Insulinoma physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, 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 insulinoma is usually unremarkable.
Appearance of the Patient
- Patients with insulinoma usually appear [general appearance].
Vital Signs
- High-grade / low-grade fever- None
- Tachycardia with regular pulse- can be tachycardic/bradycardic
- Bradycardia with regular pulse
- 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 -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
- Nocrackles 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)
- Heave / thrill can be due to palpitations
- No Friction rub
- Normal S1
- Normal S2
- NoS3
- NoS4
- NoGallops
- 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
- NoAbdominal distention
- NoRebound tenderness (positive Blumberg sign)
- No palpable abdominal mass in the right/left upper/lower abdominal quadrant
- No guarding
- No signs ofHepatomegaly / splenomegaly / hepatosplenomegaly
Back
- No tendernes
- No sacral edema
- No costovertebral angle tenderness bilaterally/unilaterally
- No hump
Genitourinary
- No pelvic/adnexal mass.
- Normal mucosa
- No discharge
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status- can have altered mental status
- Glasgow coma scale is ___ / 15. Can be comatosed
- Unilateral/bilateral fine tremors can be present
- Normal finger-to-nose test
Extremities
- NoClubbing
- NoCyanosis
- No pitting/non-pitting edema of the upper/lower extremities
- No muscle atrophy
- No fasciculations in the upper/lower extremity