Hypoglycemia physical examination: Difference between revisions

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===Appearance===
===Appearance===
* [[Macrosomia]] in [[infancy]] may indicate [[congenital hyperinsulinism|hyperinsulinism]].<ref name="pmid24685363">{{cite journal| author=Brutsaert E, Carey M, Zonszein J| title=The clinical impact of inpatient hypoglycemia. | journal=J Diabetes Complications | year= 2014 | volume= 28 | issue= 4 | pages= 565-72 | pmid=24685363 | doi=10.1016/j.jdiacomp.2014.03.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24685363  }}</ref>
* [[Macrosomia]] in [[infancy]] may indicate [[congenital hyperinsulinism|hyperinsulinism]].<ref name="pmid24685363">{{cite journal| author=Brutsaert E, Carey M, Zonszein J| title=The clinical impact of inpatient hypoglycemia. | journal=J Diabetes Complications | year= 2014 | volume= 28 | issue= 4 | pages= 565-72 | pmid=24685363 | doi=10.1016/j.jdiacomp.2014.03.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24685363  }}</ref>
* In older children and adults, moderately severe hypoglycemia can resemble [[mania]], [[mental illness]], [[drug intoxication]], or [[drunkenness]].  In the elderly, hypoglycemia can produce focal [[stroke|stroke-like]] effects or a hard-to-define [[malaise]]. The symptoms of a single person do tend to be similar from episode to episode.
* In older children and adults, moderately severe hypoglycemia can resemble [[mania]], [[mental illness]], [[drug intoxication]], or [[drunkenness]].  In the elderly, hypoglycemia can produce focal [[stroke|stroke-like]] effects or a hard-to-define [[malaise]].


=== Vitals ===
=== Vitals ===
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==== Pulse ====
==== Pulse ====
* Rate: [[Tachycardia]] may be present.
* Heart rate: [[Tachycardia]] may be present.


*Rhythm: The pulse is usually regular.
*Rhythm: Pulse is usually regular.
*[[Ventricular arrhythmias|Ventricular arrhythmia]] is fatal if occurred.<ref name="pmid17404614">{{cite journal| author=Cryer PE| title=Hypoglycemia, functional brain failure, and brain death. | journal=J Clin Invest | year= 2007 | volume= 117 | issue= 4 | pages= 868-70 | pmid=17404614 | doi=10.1172/JCI31669 | pmc=1838950 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17404614  }}</ref>
*[[Ventricular arrhythmias|Ventricular arrhythmia]] is fatal if occurred.<ref name="pmid17404614">{{cite journal| author=Cryer PE| title=Hypoglycemia, functional brain failure, and brain death. | journal=J Clin Invest | year= 2007 | volume= 117 | issue= 4 | pages= 868-70 | pmid=17404614 | doi=10.1172/JCI31669 | pmc=1838950 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17404614  }}</ref>


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===Eyes===
===Eyes===
* [[Staring|Staring]] look
*[[Dilated pupils]]
*[[Dilated pupils]]


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* [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]]<ref name="pmid24854693">{{cite journal| author=Lang T| title=Neonatal hypoglycemia. | journal=Clin Biochem | year= 2014 | volume= 47 | issue= 9 | pages= 718-9 | pmid=24854693 | doi=10.1016/j.clinbiochem.2014.05.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24854693  }}</ref>
* [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]]<ref name="pmid24854693">{{cite journal| author=Lang T| title=Neonatal hypoglycemia. | journal=Clin Biochem | year= 2014 | volume= 47 | issue= 9 | pages= 718-9 | pmid=24854693 | doi=10.1016/j.clinbiochem.2014.05.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24854693  }}</ref>
* [[Hypopituitarism|Congenital hypopituitarism]]: [[Facial defect|Midline facial defects]] and [[micropenis]]
* [[Hypopituitarism|Congenital hypopituitarism]]: [[Facial defect|Midline facial defects]] and [[micropenis]]
* [[Glycogen storage disease|Glycogen storage diseases]]: [[Hepatomegaly|hepatomegaly.]]
* [[Glycogen storage disease|Glycogen storage diseases]]: [[Hepatomegaly|Hepatomegaly.]]


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 20:38, 15 November 2017

Hypoglycemia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

Main signs of hypoglycemia are tachycardia and ventricular arrhythmia. Neurological manifestations include altered mental status, hypotonia, focal or general motor deficit and jerks. Neonatal hypoglycemia signs include large for gestational age, hepatomegaly in Beckwith-Wiedemann syndrome and glycogen storage diseases. Ambiguous genitalia, hypertension, hyponatremia, and hyperkalemia are found in congenital adrenal insufficiency.

Physical examination

Appearance

Vitals

Temperature

Pulse

Respiration

Skin

Eyes

Extremities

Neurologic

Neonatal Physical examination

References

  1. 1.0 1.1 Brutsaert E, Carey M, Zonszein J (2014). "The clinical impact of inpatient hypoglycemia". J Diabetes Complications. 28 (4): 565–72. doi:10.1016/j.jdiacomp.2014.03.002. PMID 24685363.
  2. Cryer PE (2007). "Hypoglycemia, functional brain failure, and brain death". J Clin Invest. 117 (4): 868–70. doi:10.1172/JCI31669. PMC 1838950. PMID 17404614.
  3. Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER; et al. (2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
  4. Rozance PJ (2014). "Update on neonatal hypoglycemia". Curr Opin Endocrinol Diabetes Obes. 21 (1): 45–50. doi:10.1097/MED.0000000000000027. PMC 4012366. PMID 24275620.
  5. Lang T (2014). "Neonatal hypoglycemia". Clin Biochem. 47 (9): 718–9. doi:10.1016/j.clinbiochem.2014.05.026. PMID 24854693.