Postpartum thyroiditis physical examination: Difference between revisions
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{{Postpartum thyroiditis}} | {{Postpartum thyroiditis}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{SKA}} | ||
==Overview== | ==Overview== | ||
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period | The presence of signs of [[hyperthyroidism]] or [[hypothyroidism]] in postpartum period on physical examination is highly suggestive of [[Postpartum thyroiditis|PPT.]] | ||
==Physical Examination== | ==Physical Examination== | ||
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT. | The presence of signs of [[hyperthyroidism]] or [[hypothyroidism]] in postpartum period on physical examination is highly suggestive of PPT. | ||
<ref name="pmid10874538">{{cite journal| author=Stagnaro-Green A| title=Recognizing, understanding, and treating postpartum thyroiditis. | journal=Endocrinol Metab Clin North Am | year= 2000 | volume= 29 | issue= 2 | pages= 417-30, ix | pmid=10874538 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10874538 }} </ref> | |||
<ref name="pmid15157842">{{cite journal| author=Stagnaro-Green A| title=Postpartum thyroiditis. | journal=Best Pract Res Clin Endocrinol Metab | year= 2004 | volume= 18 | issue= 2 | pages= 303-16 | pmid=15157842 | doi=10.1016/j.beem.2004.03.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15157842 }} </ref> | |||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with PPT usually appear tired or irritable depend of the phase of disease. | *Patients with PPT usually appear tired or irritable depend of the phase of disease. | ||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center" | |||
===Vital Signs= | | valign="top" | | ||
|+ | |||
*Low-grade fever | ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Systems involved}} | ||
*[[Tachycardia]] with regular pulse | ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Hyperthyroidism}} | ||
*[[ | ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Hypothyroidism}} | ||
|- | |||
*High blood pressure with | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Vital Signs | ||
*Low blood pressure | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Low-grade fever | |||
= | * [[Tachycardia]] with regular pulse or irregular pulse | ||
* [[Tachypnea]] | |||
* High blood pressure | |||
Sweating increased | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Bradycardia]] with regular pulse | |||
Onycholysis | * Low blood pressure | ||
|- | |||
Hyperpigmentation | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Skin | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Pruritus and hives | * Sweating increased | ||
* [[Onycholysis]] | |||
Vitiligo and alopecia areata | * Hyperpigmentation | ||
* [[Pruritus]] and hives | |||
Thinning of the hair | * Vitiligo and [[alopecia areata]] | ||
* Thinning of the hair | |||
* Pretibial myxedema in co-existing [[Grave's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
* Sweating decreased | |||
* Dry skin | |||
Sweating decreased | * Hair coarse and brttile | ||
* Brittle nails | |||
Dry skin | * [[Nonpitting edema|Non-pitting edema]] | ||
|- | |||
Hair coarse and brttile | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |HEENT | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
Brittle nails | * Stare and lid lag | ||
* [[Proptosis]] | |||
Nonpitting edema | * Gritty sensation in eyes | ||
* Lid lag | |||
= | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Icteric sclera]] | |||
* [[Pallor]] | |||
Stare and lid lag | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Abdomen | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
* [[Abdominal distention]] in patients with [[constipation]] | |||
*[[Abdominal tenderness]] in the right upper abdominal quadrant with autoimmune hepatitis | |||
*[[Hepatomegaly]] or [[splenomegaly]] or [[hepatosplenomegaly]] | |||
*Dull note on [[percussion]] in [[peritoneal effusion]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
* Increased peristaltic movements in patients | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Back | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Point tenderness over lumbar vertebrae in [[osteoporosis]] | |||
* | *Costovertebral angle tenderness bilaterally [[osteoporosis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
* Point tenderness over lumbar vertebrae in [[osteoporosis]] | |||
* | *Costovertebral angle tenderness bilaterally [[osteoporosis]] | ||
* | |- | ||
| '''Genitourinary''' | |||
* | | | ||
* Urinary frequency | |||
* Menstrual irregularities | |||
* | | | ||
* Menstrual irregularities | |||
= | |- | ||
*[[Abdominal distention]] in patients with constipation | | '''CNS''' | ||
*[[Abdominal tenderness]] in the right upper abdominal quadrant with autoimmune hepatitis | | | ||
*[[Hepatomegaly]] | * [[Hyperreflexia]] | ||
*Dull note on percussion in peritoneal effusion | * Proximal muscle weakness | ||
*Increased peristaltic movements in patients | * Unilateral or bilateral [[tremor]] | ||
* [[Anxiety]], [[restlessness]], irritability, and emotional liability | |||
= | | | ||
*Point tenderness over | * [[Hyporeflexia]] | ||
*Costovertebral angle tenderness bilaterally osteoporosis in | * Proximal muscle weakness | ||
* low mood, [[depression]] | |||
* [[Carpal tunnel syndrome]] | |||
*Urinary frequency | |- | ||
*Menstrual irregularities | | '''Extremities''' | ||
| | |||
* [[Fasciculations]] | |||
* [[Tremor|Tremors]] in the upper and lower extremity | |||
* Hyperreflexia | | | ||
* [[Clubbing]] in hypothyroid phase | |||
* Proximal muscle weakness | * Non-pitting [[edema]] of the lower extremities in [[hypothyroid]] phase | ||
* [[Muscle atrophy]] | |||
*Unilateral | |} | ||
* | |||
* | |||
* | |||
* | |||
*Carpal tunnel syndrome | |||
* | |||
*[[Clubbing]] in hypothyroid phase | |||
*Non-pitting [[edema]] of the lower extremities in hypothyroid phase | |||
*Muscle atrophy | |||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: | [[Category: Endocrinology]] |
Latest revision as of 17:56, 10 November 2017
Postpartum thyroiditis Microchapters |
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Treatment |
Case Studies |
Postpartum thyroiditis physical examination On the Web |
American Roentgen Ray Society Images of Postpartum thyroiditis physical examination |
Risk calculators and risk factors for Postpartum thyroiditis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT.
Physical Examination
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT. [1] [2]
Appearance of the Patient
- Patients with PPT usually appear tired or irritable depend of the phase of disease.
Systems involved | Hyperthyroidism | Hypothyroidism |
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Vital Signs |
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Skin |
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HEENT |
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Abdomen |
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Back |
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Genitourinary |
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CNS |
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Extremities |
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References
- ↑ Stagnaro-Green A (2000). "Recognizing, understanding, and treating postpartum thyroiditis". Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.
- ↑ Stagnaro-Green A (2004). "Postpartum thyroiditis". Best Pract Res Clin Endocrinol Metab. 18 (2): 303–16. doi:10.1016/j.beem.2004.03.008. PMID 15157842.