Antiphospholipid syndrome physical examination: Difference between revisions
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Skin examination of patients with APS is usually positive for: | Skin examination of patients with APS is usually positive for: | ||
*Livedo reticularis | *Livedo reticularis | ||
* | *Purpura | ||
*Superficial thrombophelibitis | *Superficial thrombophelibitis | ||
*Leg ulcers | *Leg ulcers | ||
Revision as of 16:39, 8 April 2018
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Antiphospholipid syndrome Microchapters |
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Differentiating Antiphospholipid syndrome from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Antiphospholipid syndrome physical examination On the Web |
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American Roentgen Ray Society Images of Antiphospholipid syndrome physical examination |
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Risk calculators and risk factors for Antiphospholipid syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Physical Examination
Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system.
Appearance of the Patient
- Patients with APS usually appear normal.
Vital Signs
- Low-grade fever may be present.
- Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
- High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure
Cutaneous manifestations
Skin examination of patients with APS is usually positive for:
- Livedo reticularis
- Purpura
- Superficial thrombophelibitis
- Leg ulcers
- Splinter hemorrhages
- Gangrene of the distal extremities
- Leg swelling
-
Description (Adapted from Dermatology Atlas)
-
Description (Adapted from Dermatology Atlas)
HEENT
Abnormal fundoscopic examination findings:
- Retinal artery occlusion findings
- Retinal vein thrombosis findings
Neck
- Neck examination of patients with APS is usually normal.
Lungs
Pulmonary examination of patients with APS may show the following findings:
- Tachypnea in case of pulmonary embolism.
Heart
- Cardiovascular examination of patients with [disease name] is usually normal.
OR
- 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 examination of patients with [disease name] is usually normal.
OR
- 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
- Back examination of patients with [disease name] is usually normal.
OR
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Genitourinary
- Genitourinary examination of patients with [disease name] is usually normal.
OR
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
- Clear/(color), foul-smelling/odorless penile/vaginal discharge
Neuromuscular
- Neuromuscular examination of patients with [disease name] is usually normal.
OR
- 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)