Hypoglycemia physical examination: Difference between revisions
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===Extremities=== | ===Extremities=== | ||
*[[Cyanosis]] may be present in newborns | *[[Cyanosis]] may be present in newborns | ||
=== Signs in neonatal hypoglycemia === | |||
* Large for gestational age | |||
* Beckwith-Wiedemann syndrome signs: hemihypertrophy, hepatomegaly and macroglossia. | |||
* Congenital adrenal insufficiency: ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia. | |||
* Congenital hypopituitarism: Midline facial defects and micropenis. | |||
* Glycogen storage diseases: Hepatomegaly. | |||
== References == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 18:37, 18 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Mohammed Abdelwahed M.D[2]
Overview
Main signs of hypoglycemia are attacks of diaphoresis, tachycarida, tachypnea, hypertension, hypothermia and neurological deficits.
Physical examination
Appearance
- Macrosomia in infancy usually indicates hyperinsulinism.
- In older children and adults, moderately severe hypoglycemia can resemble mania, mental illness, drug intoxication, or drunkenness. In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise. The symptoms of a single person do tend to be similar from episode to episode.
Neurologic [1]
- Mental status may be altered
- Myoclonic jerks
- Hypotonia
- Ataxia
- Incoordination
- Focal or general motor deficit
- Paralysis
- Hemiparesis
Vitals
Temperature
- Hypothermia may be present in newborns
Pulse
- Rate: Tachycardia may be present.
- Rhythm: The pulse is usually regular
- Ventricular arrhythmia is fatal if occured.[2]
Respiration
- Abnormal breathing may be present
Skin
Eyes
- Staring, "glassy" look
- Dilated pupils
Extremities
- Cyanosis may be present in newborns
Signs in neonatal hypoglycemia
- Large for gestational age
- Beckwith-Wiedemann syndrome signs: hemihypertrophy, hepatomegaly and macroglossia.
- Congenital adrenal insufficiency: ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia.
- Congenital hypopituitarism: Midline facial defects and micropenis.
- Glycogen storage diseases: Hepatomegaly.
References
- ↑ Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER; et al. (2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
- ↑ Cryer PE (2007). "Hypoglycemia, functional brain failure, and brain death". J Clin Invest. 117 (4): 868–70. doi:10.1172/JCI31669. PMC 1838950. PMID 17404614.