Hypoaldosteronism physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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 hypoaldosteronism is usually unremarkable, unless there is severe hyperkalemia. The physical findings, if present, represents underlying conditions such as chronic kidney disease and diabetic nephropathy. Increased level of serum potassium level may present with muscle weakness and cardiac arrhythmias.

Appearance of the Patient

• Patients with hypoaldosteronism usually appear fatigued.

Vital Signs

• Low blood pressure
• Orthostatic hypotension
• Bradycardia

Skin

If hypoaldosteronism is from addison's disease, change in skin and hair may be observed such as:

• Pigmented skin and mucous membranes - darkening (hyperpigmentation) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
• Absence of axillary and pubic hair in females as a result of loss of adrenal androgens

Abdomen

• 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

Neuromuscular

• Patient is usually oriented to persons, place, and time
• Altered mental status
• Hyperreflexia / hyporeflexia / areflexia

Extremities

• Muscle weakness
• Muscle tenderness
• Depressed deep tendon reflexes