Hypocalcemia physical examination: Difference between revisions

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{{Hypocalcemia}}
{{Hypocalcemia}}
 
{{CMG}}; {{AE}} {{VKG}}
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==Overview==
==Overview==
The clinical manifestations of [[hypocalcemia]] depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include [[Chvostek's sign]], [[Trousseau's sign]], and circumoral numbness.


==Signs==
==Physical Examination==
* [[Tetany (medical sign)|Tetany]], carpopedal spasm are seen. 
Physical examination of patients with [[hypocalcemia]] shows the following
* Latent tetany
** [[Trousseau sign of latent tetany]] (eliciting carpal spasm by inflating the [[blood pressure]] cuff and maintaining the cuff pressure above [[systolic]])
** [[Chvostek's sign]] (tapping of the inferior portion of the [[zygoma]] will produce facial spasms)
* Tendon reflexes are hyperactive
* Life threatening complications
** [[Laryngospasm]]
** [[Cardiac arrhythmia]]s


===Clinical Features Associated with Hypocalcemia===
==== Appearance of the Patient ====
* Patients with [[hypocalcemia]] usually appear confused,[[Disorientation|disoriented]],[[fatigue]].


* [[Abdominal pain]]
=== Skin ===
* Dry skin
* Coarse hair
* [[Brittle nails]]
* [[Alopecia]]
* [[Alopecia]]
* [[Anxiety]]
* [[Enamel]] hypoplasia
* [[Atopic eczema]]
* Shortened premolar roots
* [[Biliary colic]]
* Thickened [[lamina]] dura
* [[Brittle nails]]
* Delayed [[tooth]] eruption
* [[Bronchial spasm]]
* Calcification of cerebral cortex or cerebellum
* [[Cardiomyopathy]]
* [[Choreoathetosis]]
* [[Chvostek's sign]]
* Coarse hair
* [[Confusion]]
* [[Congestive heart failure]]
* Delayed tooth eruption
* Disorientation
* [[Dry skin]]
* [[Dysphagia]]
* [[Dyspnea]]
* Dystonic spasms
* Enamel hypoplasia
* Exfoliative dermatitis
* Extrapyramidal signs due to calcification of basal ganglia
* [[Fatigue]]
* Impaired intellectual ability
* Impetigo herpetiformis
* Increased dental caries
* Increased dental caries
* Increased intracranial pressure
* [[Atopic]] [[eczema]]
* [[Irritability]]
* [[Exfoliative dermatitis|Exfoliative]] dermatitis
* [[Laryngeal spasm]]
* [[Psoriasis]]
* [[Muscle cramp]]s
* [[Impetigo]] herpetiformis
* Nonspecific EEG changes
 
==== HEENT ====
* Subcapsular cataracts
* [[Papilledema]]
* [[Papilledema]]
* [[Paresthesia]]
 
==== Neuromuscular ====
* [[Chvostek's sign]]: Elicited by tapping the skin over the facial nerve anterior to the external auditory meatus.<ref name="JesusLandry2012">{{cite journal|last1=Jesus|first1=John Edwin|last2=Landry|first2=Alden|title=Chvostek's and Trousseau's Signs|journal=New England Journal of Medicine|volume=367|issue=11|year=2012|pages=e15|issn=0028-4793|doi=10.1056/NEJMicm1110569}}</ref><ref name="pmid23814758">{{cite journal |vauthors=Mohebbi MR, Rosenkrans KA, Jung MJ |title=Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism |journal=J Clin Diagn Res |volume=7 |issue=5 |pages=970 |date=May 2013 |pmid=23814758 |pmc=3681085 |doi=10.7860/JCDR/2013/5592.2992 |url=}}</ref>
* [[Trousseau's sign]]: Elicited by inflation of a blood pressure cuff to 20 mm Hg above the patient's systolic blood pressure for 3-5 minutes.<ref name="JesusLandry20122">{{cite journal|last1=Jesus|first1=John Edwin|last2=Landry|first2=Alden|title=Chvostek's and Trousseau's Signs|journal=New England Journal of Medicine|volume=367|issue=11|year=2012|pages=e15|issn=0028-4793|doi=10.1056/NEJMicm1110569}}</ref><ref name="pmid238147582">{{cite journal |vauthors=Mohebbi MR, Rosenkrans KA, Jung MJ |title=Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism |journal=J Clin Diagn Res |volume=7 |issue=5 |pages=970 |date=May 2013 |pmid=23814758 |pmc=3681085 |doi=10.7860/JCDR/2013/5592.2992 |url=}}</ref>
* [[Paresthesias]]
* [[Tetany]]
* [[Seizure|Seizures]] (focal, petit mal, grand mal)
* Muscle cramps
* Muscle weakness
* [[Laryngospasm]]
* [[Bronchospasm]]
'''Neurological signs '''
* [[Extrapyramidal]] signs due to calcification of [[basal ganglia]]
* [[Calcification]] of [[cerebral cortex]] or [[cerebellum]]
* Personality disturbances
* Irritability
* Impaired intellectual ability
* Nonspecific [[EEG]] changes
* Increased [[intracranial pressure]]
* [[Parkinsonism]]
* [[Parkinsonism]]
* Personality disturbances
* [[Choreoathetosis]]
* [[Polymyositis]]
* Dystonic spasm
* Prolonged QT interval in EKG
* Confusion
* [[Psoriasis]]
* Disorientation
* [[Psychoneurosis]]
* [[Psychosis]]
* Fatigue
* Anxiety
* Poor memory
* Reduced concentration
* Confusion
* [[Disorientation]]
* [[Psychosis]]
* [[Psychosis]]
* [[Seizure]]s (focal, petit mal, grand mal)
* Fatigue
* Shortened premolar roots
* Anxiety
* Subcapsular cataracts
* Poor memory
* [[Tetany]]
* Reduced concentration
* Thickened lamina dura
 
* [[Trousseau's sign]]
==== Abdomen ====
* [[Abdominal pain]]
* [[Biliary colic]]
 
==== Lungs ====
* [[Dyspnea]]
* [[Wheezing]]
* [[Wheezing]]
==== Heart ====
* Prolonged [[QT interval]] on EKG
* [[Congestive heart failure]]
* [[Cardiomyopathy]]


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


[[Category:Needs content]]
[[Category:Needs content]]
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Endocrinology]]
[[Category:Nephrology]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Latest revision as of 19:08, 16 July 2018

Hypocalcemia Microchapters

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

Overview

The clinical manifestations of hypocalcemia depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include Chvostek's sign, Trousseau's sign, and circumoral numbness.

Physical Examination

Physical examination of patients with hypocalcemia shows the following

Appearance of the Patient

Skin

HEENT

Neuromuscular

Neurological signs 

Abdomen

Lungs

Heart

References

  1. Jesus, John Edwin; Landry, Alden (2012). "Chvostek's and Trousseau's Signs". New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
  2. Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). "Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism". J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.
  3. Jesus, John Edwin; Landry, Alden (2012). "Chvostek's and Trousseau's Signs". New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
  4. Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). "Chvostek's and Trousseau's signs in a Case of Hypoparathyroidism". J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.

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