Hypoaldosteronism physical examination: Difference between revisions

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* Pigmented skin and mucous membranes - darkening ([[hyperpigmentation]]) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
* Pigmented skin and mucous membranes - darkening ([[hyperpigmentation]]) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
* Absence of axillary and pubic hair in females as a result of loss of adrenal [[androgens]]
* Absence of axillary and pubic hair in females as a result of loss of adrenal [[androgens]]
===Neck===
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Heart===
===Heart===

Revision as of 17:56, 29 August 2017

Hypoaldosteronism Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoaldosteronism from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

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

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].

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 hypoaldosteronism is usually unremarkable, unless there is severe hyperkalemia. The physical findings, if present, represents underlying conditions such as chronic kidney disease and diabetic nephropathy. Increased level of serum potassium level may present with muscle weakness and cardiac arrhythmias.

Appearance of the Patient

  • Patients with hypoaldosteronism usually appear fatigued.

Vital Signs

Skin

If hypoaldosteronism is from addison's disease, change in skin and hair may be observed such as:

  • Pigmented skin and mucous membranes - darkening (hyperpigmentation) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
  • Absence of axillary and pubic hair in females as a result of loss of adrenal androgens

Heart

  • 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 otoscope

Abdomen

Back

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

Genitourinary

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

Neuromuscular

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Hyperreflexia / hyporeflexia / areflexia

Extremities

  • Muscle weakness
  • Muscle tenderness
  • Depressed deep tendon reflexes

References

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