | Autoimmune conditions such as Hashimoto's disease and Addison's disease as well as hypothyroidism
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| Impotence | Primary hypogonadism, diabetes mellitus, hyperprolactinaemia, hypopituitism, thiazide diuretics, beta blockers
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| Amenorrhoea | Hyperthyroidism, excess androgen production, pituitary dysfunction
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| Menorrhagia | Hypothyroidism
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| Carpal tunnel syndrome | Acromegaly, hypothyroidism
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| Increased sweating | Hyperthyroidism, phaeochromocytoma, hypoglycaemia or acromegaly
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| Exophthalmos | >18 mm, specific to Graves' disease
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| Proptosis | <18mm, specific to Graves' disease
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| Lid lag and lid retraction | Signs of hyperthyroidism not specific to Graves' disease
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| Pallor of the palmar creases and peripheral neuropathy | Hypothyroidism - due to vitamin B12 deficiency
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| Systolic murmurs | Hyperthyroidism
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| Pericardial effusion and pleural effusion | Hypothyroidism
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| Dull percussion of upper manubrium | Retrosternal goitre
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| Soft thyroid | Normal
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| Firm goitre | Simple goitre
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| Rubbery hard goitre | Hashimoto's thyroiditis
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| Stony hard goitre | Carcinoma, calcification in a cyst, fibrosis or Riedel's thyroiditis
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| Neck lump rises during swallowing | Goitre or thyroglossal cyst
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| Neck lump moves upwards if the patient pokes their tongue out | Thyroglossal cyst
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| Thyroid bruits | Hyperthyroidism
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| Hung up ankle reflex | Hypothyroidism
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| Non-pitting ankle oedema | Hypothyroidism
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| Chvostek's and Trousseau's sign | Hypocalcaemia
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| T10-T11 | Renal colic
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| T11-L1 | Ureteric pain
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| Reduced visual field and headache | Acromegaly
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| Hepatomegaly, splenomegaly and renal enlargement | Acromegaly
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| Yellow skin | Hypercarotenaemia in hypothyroidism
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| Galactorrhoea | Hyperprolactinaemia
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| Tapping gently over the 7th cranial nerve results in tetany | Hypocalcaemia
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| Virilisation | The appearance of male secondary sexual characteristics due to excessive androgens
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