Postpartum thyroiditis physical examination: Difference between revisions
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===Genitourinary=== | ===Genitourinary=== | ||
*Urinary frequency are common in hyperthyroidism phase. | *Urinary frequency are common in hyperthyroidism phase . | ||
*Menstrual irregularities in hypo/hyperthyroid phase. | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
*Patient is usually oriented to persons, place, and time | *Patient is usually oriented to persons, place, and time | ||
* | * Hyperreflexia in hyperthyroidism phase. | ||
* hyporeflexia in hypothyroid phase. | |||
* Proximal muscle weakness bilaterally in hypo/hyperthyroid phase. | |||
* | * lid lag suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit) | ||
* Proximal | |||
* | |||
*Unilateral/bilateral upper/lower extremity weakness | *Unilateral/bilateral upper/lower extremity weakness | ||
*Unilateral/bilateral sensory loss in the upper/lower extremity | *Unilateral/bilateral sensory loss in the upper/lower extremity | ||
| Line 109: | Line 106: | ||
*Normal finger-to-nose test / Dysmetria | *Normal finger-to-nose test / Dysmetria | ||
*Absent/present dysdiadochokinesia (palm tapping test) | *Absent/present dysdiadochokinesia (palm tapping test) | ||
*NEUROPSYCHIATRIC : low mood, depression in hypothyroid phase. Anxiety, restlessness, irritability, and emotional lability in hyperthyroidism phase. | |||
*Carpal tunnel syndrome in hypothyroid phase. | |||
*Joint pains, aches, and stiffness in hypothyroid phase. | |||
===Extremities=== | ===Extremities=== | ||
*[[Clubbing]] | *[[Clubbing]] in hypothyroid phase. | ||
* | *Non-pitting [[edema]] of the lower extremities in hypothyroid phase. | ||
*Muscle atrophy in hypothyroid phase. | |||
*Muscle atrophy | *Fasciculations, tremors in the upper & lower extremity in hypothyroid phase. | ||
*Fasciculations in the upper | |||
==References== | ==References== | ||
Revision as of 21:01, 1 October 2017
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Postpartum thyroiditis Microchapters |
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Postpartum thyroiditis physical examination On the Web |
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American Roentgen Ray Society Images of Postpartum thyroiditis physical examination |
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Risk calculators and risk factors for Postpartum thyroiditis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT.
Physical Examination
The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT.
Appearance of the Patient
- Patients with PPT usually appear tired or irritable depend of the phase of disease.
Vital Signs
- Low-grade fever in hyperthyroid phase.
- Tachycardia with regular pulse in hyperthyroid phase.
- Bradycardia with regular pulse in hypothyroid phase.
- Tachypnea in hyperthyroid phase.
- High blood pressure with normal pulse pressure hyperthyroid phase.
- Low blood pressure with normal pulse pressure hypothyroid phase.
Skin
Hyperthyroid phase:
Sweating increased.
Onycholysis.
Hyperpigmentation
Pruritus and hives.
Vitiligo and alopecia areata.
Thinning of the hair
Peritibail myxedoma in co-existing Grave's disease
Hypothyroid phase:
Sweating decreased.
Dry skin
Hair coarse and brttile.
Brittle nails.
Nonpitting edema
HEENT
Hyperthyroid phase:
Stare and lid lag
proptosis
Gritty sensation in eyes
Hypothyroid phase:
Icteric sclera
Pallor
Neck
- Painless Thyromegaly.
Lungs
- Decreased chest expansion due to respiratory muscles fatigue
- Distant breath sounds in presence of plural effusion.
- Enspiratory wheezing with delayed expiratory phase in patient due to exacerbation of asthma
- Reduced tactile fremitus in presence of plural effusion.
Heart
- A low grade early systolic murmur best heard at the base mitral may be heard using the diaphgram of the otoscope in hyper-dynamic flow murmur in hyperthyroid phase.
Abdomen
- Abdominal distention in patients with constipation
- Abdominal tenderness in the right upper abdominal quadrant with autoimmune hepatitis.
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Dull note on percussion in peritoneal effusion.
- Increased peristaltic movements in patients with hyperthyroid phase.
Back
- Point tenderness over lumber vertebrae in osteoporosis in hypo/hyperthyroid phase.
- Costovertebral angle tenderness bilaterally osteoporosis in hypo/hyperthyroid phase.
Genitourinary
- Urinary frequency are common in hyperthyroidism phase .
- Menstrual irregularities in hypo/hyperthyroid phase.
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Hyperreflexia in hyperthyroidism phase.
- hyporeflexia in hypothyroid phase.
- Proximal muscle weakness bilaterally in hypo/hyperthyroid phase.
- lid lag 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
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
- NEUROPSYCHIATRIC : low mood, depression in hypothyroid phase. Anxiety, restlessness, irritability, and emotional lability in hyperthyroidism phase.
- Carpal tunnel syndrome in hypothyroid phase.
- Joint pains, aches, and stiffness in hypothyroid phase.
Extremities
- Clubbing in hypothyroid phase.
- Non-pitting edema of the lower extremities in hypothyroid phase.
- Muscle atrophy in hypothyroid phase.
- Fasciculations, tremors in the upper & lower extremity in hypothyroid phase.