Macrocytic anemia physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh 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 normal.
OR
Physical examination of patients with [disease name] is usually remarkable for [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].
Appearance of the Patient
- Patients with megaloblastic anemia usually appear pale. fatigued
Vital Signs
- High-grade / low-grade fever
- Tachycardia with regular pulse
- Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
Skin
HEENT
- Pale Conjunctiva
Neck
- Neck examination of patients with megaloblastic anemia is usually normal.
Lungs
- Pulmonary examination of patients with megaloblastic anemia is usually normal.
Heart
- Heave / thrill
- S1, S2 are normal.
- A low grade early systolic murmur at the mitral area can be heard using the bell/diaphgram of the stethoscope
Abdomen
- Abdominal examination of patients with megaloblastic anemia is usually normal.
Back
- Back examination of patients with megaloblastic anemia is usually normal.
Genitourinary
- Genitourinary examination of patients with megaloblastic anemia is usually normal.
Neuromuscular
- Patient is usually oriented to persons, place, and time
- 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
- Extremities examination of patients with megaloblastic anemia is usually normal.