Hypoglycemia physical examination: Difference between revisions
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===Appearance=== | ===Appearance=== | ||
* [[Macrosomia]] in [[infancy]] may indicate [[congenital hyperinsulinism|hyperinsulinism]]. | * [[Macrosomia]] in [[infancy]] may indicate [[congenital hyperinsulinism|hyperinsulinism]].<ref name="pmid24685363">{{cite journal| author=Brutsaert E, Carey M, Zonszein J| title=The clinical impact of inpatient hypoglycemia. | journal=J Diabetes Complications | year= 2014 | volume= 28 | issue= 4 | pages= 565-72 | pmid=24685363 | doi=10.1016/j.jdiacomp.2014.03.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24685363 }}</ref> | ||
* 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|stroke-like]] effects or a hard-to-define [[malaise]]. The symptoms of a single person do tend to be similar from episode to episode. | * 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|stroke-like]] effects or a hard-to-define [[malaise]]. The symptoms of a single person do tend to be similar from episode to episode. | ||
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*[[Cyanosis]] may be present in newborns | *[[Cyanosis]] may be present in newborns | ||
=== Neurologic <ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155 }}</ref> | === Neurologic === | ||
* [[Mental status]] may be altered<ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155 }}</ref> | |||
*[[Myoclonus]] | *[[Myoclonus]] | ||
*[[Hypotonia]] | *[[Hypotonia]] | ||
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=== Neonatal Physical examination === | === Neonatal Physical examination === | ||
* [[Large for gestational age]] | * [[Large for gestational age]]<ref name="pmid24685363" /> | ||
* [[Beckwith-Wiedemann syndrome]] signs: [[hemihypertrophy]], [[hepatomegaly]] and [[macroglossia]] | * [[Beckwith-Wiedemann syndrome]] signs: [[hemihypertrophy]], [[hepatomegaly]] and [[macroglossia]] | ||
* [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]] | * [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]] | ||
Revision as of 14:27, 2 October 2017
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Hypoglycemia Microchapters |
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Hypoglycemia physical examination On the Web |
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American Roentgen Ray Society Images of Hypoglycemia physical examination |
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Risk calculators and risk factors for Hypoglycemia physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Main signs of hypoglycemia are tachycardia and ventricular arrhythmia. Neurological manifestations include altered mental status, hypotonia, focal or general motor deficit and jerks. Neonatal hypoglycemia signs include large for gestational age, hepatomegaly in Beckwith-Wiedemann syndrome and glycogen storage diseases. Ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia are found in congenital adrenal insufficiency.
Physical examination
Appearance
- Macrosomia in infancy may indicate hyperinsulinism.[1]
- 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.
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 occurred.[2]
Respiration
Skin
Eyes
- Staring, "glassy" look
- Dilated pupils
Extremities
- Cyanosis may be present in newborns
Neurologic
- Mental status may be altered[3]
- Myoclonus
- Hypotonia
- Ataxia
- Incoordination
- Focal or general motor deficit
- Paralysis
- Hemiparesis
Neonatal Physical examination
- Large for gestational age[1]
- 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
- ↑ 1.0 1.1 Brutsaert E, Carey M, Zonszein J (2014). "The clinical impact of inpatient hypoglycemia". J Diabetes Complications. 28 (4): 565–72. doi:10.1016/j.jdiacomp.2014.03.002. PMID 24685363.
- ↑ 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.
- ↑ 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.