Sheehan's syndrome physical examination: Difference between revisions
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* [[Galactorrhea]] | * [[Galactorrhea]] | ||
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| | |Gonadotropins | ||
| colspan="2" | | |||
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* Breast atrophy | * Breast atrophy | ||
* Regression of [[sexual characteristics]] | * Regression of [[sexual characteristics]] | ||
|- | |- | ||
| | |Growth hormone | ||
| colspan="2" | | |||
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* Decreased [[sweating]] and impaired [[thermogenesis]] | * Decreased [[sweating]] and impaired [[thermogenesis]] | ||
* Reduced [[muscle mass]] and strength | * Reduced [[muscle mass]] and strength | ||
* Fine facial wrinkles | * Fine facial wrinkles | ||
* Increased central [[obesity]] | * Increased central [[obesity]] | ||
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Revision as of 06:34, 25 September 2017
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Sheehan's syndrome Microchapters |
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Diagnosis |
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Treatment |
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Sheehan's syndrome physical examination On the Web |
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American Roentgen Ray Society Images of Sheehan's syndrome physical examination |
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Risk calculators and risk factors for Sheehan's syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Patients with Sheehan's syndrome usually appear fatigued, lethargic, and complain of recent weight gain. Physical examination is usually remarkable for bradycardia, hypotension, pallor, and signs suggestive of respective hormonal deficiency. Clinical features depend upon the severity of hypopituitarism.
Physical Examination
Clinical features depend upon the severity of hypopituitarism that results from Sheehan's syndrome. Almost all the patients have GH, prolactin, and gonadotropin deficiency; the majority has ACTH and TSH deficiency.[1][2][3]
| Hypopituitarism | Presentation |
|---|---|
| Mild |
|
| Less severe |
|
| Severe |
|
Examination findings based upon specific hormonal deficiency
| Hormonal deficiency | Finding | |
|---|---|---|
| ACTH | Acute | |
| Chronic | ||
| TSH |
| |
| Gonadotropins |
| |
| Growth hormone |
| |
Appearance of the Patient
Vital Signs
Skin
- Pallor
- Areolar Hypopigmentation
- Coarse and dry skin
- Hair loss
HEENT
Genitourinary
Neuromuscular
- Patient is usually oriented to time, place and person
Extremities
- Pitting edema of the upper/lower extremities (myxedema)
- Muscle wasting
- Delayed relaxation of deep tendon reflexes
References
- ↑ Dökmetaş HS, Kilicli F, Korkmaz S, Yonem O (2006). "Characteristic features of 20 patients with Sheehan's syndrome". Gynecol. Endocrinol. 22 (5): 279–83. doi:10.1080/09513590600630504. PMID 16785150.
- ↑ Sert M, Tetiker T, Kirim S, Kocak M (2003). "Clinical report of 28 patients with Sheehan's syndrome". Endocr. J. 50 (3): 297–301. PMID 12940458.
- ↑ Keleştimur F (2003). "Sheehan's syndrome". Pituitary. 6 (4): 181–8. PMID 15237929.