Macrocytic anemia physical examination: Difference between revisions

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* [[Pallor]]
* [[Pallor]]
* [[Vitiligo]]- in autoimmune diseases related to pernicious anemia
* [[Vitiligo]]- in autoimmune diseases related to pernicious anemia
* [[Jaundice]] may be seen
* [[Jaundice]]  


===HEENT===
===HEENT===
* Pale [[conjunctiva]]
* Pale [[conjunctiva]]
* [[Optic atrophy]] can be seen on fundus exam
* [[Optic atrophy]] on fundus exam
* [[Icterus]] can be seen
* [[Icterus]]  
* [[Glossitis]]  
* [[Glossitis]]  
* [[Mouth ulcers]]<ref name="pmid24942828">{{cite journal |vauthors=Devalia V, Hamilton MS, Molloy AM |title=Guidelines for the diagnosis and treatment of cobalamin and folate disorders |journal=Br. J. Haematol. |volume=166 |issue=4 |pages=496–513 |date=August 2014 |pmid=24942828 |doi=10.1111/bjh.12959 |url=}}</ref>
* [[Mouth ulcers]]<ref name="pmid24942828">{{cite journal |vauthors=Devalia V, Hamilton MS, Molloy AM |title=Guidelines for the diagnosis and treatment of cobalamin and folate disorders |journal=Br. J. Haematol. |volume=166 |issue=4 |pages=496–513 |date=August 2014 |pmid=24942828 |doi=10.1111/bjh.12959 |url=}}</ref>


===Neck===
===Neck===
* Neck examination of patients with [[megaloblastic anemia]] is usually normal.
* Neck examination of patients with [[megaloblastic anemia]] is usually normal but can sometimes show thyromegaly is hypothyroidism or hyperthyroidism are the causes of megaloblastic anemia.
===Lungs===
===Lungs===
* Pulmonary examination of patients with [[megaloblastic anemia]] is usually normal.
* Pulmonary examination of patients with [[megaloblastic anemia]] is usually normal.
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===Abdomen===
===Abdomen===
* Abdominal examination of patients with megaloblastic anemia is usually normal.
* Abdominal examination of patients with megaloblastic anemia is usually normal but can sometimes show hepatomegaly if liver disease is the cause of megaloblastic anemia.
===Back===
===Back===
* Back examination of patients with megaloblastic anemia is usually normal.
* Back examination of patients with megaloblastic anemia is usually normal.
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* Genitourinary examination of patients with megaloblastic anemia is usually normal.
* Genitourinary examination of patients with megaloblastic anemia is usually normal.
===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
*Patients are usually oriented to persons, place, and time.
*
* [[Hyporeflexia]] or [[areflexia]]
* [[Hyporeflexia]] or [[areflexia]]
* Positive (abnormal) [[Babinski's Reflex|Babinski]] / [[plantar]] reflex  
* Positive (abnormal) [[Babinski's Reflex|Babinski]] / [[plantar]] reflex  

Revision as of 22:56, 2 December 2018

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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] Omer Kamal, M.D.[3]

Overview

Common physical examination findings of megaloblastic anemia include glossitis, pallor, mouth ulcers, vitiligo, subacute combined degeneration, and positive Romberg's sign.

Physical Examination

Physical examination includes the following: [1][2][3]

Appearance of the Patient

  • Patients with megaloblastic anemia usually appear pale and fatigued

Vital Signs

  • High-grade / low-grade fever
  • Tachycardia with regular pulse
  • Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse

Skin

HEENT

Neck

  • Neck examination of patients with megaloblastic anemia is usually normal but can sometimes show thyromegaly is hypothyroidism or hyperthyroidism are the causes of megaloblastic anemia.

Lungs

Heart

Abdomen

  • Abdominal examination of patients with megaloblastic anemia is usually normal but can sometimes show hepatomegaly if liver disease is the cause of megaloblastic anemia.

Back

  • Back examination of patients with megaloblastic anemia is usually normal.

Genitourinary

  • Genitourinary examination of patients with megaloblastic anemia is usually normal.

Neuromuscular

Extremities

References

  1. Nagao T, Hirokawa M (October 2017). "Diagnosis and treatment of macrocytic anemias in adults". J Gen Fam Med. 18 (5): 200–204. doi:10.1002/jgf2.31. PMC 5689413. PMID 29264027.
  2. Shojania AM (May 1980). "Problems in the diagnosis and investigation of megaloblastic anemia". Can Med Assoc J. 122 (9): 999–1004. PMC 1801696. PMID 6768440.
  3. Rauw J, Wells RA, Chesney A, Reis M, Zhang L, Buckstein R (October 2011). "Validation of a scoring system to establish the probability of myelodysplastic syndrome in patients with unexplained cytopenias or macrocytosis". Leuk. Res. 35 (10): 1335–8. doi:10.1016/j.leukres.2011.05.001. PMID 21704372.
  4. Devalia V, Hamilton MS, Molloy AM (August 2014). "Guidelines for the diagnosis and treatment of cobalamin and folate disorders". Br. J. Haematol. 166 (4): 496–513. doi:10.1111/bjh.12959. PMID 24942828.


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