Insulinoma physical examination: Difference between revisions

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{{Insulinoma}}
{{Insulinoma}}
{{CMG}}; {{AE}} {{PSD}}
{{CMG}}; {{AE}} {{ADS}}


==Overview==
==Overview==
Physical examination of patients with insulinoma is usually unremarkable. Common findings may include sweating and tachycardia/bradycardia.
Physical examination of patients with insulinoma is usually unremarkable.  


==Physical Examination==
==Physical Examination==
Physical examination of patients with insulinoma is usually unremarkable.


*Physical examination of patients with insulinoma is usually unremarkable.
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with insulinoma usually appear [general appearance].  
*Patients with insulinoma usually appear unremarkable. They may have [[altered mental status]] or [[sweating]] rarely.


===Vital Signs===
===Vital Signs===


*High-grade / low-grade fever- None
*[[Low-grade fever]]
*[[Tachycardia]] with regular pulse- can be tachycardic/bradycardic
*[[Bradycardia]] with regular pulse
*Tachypnea / bradypnea


===Skin===
===Skin===
* can have sweating
* May have [[sweating]]


===HEENT===
===HEENT===
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* No [[Nystagmus]]  
* No [[Nystagmus]]  
* Extra-ocular movements are normal
* Extra-ocular movements are normal
* Pupils -reactive to light and to accommodation  
* [[Pupils]] are reactive to light and to [[accommodation]]
* Ophthalmoscopic exam may be normal
* Ophthalmoscopic exam may be normal
* Hearing acuity is fine
* Hearing acuity is fine
*[[Weber test]] is normal.
*[[Weber test]] is normal  
* No tenderness upon palpation of the ear pinnae/tragus  
* No tenderness upon palpation of the ear pinnae/tragus  
* No facial tenderness
* No facial tenderness
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*Unremarkable
*Unremarkable
===Lungs===
===Lungs===
Unremarkable
* Unremarkable
* Symmetric chest expansion
*Lungs are hypo/hyperresonant
*No [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*No Rhonchi
*Normal Vesicular breath sounds
*No Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*Normal[[tactile fremitus]]


===Heart===
===Heart===
Unremarkable
* Unremarkable
*PMI within 2 cm of the sternum  (PMI)
*[[Heave]] / [[thrill]] can be due to palpitations
*No [[Friction rub]]
*Normal [[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*Normal [[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*No [[Heart sounds#Third heart sound S3|S3]]
*No [[Heart sounds#Fourth heart sound S4|S4]]
*No [[Heart sounds#Summation Gallop|Gallops]]
*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===
===Abdomen===
*No [[Abdominal distention]]
* Unremarkable
*No [[Rebound tenderness]] (positive Blumberg sign)
*No palpable abdominal mass in the right/left upper/lower abdominal quadrant
*No guarding
*No signs of[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]


===Back===
===Back===
Unremarkable
* Unremarkable
*No tendernes
*No sacral edema
*No costovertebral angle tenderness bilaterally/unilaterally
*No hump


===Genitourinary===
===Genitourinary===
Unremarkable
* Unremarkable
*No pelvic/adnexal mass.
*Normal mucosa
*No discharge


===Neuromuscular===
===Neuromuscular===
Unremarkable
*[[Altered mental status]]/[[confusion]]  may be present
*Patient is usually oriented to persons, place, and time
* May be [[comatose]] rarely
* Altered mental status- can have altered mental status/confusion
* Unilateral/bilateral fine [[Tremor|tremors]] can be present rarely
* Glasgow coma scale is x / 15. Can be comatose
* Unilateral/bilateral fine tremors can be present  
* Normal finger-to-nose test


===Extremities===
===Extremities===
Unremarkable
* Unremarkable
*No [[Clubbing]]
*No [[Cyanosis]]
*No pitting/non-pitting [[edema]] of the upper/lower extremities
*No muscle atrophy
*No fasciculations in the upper/lower extremity


==References==
==References==
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{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 02:07, 27 November 2017

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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

Physical examination of patients with insulinoma is usually unremarkable.

Physical Examination

Physical examination of patients with insulinoma is usually unremarkable.

Appearance of the Patient

Vital Signs

Skin

HEENT

Unremarkable

  • No abnormalities of the head/hair
  • No evidence of trauma
  • Normal sclera
  • No Nystagmus
  • Extra-ocular movements are normal
  • Pupils are 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

Heart

  • Unremarkable

Abdomen

  • Unremarkable

Back

  • Unremarkable

Genitourinary

  • Unremarkable

Neuromuscular

Extremities

  • Unremarkable

References

Template:WH Template:WS