Autoimmune pancreatitis physical examination: Difference between revisions
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===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal tenderness]] may be noticed in the epigastrium or left upper quadrant. | *[[Abdominal tenderness]] may be noticed in the epigastrium or left upper quadrant. | ||
*A palpable abdominal mass in the epigastrium or left upper quadrant. | |||
*A palpable abdominal mass in the | |||
===Back=== | ===Back=== | ||
Revision as of 16:34, 2 January 2018
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Autoimmune pancreatitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Autoimmune pancreatitis physical examination On the Web |
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American Roentgen Ray Society Images of Autoimmune pancreatitis physical examination |
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Risk calculators and risk factors for Autoimmune pancreatitis 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 [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 [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
- The presence of [finding(s)] on physical examination is diagnostic of [disease name].
- The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
Patients with acute on chronic autoimmune pancreatitis may assume a characteristic position in an attempt to relieve their abdominal pain:
- Lying on the left side
- Flexing the spine
- Drawing the knees up toward the chest
- Patients with steatorrhea or advanced disease may present as
- Loss of subcutaneous fat
- Temporal wasting
- Sunken supraclavicular fossa
- Other physical signs of malnutritio
Vital Signs
- Vital signs are usually within normal limits.
Skin
Neck
- Jugular venous distension absent.
- Carotid bruits absent.
- Lymphadenopathy not present.
- No Thyromegaly / thyroid nodules.
- Hepatojugular reflux absent.
Lungs
- Vesicular breath sounds
- Wheezing absent
- Egophony absent
- Bronchophony absent
- Normal tactile fremitus
Heart
Abdomen
- Abdominal tenderness may be noticed in the epigastrium or left upper quadrant.
- A palpable abdominal mass in the epigastrium or left upper quadrant.
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
- Glasgow coma scale is ___ / 15
- Clonus may be present
- Hyperreflexia / hyporeflexia / areflexia
- Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
Extremities
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity
References
- ↑ Ghazale A, Chari ST, Zhang L, Smyrk TC, Takahashi N, Levy MJ, Topazian MD, Clain JE, Pearson RK, Petersen BT, Vege SS, Lindor K, Farnell MB (2008). "Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy". Gastroenterology. 134 (3): 706–15. doi:10.1053/j.gastro.2007.12.009. PMID 18222442.
- ↑ Church NI, Pereira SP, Deheragoda MG, Sandanayake N, Amin Z, Lees WR, Gillams A, Rodriguez-Justo M, Novelli M, Seward EW, Hatfield AR, Webster GJ (2007). "Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series". Am. J. Gastroenterol. 102 (11): 2417–25. doi:10.1111/j.1572-0241.2007.01531.x. PMID 17894845.
- ↑ Sahani DV, Kalva SP, Farrell J, Maher MM, Saini S, Mueller PR, Lauwers GY, Fernandez CD, Warshaw AL, Simeone JF (2004). "Autoimmune pancreatitis: imaging features". Radiology. 233 (2): 345–52. doi:10.1148/radiol.2332031436. PMID 15459324.
- ↑ Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ (2009). "Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis". Clin. Gastroenterol. Hepatol. 7 (10): 1089–96. doi:10.1016/j.cgh.2009.03.021. PMID 19345283.