Postpartum thyroiditis physical examination: Difference between revisions
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==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=== | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Vital Signs | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Vital Signs | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Low-grade fever | * Low-grade fever | ||
* [[Tachycardia]] with regular pulse or irregular pulse | |||
* [[Tachypnea]] | |||
* High blood pressure | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Bradycardia with regular pulse | * [[Bradycardia]] with regular pulse | ||
* Low blood pressure | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Skin | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Skin | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Sweating increased | * Sweating increased | ||
* [[Onycholysis]] | |||
* Hyperpigmentation | |||
* [[Pruritus]] and hives | |||
* Vitiligo and [[alopecia areata]] | |||
* Thinning of the hair | |||
* Pretibial myxedema in co-existing [[Grave's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Sweating decreased | * Sweating decreased | ||
* Dry skin | |||
* Hair coarse and brttile | |||
* Brittle nails | |||
* [[Nonpitting edema|Non-pitting edema]] | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |HEENT | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |HEENT | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Stare and lid lag | * Stare and lid lag | ||
* [[Proptosis]] | |||
* Gritty sensation in eyes | |||
* Lid lag | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Icteric sclera | * [[Icteric sclera]] | ||
* [[Pallor]] | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Abdomen | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Abdomen | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Abdominal distention]] in patients with constipation | * [[Abdominal distention]] in patients with [[constipation]] | ||
*[[Abdominal tenderness]] in the right upper abdominal quadrant with autoimmune hepatitis | *[[Abdominal tenderness]] in the right upper abdominal quadrant with autoimmune hepatitis | ||
*[[Hepatomegaly]] | *[[Hepatomegaly]] or [[splenomegaly]] or [[hepatosplenomegaly]] | ||
*Dull note on percussion in peritoneal effusion | *Dull note on [[percussion]] in [[peritoneal effusion]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Increased peristaltic movements in patients | * Increased peristaltic movements in patients | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Back | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Back | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Point tenderness over | *Point tenderness over lumbar vertebrae in [[osteoporosis]] | ||
*Costovertebral angle tenderness bilaterally [[osteoporosis]] | *Costovertebral angle tenderness bilaterally [[osteoporosis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Point tenderness over | * Point tenderness over lumbar vertebrae in [[osteoporosis]] | ||
*Costovertebral angle tenderness bilaterally [[osteoporosis]] | *Costovertebral angle tenderness bilaterally [[osteoporosis]] | ||
|- | |||
| '''Genitourinary''' | |||
| | |||
* Urinary frequency | |||
* Menstrual irregularities | |||
| | |||
* Menstrual irregularities | |||
|- | |||
| '''CNS''' | |||
| | |||
* [[Hyperreflexia]] | |||
* Proximal muscle weakness | |||
* Unilateral or bilateral [[tremor]] | |||
* [[Anxiety]], [[restlessness]], irritability, and emotional liability | |||
| | |||
* [[Hyporeflexia]] | |||
* Proximal muscle weakness | |||
* low mood, [[depression]] | |||
* [[Carpal tunnel syndrome]] | |||
|- | |||
| '''Extremities''' | |||
| | |||
* [[Fasciculations]] | |||
* [[Tremor|Tremors]] in the upper and lower extremity | |||
| | |||
* [[Clubbing]] in hypothyroid phase | |||
* Non-pitting [[edema]] of the lower extremities in [[hypothyroid]] phase | |||
* [[Muscle atrophy]] | |||
|} | |} | ||
==References== | ==References== |
Latest revision as of 17:56, 10 November 2017
Postpartum thyroiditis Microchapters |
Diagnosis |
---|
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.