Immune Thrombocytopenia physical examination: Difference between revisions

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__NOTOC__
__NOTOC__
{{Xyz}}
{{Immune Thrombocytopenia}}
{{CMG}}; {{AE}} {{Maryam}}
 
==Overview==
Physical examination of patients with immune thrombocytopenia is usually remarkable for mucocutaneous lesions, splenomegaly , and constitutional symptoms ( fever, lymphadenopathy, weight loss and hepatomegaly indicate for HIV, SLE or lymphoproliferative disorder.


{{CMG}}; {{AE}}


==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].


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OR
OR


Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Physical examination of patients with immune thrombocytopenia is usually remarkable for mucocutaneous lesions, splenomegaly , and constitutional symptoms ( fever, lymphadenopathy, weight loss and hepatomegaly indicate for HIV, SLE or lymphoproliferative disorder.<ref name="pmiddoi.org/10.1182/blood-2009-06-225565">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=doi.org/10.1182/blood-2009-06-225565 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }}</ref>


OR
OR
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===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
 
*Patients with [disease name] usually appear [general appearance].


===Vital Signs===
===Vital Signs===
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===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
 
*Skin examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Cyanosis]]  
 
*[[Cyanosis]]
*[[Jaundice]]
*[[Jaundice]]
* [[Pallor]]
*[[Pallor]]
* Bruises
*Bruises


<gallery widths="150px">
<gallery widths="150px">
File:UploadedImage-01.jpg| Description {{dermref}}
File:UploadedImage-02.jpg| Description {{dermref}}
</gallery>


UploadedImage-01.jpg | Description {{dermref}}
===HEENT===
UploadedImage-02.jpg | Description {{dermref}}


</gallery>
*HEENT examination of patients with [disease name] is usually normal.


===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
OR
OR
* Abnormalities of the head/hair may include ___
 
* Evidence of trauma
*Abnormalities of the head/hair may include ___
* Icteric sclera  
*Evidence of trauma
* [[Nystagmus]]  
*Icteric sclera
* Extra-ocular movements may be abnormal
*[[Nystagmus]]
*Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
*[[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
*[[Purulent]] exudate from the nares
* Facial tenderness
*Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
*Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae


===Neck===
===Neck===
* Neck examination of patients with [disease name] is usually normal.
 
*Neck examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Jugular venous distension]]
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
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===Lungs===
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
 
*Pulmonary examination of patients with [disease name] is usually normal.
 
OR
OR
* Asymmetric chest expansion OR decreased chest expansion
 
*Asymmetric chest expansion OR decreased chest expansion
*Lungs are hyporesonant OR hyperresonant
*Lungs are hyporesonant OR hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
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===Heart===
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
 
*Cardiovascular examination of patients with [disease name] is usually normal.
 
OR
OR
*Chest tenderness upon palpation
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
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===Abdomen===
===Abdomen===
* Abdominal examination of patients with [disease name] is usually normal.
 
*Abdominal examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Abdominal distension]]  
 
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant  
*[[Abdominal distension]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
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===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
 
*Back examination of patients with [disease name] is usually normal.
 
OR
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Sacral edema
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===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
 
*Genitourinary examination of patients with [disease name] is usually normal.
 
OR
OR
*A pelvic/adnexal mass may be palpated
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Inflamed mucosa
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===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
 
*Neuromuscular examination of patients with [disease name] is usually normal.
 
OR
OR
*Patient is usually oriented to persons, place, and time
*Patient is usually oriented to persons, place, and time
* Altered mental status
*Altered mental status
* Glasgow coma scale is ___ / 15
*Glasgow coma scale is ___ / 15
* Clonus may be present
*Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
*Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
*Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
*Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
*Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Unilateral/bilateral sensory loss in the upper/lower extremity
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===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
 
*Extremities examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Clubbing]]  
 
*[[Cyanosis]]  
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Muscle atrophy

Latest revision as of 14:48, 8 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maryam Barkhordarian, M.D.[2]

Overview

Physical examination of patients with immune thrombocytopenia is usually remarkable for mucocutaneous lesions, splenomegaly , and constitutional symptoms ( fever, lymphadenopathy, weight loss and hepatomegaly indicate for HIV, SLE or lymphoproliferative disorder.


Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

Physical examination of patients with [disease name] is usually normal.

OR

Physical examination of patients with immune thrombocytopenia is usually remarkable for mucocutaneous lesions, splenomegaly , and constitutional symptoms ( fever, lymphadenopathy, weight loss and hepatomegaly indicate for HIV, SLE or lymphoproliferative disorder.[1]

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

  • Patients with [disease name] usually appear [general appearance].

Vital Signs

  • High-grade / low-grade fever
  • Hypothermia / hyperthermia may be present
  • Tachycardia with regular pulse or (ir)regularly irregular pulse
  • Bradycardia with regular pulse or (ir)regularly irregular pulse
  • Tachypnea / bradypnea
  • Kussmal respirations may be present in _____ (advanced disease state)
  • Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
  • High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure

Skin

  • Skin examination of patients with [disease name] is usually normal.

OR

HEENT

  • HEENT examination of patients with [disease name] is usually normal.

OR

  • Abnormalities of the head/hair may include ___
  • Evidence of trauma
  • Icteric sclera
  • Nystagmus
  • Extra-ocular movements may be abnormal
  • Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
  • Ophthalmoscopic exam may be abnormal with findings of ___
  • Hearing acuity may be reduced
  • Weber test may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
  • Rinne test may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
  • Exudate from the ear canal
  • Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
  • Inflamed nares / congested nares
  • Purulent exudate from the nares
  • Facial tenderness
  • Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae

Neck

  • Neck examination of patients with [disease name] is usually normal.

OR

Lungs

  • Pulmonary examination of patients with [disease name] is usually normal.

OR

  • Asymmetric chest expansion OR decreased chest expansion
  • Lungs are hyporesonant OR hyperresonant
  • Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
  • Rhonchi
  • Vesicular breath sounds OR distant breath sounds
  • Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
  • Wheezing may be present
  • Egophony present/absent
  • Bronchophony present/absent
  • Normal/reduced tactile fremitus

Heart

  • Cardiovascular examination of patients with [disease name] is usually normal.

OR

  • Chest tenderness upon palpation
  • PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
  • Heave / thrill
  • Friction rub
  • S1
  • S2
  • S3
  • S4
  • Gallops
  • A high/low grade early/late systolic murmur / diastolic murmur best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope

Abdomen

  • Abdominal examination of patients with [disease name] is usually normal.

OR

Back

  • Back examination of patients with [disease name] is usually normal.

OR

  • Point tenderness over __ vertebrae (e.g. L3-L4)
  • Sacral edema
  • Costovertebral angle tenderness bilaterally/unilaterally
  • Buffalo hump

Genitourinary

  • Genitourinary examination of patients with [disease name] is usually normal.

OR

  • A pelvic/adnexal mass may be palpated
  • Inflamed mucosa
  • Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

  • Neuromuscular examination of patients with [disease name] is usually normal.

OR

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is ___ / 15
  • Clonus may be present
  • Hyperreflexia / hyporeflexia / areflexia
  • Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally/bilaterally
  • ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
  • Unilateral/bilateral upper/lower extremity weakness
  • Unilateral/bilateral sensory loss in the upper/lower extremity
  • Positive straight leg raise test
  • Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
  • Positive/negative Trendelenburg sign
  • Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
  • Normal finger-to-nose test / Dysmetria
  • Absent/present dysdiadochokinesia (palm tapping test)

Extremities

  • Extremities examination of patients with [disease name] is usually normal.

OR

  • Clubbing
  • Cyanosis
  • Pitting/non-pitting edema of the upper/lower extremities
  • Muscle atrophy
  • Fasciculations in the upper/lower extremity

References

  1. ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes" Check |url= value (help). Biochem Pharmacol. 24 (17): 1639–41. PMID doi.org/10.1182/blood-2009-06-225565 Check |pmid= value (help).

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