Amnesia physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(20 intermediate revisions by the same user not shown)
Line 2: Line 2:
{{Amnesia}}
{{Amnesia}}
{{CMG}}; {{AE}} {{ZMalik}}
{{CMG}}; {{AE}} {{ZMalik}}


==Overview==
==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].
[[Patients]] with amnesia may have variable [[general appearance]] depending on the underlying cause of [[memory]] loss. Amnesia is largely a clinical [[diagnosis]]. Focal [[examination]] including [[vital signs]], [[altered mental status]], [[mini mental status exam]] ([[MMSE]]), [[Glasgow Coma Scale]], [[nystagmus]], [[papilledema]], [[gait]], [[instruments of daily activities]] should be assessed.
 
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 [disease name] is usually normal.
[[Patients]] with amnesia may have variable general appearance depending on the underlying cause of [[memory]] loss.
 
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===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
*Patients with [[memory]] loss could appear completely normal or may present with [[cognitive impairment]], [[signs]] of [[head]] [[trauma]], [[alcohol]] [[abuse]].


===Vital Signs===
===Vital Signs===
 
*It is crucial to assess [[vital signs]] repeatedly and compare [[Glasgow Coma Scale]] scores in intervals for patients with recent history of [[head]] [[trauma]] with or without [[loss of consciousness]].<ref name="pmid20393093">{{cite journal| author=Levine Z| title=Mild traumatic brain injury: part 1: determining the need to scan. | journal=Can Fam Physician | year= 2010 | volume= 56 | issue= 4 | pages= 346-9 | pmid=20393093 | doi= | pmc=2860826 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20393093  }} </ref>
*High-grade / low-grade fever
*[[Vital Signs]] should include assessment of [[heart rate]], [[blood pressure]], [[oxygen saturation]], and temperature.
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
* [[Skin]] [[examination]] of [[patients]] with [[memory]] loss is usually normal, [[signs]] of [[head]] [[trauma]] should be assessed.
OR
*[[Cyanosis]]  
*[[Jaundice]]
* [[Pallor]]
* Bruises
 
<gallery widths="150px">
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
*HEENT [[examination]] of [[patients]] with amnesia is usually normal. [[Abnormalities]] to be observed includes:
OR
**Evidence of [[trauma]]
* Abnormalities of the head/hair may include ___
**[[Nystagmus]] in [[Korsakoff's syndrome]]<ref name="pmid6853227">{{cite journal| author=Probst R| title=[Neuro-otologic findings in the Wernicke-Korsakoff syndrome]. | journal=HNO | year= 1983 | volume= 31 | issue= 4 | pages= 123-7 | pmid=6853227 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6853227  }} </ref>
* Evidence of trauma
**[[Ophthalmoscope]] [[examination]] may be [[abnormal]] with findings of [[papilledema]] in case of [[head]] [[trauma]].<ref name="pmid28539794">{{cite journal| author=Rigi M, Almarzouqi SJ, Morgan ML, Lee AG| title=Papilledema: epidemiology, etiology, and clinical management. | journal=Eye Brain | year= 2015 | volume= 7 | issue=  | pages= 47-57 | pmid=28539794 | doi=10.2147/EB.S69174 | pmc=5398730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28539794  }} </ref>
* Icteric sclera
* [[Nystagmus]]  
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae


===Neck===
===Neck===
* Neck examination of patients with [disease name] is usually normal.
*[[Neck]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
* [[Pulmonary]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
* Asymmetric chest expansion OR decreased chest expansion
*Lungs are hyporesonant OR hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds OR distant breath sounds
*Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
* [[Cardiovascular]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*[[Heave]] / [[thrill]]
*[[Friction rub]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|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 stethoscope


===Abdomen===
===Abdomen===
* Abdominal examination of patients with [disease name] is usually normal.
* [[Abdominal]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*[[Abdominal distension]]  
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
* [[Back]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
* [[Genitourinary]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge


===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
* [[Neuromuscular]] [[examination]] of [[patients]] with amnesia depends on the underlying cause.
OR
*[[Patient's]] orientation to persons, place, and time should be determined.
*Patient is usually oriented to persons, place, and time
*[[Altered mental status]]
* Altered mental status
*[[Glasgow coma scale]]
* Glasgow coma scale is ___ / 15
*[[Mini-Mental Status Examination]] ([[MMSE]])<ref name="pmid30135715">{{cite journal| author=Weller J, Budson A| title=Current understanding of Alzheimer's disease diagnosis and treatment. | journal=F1000Res | year= 2018 | volume= 7 | issue=  | pages=  | pmid=30135715 | doi=10.12688/f1000research.14506.1 | pmc=6073093 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30135715  }} </ref>
* Clonus may be present
*Montreal Cognitive Assessment (MOCA)
* Hyperreflexia / hyporeflexia / areflexia
*Instruments of Activities of Daily Living (IADL)
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
*[[Muscle]] rigidity, abnormal [[gait]]
* 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
*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)


===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
* [[Extremities]] [[examination]] of [[patients]] with amnesia is usually normal.
OR
*[[Clubbing]]  
*[[Cyanosis]]  
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity


==References==
==References==

Latest revision as of 02:55, 25 March 2021

Amnesia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Amnesia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Amnesia physical examination On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Amnesia physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Amnesia physical examination

CDC on Amnesia physical examination

Amnesia physical examination in the news

Blogs on Amnesia physical examination

Directions to Hospitals Treating Amnesia

Risk calculators and risk factors for Amnesia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss. Amnesia is largely a clinical diagnosis. Focal examination including vital signs, altered mental status, mini mental status exam (MMSE), Glasgow Coma Scale, nystagmus, papilledema, gait, instruments of daily activities should be assessed.

Physical Examination

Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss.

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

  1. ↑ Levine Z (2010). "Mild traumatic brain injury: part 1: determining the need to scan". Can Fam Physician. 56 (4): 346–9. PMC 2860826. PMID 20393093.
  2. ↑ Probst R (1983). "[Neuro-otologic findings in the Wernicke-Korsakoff syndrome]". HNO. 31 (4): 123–7. PMID 6853227.
  3. ↑ Rigi M, Almarzouqi SJ, Morgan ML, Lee AG (2015). "Papilledema: epidemiology, etiology, and clinical management". Eye Brain. 7: 47–57. doi:10.2147/EB.S69174. PMC 5398730. PMID 28539794.
  4. ↑ Weller J, Budson A (2018). "Current understanding of Alzheimer's disease diagnosis and treatment". F1000Res. 7. doi:10.12688/f1000research.14506.1. PMC 6073093. PMID 30135715.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Amnesia_physical_examination&oldid=1695354"