Metabolic alkalosis physical examination: Difference between revisions

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Revision as of 07:32, 1 February 2021

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

Overview

Patients with Metabolic alkalosis usually appear restless, irritable. Physical examination of patients with metabolic alkalosis is usually remarkable for tachycardia/dysrhythmia, hypoxemia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor, tingling and numbness in extremities, Weakness.

Physical Examination

Physical examination of patients with metabolic alkalosis is usually remarkable for : tachycardia/dysrhythmia, hypoxemia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor, tingling and numbness in extremities, Weakness.

Appearance of the Patient

Patients with metabolic alkalosis usually appear Restlessness/ Irritable/lethargic.

Vital Signs

High-grade / low-grade fever
Hypothermia may present in hypovolemic conditions, hyperthermia may be seen endocrine or infectious causes.
Tachycardia with regular pulse.
Compensatory Bradypnea.
High/low blood pressure depending on causes of metabolic alkalosis

Skin

Skin examination of patients with metabolic alkalosis is usually:
Decreased or normal turgor
Cool and clammy in hypovolemic condition
Pallor

HEENT

Headache
Dizziness
Dry oral mucosa without tonsillar swelling, exudates, and/or petechiae

Neck

Jugular venous distension or Flat JVD depending on causes.
Carotid bruits may or may not be auscultated unilaterally/bilaterally using the bell/diaphragm of the stethoscope

Lungs

Hypoxemia
Compensatory hypoventilation
Pulmonary microatelactasis
Increased V/Q mismatch

Heart

Tachycardia
Dysarrythmia
CHF findings

Abdomen

Abdominal examination of patients with metabolic alkalosis is usually depends on the causes.

Back

Back examination of patients with metabolic alkalosis is usually normal.

Genitourinary

Urine output and frequency should be measured.

Neuromuscular

Confusion
Loss of consciousness/Mental obtundation, *Neuromuscular excitability/Muscle cramps, *Tremor

Extremities

Tingling and numbness in extremities, *Weakness

References

Template:WH Template:WS

@@ Line 2: / Line 2: @@
 {{Metabolic alkalosis}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}} {{MMT}}
 ==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 Metabolic alkalosis usually appear restless, irritable. Physical examination of patients with metabolic alkalosis is usually remarkable for tachycardia/dysrhythmia, hypoxemia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor, tingling and numbness in extremities, Weakness.
-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 of patients with [disease name] is usually normal.
+*Physical examination of patients with metabolic alkalosis is usually remarkable for : tachycardia/dysrhythmia, hypoxemia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor, tingling and numbness in extremities, Weakness.
-OR
-*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
-*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
-*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
 ===Appearance of the Patient===
-*Patients with [disease name] usually appear [general appearance].
+*Patients with metabolic alkalosis usually appear Restlessness/ Irritable/lethargic.
 ===Vital Signs===
 *High-grade / low-grade fever
-*[[Hypothermia]] / hyperthermia may be present
+*[[Hypothermia]] may present in hypovolemic conditions, hyperthermia may be seen endocrine or infectious causes.
-*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
+*[[Tachycardia]] with regular pulse.
-*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
+*Compensatory Bradypnea.
-*Tachypnea / bradypnea
+*High/low blood pressure depending on causes of metabolic alkalosis
-*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 examination of patients with [disease name] is usually normal.
+* Skin examination of patients with metabolic alkalosis is usually:
-OR
+*Decreased or normal [[turgor ]]
-*[[Cyanosis]]
+*[[Cool and clammy in hypovolemic condition]]
-*[[Jaundice]]
 * [[Pallor]]
-* Bruises
-<gallery widths="150px">
-UploadedImage-01.jpg | Description {{dermref}}
-UploadedImage-02.jpg | Description {{dermref}}
-</gallery>
 ===HEENT===
-* HEENT examination of patients with [disease name] is usually normal.
+*Headache
-OR
+*Dizziness
-* Abnormalities of the head/hair may include ___
+*Dry oral mucosa without tonsillar swelling, exudates, and/or petechiae
-* Evidence of trauma
-* 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 examination of patients with [disease name] is usually normal.
+*[[Jugular venous distension]] or Flat JVD depending on causes.
-OR
+*[[Carotid bruits]] may or may not be auscultated unilaterally/bilaterally using the bell/diaphragm of the stethoscope
-*[[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===
-* Pulmonary examination of patients with [disease name] is usually normal.
+*Hypoxemia
-OR
+*Compensatory hypoventilation
-* Asymmetric chest expansion / Decreased chest expansion
+*Pulmonary microatelactasis
-*Lungs are hypo/hyperresonant
+*Increased V/Q mismatch
-*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
-*Rhonchi
-*Vesicular breath sounds / Distant breath sounds
-*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
-*[[Wheezing]] may be present
-*[[Egophony]] present/absent
-*[[Bronchophony]] present/absent
-*Normal/reduced [[tactile fremitus]]
 ===Heart===
-* Cardiovascular examination of patients with [disease name] is usually normal.
+*Tachycardia
-OR
+*Dysarrythmia
-*Chest tenderness upon palpation
+*CHF findings
-*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 otoscope
 ===Abdomen===
-Abdominal examination of patients with [disease name] is usually normal.
+Abdominal examination of patients with metabolic alkalosis is usually depends on the causes.
-OR
+===Back===
-*[[Abdominal distention]]
+* Back examination of patients with metabolic alkalosis is usually normal.
-*[[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 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.
+*Urine output and frequency should be measured.
-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.
+*Confusion
-OR
+*Loss of consciousness/Mental obtundation, *Neuromuscular excitability/Muscle cramps, *Tremor
-*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 [disease name] is usually normal.
+*Tingling and numbness in extremities, *Weakness
-OR
-*[[Clubbing]]
-*[[Cyanosis]]
-*Pitting/non-pitting [[edema]] of the upper/lower extremities
-*Muscle atrophy
-*Fasciculations in the upper/lower extremity
 ==References==