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=== | |||
*Chest tenderness upon palpation | |||
*PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____ | |||
*[[Heave]] / [[thrill]] | |||
*[[Friction rub]] | |||
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]] | |||
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] | |||
*[[Heart sounds#Third heart sound S3|S3]] | |||
*[[Heart sounds#Fourth heart sound S4|S4]] | |||
*[[Heart sounds#Summation Gallop|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=== | |||
*[[Abdominal distention]] | |||
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant | |||
*[[Rebound tenderness]] (positive Blumberg sign) | |||
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant | |||
*Guarding may be present | |||
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | |||
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test | |||
===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=== | ===Neuromuscular=== | ||
* | *Patient is usually oriented to persons, place, and time | ||
* | * Altered mental status | ||
* Hyperreflexia / hyporeflexia / areflexia | |||
* | |||
===Extremities=== | ===Extremities=== | ||
Revision as of 17:56, 29 August 2017
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Hypoaldosteronism Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hypoaldosteronism physical examination On the Web |
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American Roentgen Ray Society Images of Hypoaldosteronism physical examination |
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Risk calculators and risk factors for Hypoaldosteronism physical examination |
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
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
- 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
- Abdominal distention
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right/left upper/lower abdominal quadrant
- Guarding may be present
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
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