Appendix cancer physical examination: Difference between revisions

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{{Appendix cancer}}
{{Appendix cancer}}


{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{Soroush}}


==Overview==
==Overview==
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==Physical Examination==
==Physical Examination==
*
* Patients with appendix cancer may appear normal, pale or diaphoretic.
*


*Physical examination of patients with appendix cancer is usually normal.
*Physical examination of patients with appendix cancer is usually normal.
*If the patient with appendix cancer present with [[acute appendicitis]] which is quit common, abdominal tenderness, [[Rebound tenderness]], [[Abdominal guarding|abdominal guarding,]] [[Rovsing's sign|Rovsing's sign,]] as well as [[Psoas sign]] might be present.  
*If the patient with appendix cancer present with [[acute appendicitis]] which is quit common, abdominal tenderness, [[Rebound tenderness]], [[Abdominal guarding|abdominal guarding,]] [[Rovsing's sign|Rovsing's sign,]] as well as [[Psoas sign]] might be present.  
*Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome.
*Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome.
*Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common.  
*Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common.  
*In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of  of [[Pellagra]] disease.
*In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of  of [[Pellagra]] disease.



Revision as of 19:29, 24 January 2019

Appendix cancer Microchapters

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

Overview

Patients with appendix cancer usually appear normal, pale or diaphoretic. If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present. Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome. Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common. In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.

Physical Examination

  • Physical examination of patients with appendix cancer is usually normal.
  • If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present.
  • Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome.
  • Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common.
  • In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.

Appearance of the Patient

  • Patients with appendix cancer usually appear normal but might be pale or diaphoretic, or even present with a facial flushing.

Vital Signs

  • Fever might be present in patients presenting with appendicitis.
  • Tachycardia is prevalent in patients with carcinoid syndrome as well as patients with appendicitis.
  • Tachypnea
  • Hypertension

Skin

  • Skin examination of patients with appendix cancer is usually normal.

in the presence of carcinoid syndrome the following might be present:

HEENT

  • HEENT examination of patients with appendix cancer is usually normal.

Neck

Lungs

  • Pulmonary examination of patients with appendix cancer is usually normal.
  • Wheezing : if the patient develop carcinoid syndrome

Heart

  • Cardiovascular examination of patients with appendix cancer is usually normal.

but

Abdomen

  • Abdominal examination of patients with [disease name] is usually normal.

OR

Palpation

Rectal examination

Back

  • Back examination of patients with [disease name] is usually normal.

OR

  • Point tenderness over __ vertebrae (e.g. L3-L4)
  • Sacral edema
  • Costovertebral angle tenderness bilaterally/unilaterally
  • Buffalo hump

Genitourinary

  • Genitourinary examination of patients with [disease name] is usually normal.

OR

  • A pelvic/adnexal mass may be palpated
  • Inflamed mucosa
  • Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

  • Neuromuscular examination of patients with [disease name] is usually normal.

OR

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is ___ / 15
  • Clonus may be present
  • 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
  • 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 examination of patients with appendix cancer is usually normal.

References

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