Hypocalcemia physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hypocalcemia}} | {{Hypocalcemia}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{VKG}} | ||
==Overview== | ==Overview== | ||
The clinical manifestations of hypocalcemia depend on the degree of | The clinical manifestations of [[hypocalcemia]] depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include [[Chvostek's sign]], [[Trousseau's sign]], and circumoral numbness. | ||
==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients with hypocalcemia shows the following | Physical examination of patients with [[hypocalcemia]] shows the following | ||
==== Appearance of the Patient ==== | ==== Appearance of the Patient ==== | ||
* Patients with hypocalcemia usually appear confused,disoriented,fatigue. | * Patients with [[hypocalcemia]] usually appear confused,[[Disorientation|disoriented]],[[fatigue]]. | ||
=== Skin === | === Skin === | ||
* Dry skin | * Dry skin | ||
* Coarse hair | * Coarse hair | ||
* Brittle nails | * [[Brittle nails]] | ||
* Alopecia | * [[Alopecia]] | ||
* Enamel hypoplasia | * [[Enamel]] hypoplasia | ||
* Shortened premolar roots | * Shortened premolar roots | ||
* Thickened lamina dura | * Thickened [[lamina]] dura | ||
* Delayed tooth eruption | * Delayed [[tooth]] eruption | ||
* Increased dental caries | * Increased dental caries | ||
* Atopic eczema | * [[Atopic]] [[eczema]] | ||
* Exfoliative dermatitis | * [[Exfoliative dermatitis|Exfoliative]] dermatitis | ||
* Psoriasis | * [[Psoriasis]] | ||
* Impetigo herpetiformis | * [[Impetigo]] herpetiformis | ||
* | ==== HEENT ==== | ||
* Subcapsular cataracts | |||
* [[Papilledema]] | |||
==== Neuromuscular ==== | |||
* [[Chvostek's sign]]: Elicited by tapping the skin over the facial nerve anterior to the external auditory meatus.<ref name="JesusLandry2012">{{cite journal|last1=Jesus|first1=John Edwin|last2=Landry|first2=Alden|title=Chvostek's and Trousseau's Signs|journal=New England Journal of Medicine|volume=367|issue=11|year=2012|pages=e15|issn=0028-4793|doi=10.1056/NEJMicm1110569}}</ref><ref name="pmid23814758">{{cite journal |vauthors=Mohebbi MR, Rosenkrans KA, Jung MJ |title=Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism |journal=J Clin Diagn Res |volume=7 |issue=5 |pages=970 |date=May 2013 |pmid=23814758 |pmc=3681085 |doi=10.7860/JCDR/2013/5592.2992 |url=}}</ref> | |||
* [[Trousseau's sign]]: Elicited by inflation of a blood pressure cuff to 20 mm Hg above the patient's systolic blood pressure for 3-5 minutes.<ref name="JesusLandry20122">{{cite journal|last1=Jesus|first1=John Edwin|last2=Landry|first2=Alden|title=Chvostek's and Trousseau's Signs|journal=New England Journal of Medicine|volume=367|issue=11|year=2012|pages=e15|issn=0028-4793|doi=10.1056/NEJMicm1110569}}</ref><ref name="pmid238147582">{{cite journal |vauthors=Mohebbi MR, Rosenkrans KA, Jung MJ |title=Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism |journal=J Clin Diagn Res |volume=7 |issue=5 |pages=970 |date=May 2013 |pmid=23814758 |pmc=3681085 |doi=10.7860/JCDR/2013/5592.2992 |url=}}</ref> | |||
* [[Paresthesias]] | |||
* [[Tetany]] | |||
* [[Seizure|Seizures]] (focal, petit mal, grand mal) | |||
* Muscle cramps | |||
* Muscle weakness | |||
* [[Laryngospasm]] | |||
* [[Bronchospasm]] | |||
'''Neurological signs ''' | |||
* [[Extrapyramidal]] signs due to calcification of [[basal ganglia]] | |||
* [[Calcification]] of [[cerebral cortex]] or [[cerebellum]] | |||
* Personality disturbances | |||
* Irritability | |||
* Impaired intellectual ability | |||
* Nonspecific [[EEG]] changes | |||
