Insulinoma physical examination: Difference between revisions

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


==Overview==
==Overview==
Physical examination of patients with insulinoma is usually unremarkable. They can have altered mental status or sweating rarely.
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==


*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 unremarkable. They can have altered mental status or sweating rarely.
*Patients with insulinoma usually appear [general appearance].  


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


*No high-grade / low-grade fever
*High-grade / low-grade fever- None
*No [[tachycardia]] with regular pulse
*[[Tachycardia]] with regular pulse- can be tachycardic/bradycardic
*No [[bradycardia]] with regular pulse  
*[[Bradycardia]] with regular pulse  
* No tachypnea / bradypnea
*Tachypnea / bradypnea


===Skin===
===Skin===
* can have sweating
* can have sweating
<gallery widths=150px>
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
</gallery>


===HEENT===
===HEENT===
Unremarkable
* No abnormalities of the head/hair  
* No abnormalities of the head/hair  
* No evidence of trauma
* No evidence of trauma
* Normal sclera  
* Normal sclera  
* No [[Nystagmus]]  
* No[[Nystagmus]]  
* Extra-ocular movements are normal
* Extra-ocular movements are normal
* Pupils -reactive to light and to accommodation  
* Pupils -reactive to light and to accommodation  
* Ophthalmoscopic exam may be normal
*Ophthalmoscopic exam may be normal with finding.
* 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
* No erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
* No erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
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*Unremarkable
*Unremarkable
===Lungs===
===Lungs===
Unremarkable
* Symmetric chest expansion
* Symmetric chest expansion
*Lungs are hypo/hyperresonant
*Lungs are hypo/hyperresonant
*No [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*No[[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*No Rhonchi
*No Rhonchi
*Normal Vesicular breath sounds  
*Normal Vesicular breath sounds  
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===Heart===
===Heart===
Unremarkable
*PMI within 2 cm of the sternum  (PMI)  
*PMI within 2 cm of the sternum  (PMI)  
*No [[heave]] / [[thrill]]
*[[Heave]] / [[thrill]]can bedue to palpitations
*No [[friction rub]]
*[[Friction rub]]
*Normal [[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*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]]
*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#Third heart sound S3|S3]]
*No [[Heart sounds#Fourth heart sound S4|S4]]
*No[[Heart sounds#Fourth heart sound S4|S4]]
*No [[Heart sounds#Summation Gallop|Gallops]]
*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
*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]]  
*No[[Abdominal distention]]  
*No [[Rebound tenderness]] (positive Blumberg sign)
*No[[Rebound tenderness]] (positive Blumberg sign)
*No palpable abdominal mass in the right/left upper/lower abdominal quadrant
*No palpable abdominal mass in the right/left upper/lower abdominal quadrant
*No guarding  
*No guarding  
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===Back===
===Back===
Unremarkable
*No tendernes
*No tenderness
*No sacral edema
*No sacral edema
*No costovertebral angle tenderness bilaterally/unilaterally
*No costovertebral angle tenderness bilaterally/unilaterally
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===Genitourinary===
===Genitourinary===
Unremarkable
*No pelvic/adnexal mass.
*No pelvic/adnexal mass.
*Normal mucosa
*Normal mucosa
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===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
*Patient is usually oriented to persons, place, and time
* Altered mental status- can have [[altered mental status]]/confusion
* Altered mental status- can have altered mental status
* Glasgow coma scale is x / 15. Can be [[comatose]] rarely
* Glasgow coma scale is ___ / 15. Can be comatosed
* Unilateral/bilateral fine [[Tremor|tremors]] can be present rarely
* Unilateral/bilateral fine tremors can be present  
* Normal finger-to-nose test
* Normal finger-to-nose test
===Extremities===
===Extremities===
Unremarkable
*No[[Clubbing]]  
*No [[Clubbing]]  
*No[[Cyanosis]]  
*No [[Cyanosis]]  
*No pitting/non-pitting [[edema]] of the upper/lower extremities
*No pitting/non-pitting [[edema]] of the upper/lower extremities
*No muscle atrophy
*No muscle atrophy

Revision as of 18:24, 17 August 2017

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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

  • No abnormalities of the head/hair
  • No evidence of trauma
  • Normal sclera
  • NoNystagmus
  • Extra-ocular movements are normal
  • Pupils -reactive to light and to accommodation
  • Ophthalmoscopic exam may be normal with finding.
  • 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

  • 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

Abdomen

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

References

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