Hypercalcemia physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hypercalcemia}} | {{Hypercalcemia}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{Anmol}} | ||
{{ | |||
==Overview== | ==Overview== | ||
Physical examination of patients with hypercalcemia is usually unremarkable. Patients may have physical findings due to severe [[hypercalcemia]] and other complications. | |||
==Physical Examination== | ==Physical Examination== | ||
=== | *Physical examination of patients with hypercalcemia is usually unremarkable.<ref name="pmid21321169">{{cite journal |vauthors=Pallan S, Khan A |title=Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care |journal=Can Fam Physician |volume=57 |issue=2 |pages=184–9 |year=2011 |pmid=21321169 |pmc=3038812 |doi= |url=}}</ref> | ||
* | *Patients may have physical findings due to severe [[hypercalcemia]] and other complication.<ref name="pmid11350446">{{cite journal |vauthors=Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J |title=Unique clinical characteristics of primary hyperparathyroidism in India |journal=Br J Surg |volume=88 |issue=5 |pages=708–14 |year=2001 |pmid=11350446 |doi=10.1046/j.0007-1323.2001.01775.x |url=}}</ref> | ||
* [[ | |||
* [[ | ===Appearance of the Patient=== | ||
* [[Coma]] | *Patients with hypercalcaemia usually appear well. | ||
===Vital Signs=== | |||
*[[High blood pressure]] due to [[hypercalcemia]] and [[renal failure]] | |||
===Skin=== | |||
*Persistent [[itching]] may be present due to [[renal failure]] | |||
===HEENT=== | |||
* [[Band keratopathy]] ([[calcium]] precipitation in a horizontal band across the [[cornea]] in the palpebral aperture); may lead to [[Visual impairment|vision impairment]] | |||
===Lungs=== | |||
*[[Dyspnea]] due to [[fluid overload]] form [[renal failure]] | |||
===Cardiovasvular=== | |||
*[[Palpitation|Palpitations]] due to [[arrhythmias]] | |||
*[[Chest pain]] due to [[fluid overload]] form [[renal failure]] | |||
*[[Rales]] and [[S3]] due to [[fluid overload]] form [[renal failure]] | |||
===Abdomen=== | |||
*[[Nausea and vomiting]] | |||
*[[Anorexia]] | |||
*[[Fecal impaction]] (from [[constipation]]) | |||
*[[Epigastric pain]] and [[tenderness]] due to development of [[pancreatitis]] | |||
*[[Flank pain]] and [[tenderness]] due to [[nephrolithiasis]] | |||
===Genitourinary=== | |||
*Alteration in [[urinary]] habits | |||
*[[Volume depletion]] | |||
*Signs of [[renal failure]] | |||
===Neuromuscular=== | |||
*Patient is usually oriented to persons, place, and time. | |||
*Patients with severe [[hypercalcemia]] and other complications may have: | |||
**[[Anxiety]] | |||
**[[Fatigue]] and [[weakness]] due to [[renal failure]] | |||
**[[Lethargy]] | |||
**[[Sleep disturbances]] | |||
**[[Muscle twitch]] and [[cramps]] | |||
**Signs of [[depression]] | |||
**[[Confusion]] | |||
**[[Memory]] disturbances | |||
**[[Hypotonia]] | |||
**[[Hyporeflexia]] | |||
**[[Paresis]] | |||
**[[Coma]] | |||
===Extremities=== | ===Extremities=== | ||
* [[ | *Swelling of feet and [[Ankle|ankles]] due to [[renal failure]] | ||
*[[Arthralgia]] due to bone [[resorption]] | |||
* | |||
==References== | ==References== | ||
Latest revision as of 14:09, 6 July 2018
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American Roentgen Ray Society Images of Hypercalcemia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
Physical examination of patients with hypercalcemia is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications.
Physical Examination
- Physical examination of patients with hypercalcemia is usually unremarkable.[1]
- Patients may have physical findings due to severe hypercalcemia and other complication.[2]
Appearance of the Patient
- Patients with hypercalcaemia usually appear well.
Vital Signs
- High blood pressure due to hypercalcemia and renal failure
Skin
- Persistent itching may be present due to renal failure
HEENT
- Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairment
Lungs
- Dyspnea due to fluid overload form renal failure
Cardiovasvular
- Palpitations due to arrhythmias
- Chest pain due to fluid overload form renal failure
- Rales and S3 due to fluid overload form renal failure
Abdomen
- Nausea and vomiting
- Anorexia
- Fecal impaction (from constipation)
- Epigastric pain and tenderness due to development of pancreatitis
- Flank pain and tenderness due to nephrolithiasis
Genitourinary
- Alteration in urinary habits
- Volume depletion
- Signs of renal failure
Neuromuscular
- Patient is usually oriented to persons, place, and time.
- Patients with severe hypercalcemia and other complications may have:
- Anxiety
- Fatigue and weakness due to renal failure
- Lethargy
- Sleep disturbances
- Muscle twitch and cramps
- Signs of depression
- Confusion
- Memory disturbances
- Hypotonia
- Hyporeflexia
- Paresis
- Coma
Extremities
- Swelling of feet and ankles due to renal failure
- Arthralgia due to bone resorption
References
- ↑ Pallan S, Khan A (2011). "Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care". Can Fam Physician. 57 (2): 184–9. PMC 3038812. PMID 21321169.
- ↑ Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J (2001). "Unique clinical characteristics of primary hyperparathyroidism in India". Br J Surg. 88 (5): 708–14. doi:10.1046/j.0007-1323.2001.01775.x. PMID 11350446.