* Increased [[intracranial pressure]] | |||
* [[Parkinsonism]] | |||
* [[Choreoathetosis]] | |||
* Dystonic spasm | |||
* Confusion | |||
* Disorientation | |||
* [[Psychosis]] | |||
* Fatigue | |||
* Anxiety | |||
* Poor memory | |||
* Reduced concentration | |||
* Confusion | |||
* [[Disorientation]] | |||
* [[Psychosis]] | |||
* Fatigue | |||
* Anxiety | |||
* Poor memory | |||
* Reduced concentration | |||
==== Abdomen ==== | |||
=== | |||
* [[Abdominal pain]] | * [[Abdominal pain]] | ||
* [[Biliary colic]] | * [[Biliary colic]] | ||
==== Lungs ==== | |||
* [[Dyspnea]] | * [[Dyspnea]] | ||
* [[Wheezing]] | * [[Wheezing]] | ||
==== Heart ==== | |||
* Prolonged [[QT interval]] on EKG | |||
* [[Congestive heart failure]] | |||
* [[Cardiomyopathy]] | |||
==References== | ==References== | ||
Latest revision as of 19:08, 16 July 2018
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Hypocalcemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hypocalcemia physical examination On the Web |
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American Roentgen Ray Society Images of Hypocalcemia physical examination |
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Risk calculators and risk factors for Hypocalcemia physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
The clinical manifestations of hypocalcemia depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include Chvostek's sign, Trousseau's sign, and circumoral numbness.
Physical Examination
Physical examination of patients with hypocalcemia shows the following
Appearance of the Patient
- Patients with hypocalcemia usually appear confused,disoriented,fatigue.
Skin
- Dry skin
- Coarse hair
- Brittle nails
- Alopecia
- Enamel hypoplasia
- Shortened premolar roots
- Thickened lamina dura
- Delayed tooth eruption
- Increased dental caries
- Atopic eczema
- Exfoliative dermatitis
- Psoriasis
- Impetigo herpetiformis
HEENT
- Subcapsular cataracts
- Papilledema
Neuromuscular
- Chvostek's sign: Elicited by tapping the skin over the facial nerve anterior to the external auditory meatus.[1][2]
- Trousseau's sign: Elicited by inflation of a blood pressure cuff to 20 mm Hg above the patient's systolic blood pressure for 3-5 minutes.[3][4]
- Paresthesias
- Tetany
- Seizures (focal, petit mal, grand mal)
- Muscle cramps
- Muscle weakness
- Laryngospasm
- Bronchospasm
Neurological signs
- Extrapyramidal signs due to calcification of basal ganglia
- Calcification of cerebral cortex or cerebellum
- Personality disturbances
- Irritability
- Impaired intellectual ability
- Nonspecific EEG changes
- Increased intracranial pressure
- Parkinsonism
- Choreoathetosis
- Dystonic spasm
- Confusion
- Disorientation
- Psychosis
- Fatigue
- Anxiety
- Poor memory
- Reduced concentration
- Confusion
- Disorientation
- Psychosis
- Fatigue
- Anxiety
- Poor memory
- Reduced concentration
Abdomen
Lungs
Heart
- Prolonged QT interval on EKG
- Congestive heart failure
- Cardiomyopathy
References
- ↑ Jesus, John Edwin; Landry, Alden (2012). "Chvostek's and Trousseau's Signs". New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
- ↑ Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). "Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism". J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.
- ↑ Jesus, John Edwin; Landry, Alden (2012). "Chvostek's and Trousseau's Signs". New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
- ↑ Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). "Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism". J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.