Postpartum thyroiditis physical examination: Difference between revisions

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VisualWikitext

Latest revision as of 17:56, 10 November 2017

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

Vital Signs	Low-grade fever Tachycardia with regular pulse or irregular pulse Tachypnea High blood pressure	Bradycardia with regular pulse Low blood pressure
Skin	Sweating increased Onycholysis Hyperpigmentation Pruritus and hives Vitiligo and alopecia areata Thinning of the hair Pretibial myxedema in co-existing Grave's disease	Sweating decreased Dry skin Hair coarse and brttile Brittle nails Non-pitting edema
HEENT	Stare and lid lag Proptosis Gritty sensation in eyes Lid lag	Icteric sclera Pallor
Abdomen	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	Increased peristaltic movements in patients
Back	Point tenderness over lumbar vertebrae in osteoporosis Costovertebral angle tenderness bilaterally osteoporosis	Point tenderness over lumbar vertebrae in 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 Tremors in the upper and lower extremity	Clubbing in hypothyroid phase Non-pitting edema of the lower extremities in hypothyroid phase Muscle atrophy

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.

Template:WH Template:WS

[pmid10874538-1] Stagnaro-Green A (2000). "Recognizing, understanding, and treating postpartum thyroiditis". Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.

[pmid15157842-2] 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.

[1]

[2]

@@ Line 22: / Line 22: @@
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Vital Signs
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Low-grade fever,[[Tachycardia]] with regular pulse or irregular pulse,[[Tachypnea]], High blood pressure
+* Low-grade fever
+* [[Tachycardia]] with regular pulse or irregular pulse
+* [[Tachypnea]]
+* High blood pressure
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Bradycardia with regular pulse, Low blood pressure
+* [[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: #F5F5F5;" |
-* Sweating increased, [[Onycholysis]], Hyperpigmentation,[[Pruritus]] and hives, [[vitiligo]] and [[alopecia areata]], thinning of the hair, [[peritibial myxedoma]] in co-existing [[Grave's disease]]
+* 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;" |
-* Sweating decreased, Dry skin, Hair coarse and brttile, Brittle nails, [[Nonpitting edema]]
+* 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: #F5F5F5;" |
-* Stare and lid lag, [[proptosis]], Gritty sensation in eyes
+* Stare and lid lag
-* lid lag
+* [[Proptosis]]
+* Gritty sensation in eyes
+* Lid lag
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* [[Icteric sclera]], [[Pallor]]
+* [[Icteric sclera]]
+* [[Pallor]]
 |-
 | 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.
+*[[Abdominal tenderness]] in the right upper abdominal quadrant with autoimmune hepatitis
-*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
+*[[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;" |
 * Increased peristaltic movements in patients
@@ Line 67: / Line 84: @@
 * [[Hyperreflexia]]
 * Proximal muscle weakness
-* Unilateral/bilateral [[tremor]]
+* Unilateral or bilateral [[tremor]]
 * [[Anxiety]], [[restlessness]], irritability, and emotional liability
 |
@@ Line 77: / Line 94: @@
 |                         '''Extremities'''
 |
-* [[Fasciculations]], [[tremors]] in the upper & lower extremity
+* [[Fasciculations]]
+* [[Tremor|Tremors]] in the upper and lower extremity
 |
 * [[Clubbing]] in hypothyroid phase