Hyperparathyroidism physical examination

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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 hyperparathyroidism is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.

Physical Examination

• Physical examination of patients with hyperparathyroidism is usually unremarkable.
• Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.

Appearance of the Patient

• Patients with hyperparathyroidism usually appear well.

Vital Signs

• Patients with hypercalcemia and other complications may have:
  • High blood pressure due to hypercalcemia and renal failure

Skin

• Persistent itching may be present due to renal failure

HEENT

• Patients with severe hypercalcemia may have:
  • Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairment

Lungs

• Patients with hypercalcemia and other complications may have:
  • Dyspnea due to fluid overload form renal failure

Cardiovasvular

• Patients with hypercalcemia and other complications may have:
  • Palpitations due to arrhythmias
  • Shortened QT interval
  • Chest pain due to fluid overload form renal failure
  • Rales and S3 due to fluid overload form renal failure

Abdomen

• Patients with hypercalcemia and other complications may have:
  • 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

• Patients with severe hypercalcemia and other complications may have:
  • 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