Macrocytic anemia physical examination: Difference between revisions

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


===HEENT===
===HEENT===
* Pale [[Conjunctiva]]
* Pale [[Conjunctiva]]
* [[Optic atrophy]] can be seen on fundus exam
* [[Icterus]] can be seen
===Neck===
===Neck===
* Neck examination of patients with megaloblastic anemia is usually normal.
* Neck examination of patients with megaloblastic anemia is usually normal.
Line 71: Line 75:
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral upper/lower extremity weakness
**Can proceed to [[paraplegia]]
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
**Position and vibration sense is impaired
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Abnormal gait
*Positive [[Romberg's test]]
*Positive [[Lhermitte's sign]]
*Positive/negative Trendelenburg sign
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Unilateral/bilateral tremor  
*Normal finger-to-nose test / Dysmetria
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)
*Absent/present dysdiadochokinesia (palm tapping test)


===Extremities===
===Extremities===
* Extremities examination of patients with megaloblastic anemia is usually normal.
* Extremities examination of patients with megaloblastic anemia may show:
** [[Tremors]]
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 20:34, 6 August 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]

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 normal.

OR

Physical examination of patients with [disease name] is usually remarkable for [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].

Appearance of the Patient

  • Patients with megaloblastic anemia usually appear pale. 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.

Lungs

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

Heart

Abdomen

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

Back

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

Genitourinary

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

Neuromuscular

  • Patient is usually oriented to persons, place, and time
  • Hyperreflexia / hyporeflexia / areflexia
  • Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally/bilaterally
  • ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
  • Unilateral/bilateral upper/lower extremity weakness
  • Unilateral/bilateral sensory loss in the upper/lower extremity
    • Position and vibration sense is impaired
  • Abnormal gait
  • Positive Romberg's test
  • Positive Lhermitte's sign
  • Positive/negative Trendelenburg sign
  • Unilateral/bilateral tremor
  • Normal finger-to-nose test / Dysmetria
  • Absent/present dysdiadochokinesia (palm tapping test)

Extremities

  • Extremities examination of patients with megaloblastic anemia may show:

References


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