Hyperosmolar hyperglycemic state physical examination: Difference between revisions
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===Neuromuscular=== | ===Neuromuscular=== | ||
* | * [[Irritability]] | ||
* | * [[Restlessness]] | ||
* | * [[Stupor]] | ||
* | * [[Muscular twitching]] | ||
* Hyperreflexia | * [[Hyperreflexia]] | ||
* | * [[Lethargy]] | ||
* | * [[Spasticity]] | ||
* | * [[Seizures]]<ref name="pmid23590576">{{cite journal |vauthors=Yun C, Xuefeng W |title=Association between seizures and diabetes mellitus: a comprehensive review of literature |journal=Curr Diabetes Rev |volume=9 |issue=4 |pages=350–4 |year=2013 |pmid=23590576 |doi= |url=}}</ref> | ||
* [[Coma]] | |||
* | |||
===Extremities=== | ===Extremities=== | ||
Revision as of 14:03, 22 September 2017
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Hyperosmolar hyperglycemic state Microchapters |
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Differentiating Hyperosmolar hyperglycemic state from other Diseases |
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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 [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
- The presence of [finding(s)] on physical examination is diagnostic of [disease name].
- The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
- Patients with [disease name] usually appear [general appearance].
Vital Signs
Skin
- Cutaneous infection (non-healing ulcer)[4]
- Xerosis[4]
- Hair loss[4]
- Acanthosis nigricans in type 2 diabetics[5]
- Diabetic dermopathy (small <1 cm, well-demarcated, atrophic depressions, macules, or papules on the pretibia) in type 2 diabetics[6]
- Eruptive xanthomas in type 2 diabetics[7][4]
- Necrobiosis lipoidica (irregular, painless ovoid plaques with a yellow atrophic center and a red to purple periphery)[4]
- Vitiligo[4]
- Diabetic bullae[8][4]
HEENT
- Extra-ocular movements may be abnormal due to the involvement of third, fourth, sixth, and seventh cranial nerves affecting ocular movements[9]
- Ophthalmoscopic exam may be abnormal with findings of diabetic retinopathy.
- Hearing acuity may be reduced.
Neck
- Not significant
Lungs
- Rales/crackles due to pulmonary edema (in case of treatmnet complication) or pneumonia (in cases where infection is a precipitating cause)[10]
Heart
- Chest tenderness upon palpation
- PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
- Heave / thrill
- Friction rub
- S1
- S2
- S3
- S4
- Gallops
- A 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
Back
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Genitourinary
Neuromuscular
- Irritability
- Restlessness
- Stupor
- Muscular twitching
- Hyperreflexia
- Lethargy
- Spasticity
- Seizures[11]
- Coma
Extremities
References
- ↑ Gale EA, Tattersall RB (1978). "Hypothermia: a complication of diabetic ketoacidosis". Br Med J. 2 (6149): 1387–9. PMC 1608617. PMID 102402.
- ↑ 2.0 2.1 2.2 2.3 Kearney T, Dang C (2007). "Diabetic and endocrine emergencies". Postgrad Med J. 83 (976): 79–86. doi:10.1136/pgmj.2006.049445. PMC 2805944. PMID 17308209.
- ↑ Rosenbloom AL (2010). "The management of diabetic ketoacidosis in children". Diabetes Ther. 1 (2): 103–20. doi:10.1007/s13300-010-0008-2. PMC 3138479. PMID 22127748.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Duff M, Demidova O, Blackburn S, Shubrook J (2015). "Cutaneous manifestations of diabetes mellitus". Clin Diabetes. 33 (1): 40–8. doi:10.2337/diaclin.33.1.40. PMC 4299750. PMID 25653473.
- ↑ "Chapter 151. Diabetes Mellitus and Other Endocrine Diseases | Fitzpatrick's Dermatology in General Medicine, 8e | AccessMedicine | McGraw-Hill Medical".
- ↑ "Chapter 66. Dermal Hypertrophies and Benign Fibroblastic/Myofibroblastic Tumors | Fitzpatrick's Dermatology in General Medicine, 8e | AccessMedicine | McGraw-Hill Medical".
- ↑ Paron NG, Lambert PW (2000). "Cutaneous manifestations of diabetes mellitus". Prim. Care. 27 (2): 371–83. PMID 10815049.
- ↑ Ferringer T, Miller F (2002). "Cutaneous manifestations of diabetes mellitus". Dermatol Clin. 20 (3): 483–92. PMID 12170881.
- ↑ Skarbez K, Priestley Y, Hoepf M, Koevary SB (2010). "Comprehensive Review of the Effects of Diabetes on Ocular Health". Expert Rev Ophthalmol. 5 (4): 557–577. doi:10.1586/eop.10.44. PMC 3134329. PMID 21760834.
- ↑ Konstantinov NK, Rohrscheib M, Agaba EI, Dorin RI, Murata GH, Tzamaloukas AH (2015). "Respiratory failure in diabetic ketoacidosis". World J Diabetes. 6 (8): 1009–23. doi:10.4239/wjd.v6.i8.1009. PMC 4515441. PMID 26240698.
- ↑ Yun C, Xuefeng W (2013). "Association between seizures and diabetes mellitus: a comprehensive review of literature". Curr Diabetes Rev. 9 (4): 350–4. PMID 23590576.
- ↑ Wyatt LH, Ferrance RJ (2006). "The musculoskeletal effects of diabetes mellitus". J Can Chiropr Assoc. 50 (1): 43–50. PMC 1839979. PMID 17549168.