Insulinoma physical examination: Difference between revisions
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===Skin=== | ===Skin=== | ||
* | * Can have sweating | ||
===HEENT=== | ===HEENT=== | ||
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* No [[Nystagmus]] | * No [[Nystagmus]] | ||
* Extra-ocular movements are normal | * Extra-ocular movements are normal | ||
* Pupils | * [[Pupils]] are reactive to light and to [[accommodation]] | ||
* Ophthalmoscopic exam may be normal | * Ophthalmoscopic exam may be normal | ||
* Hearing acuity is fine | * Hearing acuity is fine | ||
*[[Weber test]] is normal | *[[Weber test]] is normal | ||
* No tenderness upon palpation of the ear pinnae/tragus | * No tenderness upon palpation of the ear pinnae/tragus | ||
* No facial tenderness | * No facial tenderness | ||
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Unremarkable | Unremarkable | ||
* Symmetric chest expansion | * Symmetric chest expansion | ||
*Lungs are hypo/hyperresonant | *[[Lungs]] are hypo/hyperresonant | ||
*No [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally | *No [[crackles]] upon auscultation of the [[lung]] bases/apices unilaterally/bilaterally | ||
*No Rhonchi | *No Rhonchi | ||
*Normal | *Normal vesicular [[breath sounds]] | ||
*No | *No expiratory/inspiratory wheezing with normal / delayed expiratory phase | ||
*Normal[[tactile fremitus]] | *Normal[[tactile fremitus]] | ||
===Heart=== | ===Heart=== | ||
Unremarkable | Unremarkable | ||
*PMI within 2 cm of the sternum (PMI) | *[[PMI]] within 2 cm of the sternum ([[PMI]]) | ||
*No [[heave]] / [[thrill]] | *No [[heave]] / [[thrill]] | ||
*No [[friction rub]] | *No [[friction rub]] | ||
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*No [[Abdominal distention]] | *No [[Abdominal distention]] | ||
*No [[Rebound tenderness]] (positive Blumberg sign) | *No [[Rebound tenderness]] (positive Blumberg sign) | ||
*No palpable abdominal mass in the right/left upper/lower abdominal quadrant | *No palpable [[abdominal mass]] in the right/left upper/lower abdominal quadrant | ||
*No guarding | *No guarding | ||
*No signs of[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | *No signs of[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | ||
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Unremarkable | Unremarkable | ||
*No tenderness | *No tenderness | ||
*No sacral edema | *No sacral [[edema]] | ||
*No costovertebral angle tenderness bilaterally/unilaterally | *No costovertebral angle tenderness bilaterally/unilaterally | ||
*No hump | *No hump | ||
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===Genitourinary=== | ===Genitourinary=== | ||
Unremarkable | Unremarkable | ||
*No pelvic/adnexal mass. | *No [[pelvic]]/[[adnexal]] mass. | ||
*Normal mucosa | *Normal [[mucosa]] | ||
*No discharge | *No discharge | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
*Patient is usually oriented to persons, place, and time | *Patient is usually oriented to persons, place, and time | ||
* Altered mental status- can have [[altered mental status]]/confusion | * [[Altered mental status]]- can have [[altered mental status]]/confusion | ||
* Glasgow coma scale is x / 15. Can be [[comatose]] rarely | * [[Glasgow coma scale]] is x / 15. Can be [[comatose]] rarely | ||
* Unilateral/bilateral fine [[Tremor|tremors]] can be present rarely | * Unilateral/bilateral fine [[Tremor|tremors]] can be present rarely | ||
* Normal finger-to-nose test | * Normal finger-to-nose test | ||
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*No [[Cyanosis]] | *No [[Cyanosis]] | ||
*No pitting/non-pitting [[edema]] of the upper/lower extremities | *No pitting/non-pitting [[edema]] of the upper/lower extremities | ||
*No muscle atrophy | *No [[muscle]] atrophy | ||
*No fasciculations in the upper/lower extremity | *No [[fasciculations]] in the upper/lower extremity | ||
==References== | ==References== | ||
Revision as of 14:55, 22 September 2017
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Insulinoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Insulinoma physical examination On the Web |
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American Roentgen Ray Society Images of Insulinoma physical examination |
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Risk calculators and risk factors for Insulinoma physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Overview
Physical examination of patients with insulinoma is usually unremarkable.
Physical Examination
- Physical examination of patients with insulinoma is usually unremarkable.
Appearance of the Patient
- Patients with insulinoma usually appear unremarkable. They can have altered mental status or sweating rarely.
Vital Signs
- No high-grade / low-grade fever
- No tachycardia with regular pulse
- No bradycardia with regular pulse
- No tachypnea / bradypnea
Skin
- Can have sweating
HEENT
Unremarkable
- No abnormalities of the head/hair
- No evidence of trauma
- Normal sclera
- No Nystagmus
- Extra-ocular movements are normal
- Pupils are reactive to light and to accommodation
- Ophthalmoscopic exam may be normal
- Hearing acuity is fine
- Weber test is normal
- No tenderness upon palpation of the ear pinnae/tragus
- No facial tenderness
- No erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
Neck
- Unremarkable
Lungs
Unremarkable
- Symmetric chest expansion
- Lungs are hypo/hyperresonant
- No crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- No Rhonchi
- Normal vesicular breath sounds
- No expiratory/inspiratory wheezing with normal / delayed expiratory phase
- Normaltactile fremitus
Heart
Unremarkable
- PMI within 2 cm of the sternum (PMI)
- No heave / thrill
- No friction rub
- Normal S1
- Normal S2
- No S3
- No S4
- No Gallops
- No 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
- No Abdominal distention
- No Rebound tenderness (positive Blumberg sign)
- No palpable abdominal mass in the right/left upper/lower abdominal quadrant
- No guarding
- No signs ofHepatomegaly / splenomegaly / hepatosplenomegaly
Back
Unremarkable
- No tenderness
- No sacral edema
- No costovertebral angle tenderness bilaterally/unilaterally
- No hump
Genitourinary
Unremarkable
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status- can have altered mental status/confusion
- Glasgow coma scale is x / 15. Can be comatose rarely
- Unilateral/bilateral fine tremors can be present rarely
- Normal finger-to-nose test
Extremities
Unremarkable
- No Clubbing
- No Cyanosis
- No pitting/non-pitting edema of the upper/lower extremities
- No muscle atrophy
- No fasciculations in the upper/lower extremity