Familial hypocalciuric hypercalcemia physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
*Physical examination of patients with | *Physical examination of patients with FHH is usually unremarkable.<ref name="pmid21321169">{{cite journal |vauthors=Pallan S, Khan A |title=Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care |journal=Can Fam Physician |volume=57 |issue=2 |pages=184–9 |year=2011 |pmid=21321169 |pmc=3038812 |doi= |url=}}</ref> | ||
*Patients may have physical findings due to | *Patients may have physical examination findings due to [[hypercalcemia]]<ref name="pmid11350446">{{cite journal |vauthors=Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J |title=Unique clinical characteristics of primary hyperparathyroidism in India |journal=Br J Surg |volume=88 |issue=5 |pages=708–14 |year=2001 |pmid=11350446 |doi=10.1046/j.0007-1323.2001.01775.x |url=}}</ref>. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with | *Patients with FHH usually have a normal appearance. | ||
===Vital Signs=== | ===Vital Signs=== | ||
*Patients with [[hypercalcemia]] | *Patients with [[hypercalcemia]] may have: | ||
**[[High blood pressure]] due to [[hypercalcemia | **[[High blood pressure]] due to [[hypercalcemia]] | ||
===Skin=== | ===Skin=== | ||
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===HEENT=== | ===HEENT=== | ||
*Patients with | *Patients with [[hypercalcemia]] may have: | ||
** [[Band keratopathy]] ([[calcium]] precipitation in a horizontal band across the [[cornea]] in the palpebral aperture); may lead to [[Visual impairment|vision impairment]] | ** [[Band keratopathy]] ([[calcium]] precipitation in a horizontal band across the [[cornea]] in the palpebral aperture); may lead to [[Visual impairment|vision impairment]] | ||
===Lungs=== | ===Lungs=== | ||
*Patients with [[hypercalcemia]] | *Patients with [[hypercalcemia]] may have: | ||
**[[Dyspnea]] due to [[fluid overload]] form [[renal failure]] | **[[Dyspnea]] due to [[fluid overload]] form [[renal failure]] | ||
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===Abdomen=== | ===Abdomen=== | ||
*Patients with [[hypercalcemia]] | *Patients with [[hypercalcemia]] may have: | ||
**[[Nausea and vomiting]] | **[[Nausea and vomiting]] | ||
**[[Anorexia]] | **[[Anorexia]] | ||
** | **[[constipation]] | ||
**[[Epigastric pain]] and [[tenderness]] due to development of [[pancreatitis]] | **[[Epigastric pain]] and [[tenderness]] due to development of [[pancreatitis]] | ||
**[[Flank pain]] and [[tenderness]] due to [[nephrolithiasis]] | **[[Flank pain]] and [[tenderness]] due to [[nephrolithiasis]] | ||
===Genitourinary=== | ===Genitourinary=== | ||
*Patients with severe [[hypercalcemia]] | *Patients with severe [[hypercalcemia]] may have: | ||
**Alteration in [[urinary]] habits | **Alteration in [[urinary]] habits | ||
**[[Volume depletion]] | **[[Volume depletion]] | ||
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===Neuromuscular=== | ===Neuromuscular=== | ||
*Patient is usually oriented to persons, place, and time. | *Patient is usually oriented to persons, place, and time. | ||
*Patients with severe [[hypercalcemia]] | *Patients with severe [[hypercalcemia]] may have: | ||
**[[Anxiety]] | **[[Anxiety]] | ||
**[[Fatigue]] and [[weakness | **[[Fatigue]] and [[weakness]] | ||
**[[Lethargy]] | **[[Lethargy]] | ||
**[[Sleep disturbances]] | **[[Sleep disturbances]] | ||
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**[[Hypotonia]] | **[[Hypotonia]] | ||
**[[Hyporeflexia]] | **[[Hyporeflexia]] | ||
===Extremities=== | ===Extremities=== | ||
* | *Normal | ||
==References== | ==References== | ||
Revision as of 03:53, 22 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Physical examination of patients with familial hypocalciuric hypercalcemia (FHH) is usually unremarkable. Very rarely patients may have examination findings due to hypercalcemia.
Physical Examination
- Physical examination of patients with FHH is usually unremarkable.[1]
- Patients may have physical examination findings due to hypercalcemia[2].
Appearance of the Patient
- Patients with FHH usually have a normal appearance.
Vital Signs
- Patients with hypercalcemia may have:
- High blood pressure due to hypercalcemia
Skin
- Persistent itching may be present due to renal failure
HEENT
- Patients with 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 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 may have:
- Nausea and vomiting
- Anorexia
- constipation
- Epigastric pain and tenderness due to development of pancreatitis
- Flank pain and tenderness due to nephrolithiasis
Genitourinary
- Patients with severe hypercalcemia 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 may have:
- Anxiety
- Fatigue and weakness
- Lethargy
- Sleep disturbances
- Muscle twitch and cramps
- Signs of depression
- Confusion
- Memory disturbances
- Hypotonia
- Hyporeflexia
Extremities
- Normal
References
- ↑ Pallan S, Khan A (2011). "Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care". Can Fam Physician. 57 (2): 184–9. PMC 3038812. PMID 21321169.
- ↑ Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J (2001). "Unique clinical characteristics of primary hyperparathyroidism in India". Br J Surg. 88 (5): 708–14. doi:10.1046/j.0007-1323.2001.01775.x. PMID 11350446.