Hyperparathyroidism physical examination: Difference between revisions

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==Overview==
==Overview==
Physical examination of patients with hyperparathyroidism is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.
Physical examination of patients with hyperparathyroidism is usually unremarkable. Patients may have physical findings due to severe [[hypercalcemia]] and other [[Hyperparathyroidism natural history, complications and prognosis#Natural History, Complications, and Prognosis|complications of hyperparathyroidism]].


==Physical Examination==
==Physical Examination==


*Physical examination of patients with hyperparathyroidism is usually unremarkable.
*Physical examination of patients with hyperparathyroidism is usually unremarkable.<ref name="pmid21321169">{{cite journal |vauthors=Pallan S, Khan A |title=Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care |journal=Can Fam Physician |volume=57 |issue=2 |pages=184–9 |year=2011 |pmid=21321169 |pmc=3038812 |doi= |url=}}</ref>
*Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.
*Patients may have physical findings due to severe [[hypercalcemia]] and other [[Hyperparathyroidism natural history, complications and prognosis#Natural History, Complications, and Prognosis|complications of hyperparathyroidism]].<ref name="pmid11350446">{{cite journal |vauthors=Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J |title=Unique clinical characteristics of primary hyperparathyroidism in India |journal=Br J Surg |volume=88 |issue=5 |pages=708–14 |year=2001 |pmid=11350446 |doi=10.1046/j.0007-1323.2001.01775.x |url=}}</ref>


===Appearance of the Patient===
===Appearance of the Patient===
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===Vital Signs===
===Vital Signs===
*Patients with hypercalcemia and other complications may have:
*Patients with [[hypercalcemia]] and other complications may have:
**High blood pressure may be present due to hypercalcemia and renal failure
**[[High blood pressure]] due to [[hypercalcemia]] and [[renal failure]]


===Skin===
===Skin===
*Perisitent itching may be present due to renal failure
*Persistent [[itching]] may be present due to [[renal failure]]


===HEENT===
===HEENT===
*Patients with severe hypercalcemia may have:
*Patients with severe [[hypercalcemia]] may have:
** Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairement
** [[Band keratopathy]] ([[calcium]] precipitation in a horizontal band across the [[cornea]] in the palpebral aperture); may lead to [[Visual impairment|vision impairment]]


===Lungs===
===Lungs===
*Patients with hypercalcemia and other complications may have:
*Patients with [[hypercalcemia]] and other complications may have:
*Dyspnea due to fluid overload form renal failure
**[[Dyspnea]] due to [[fluid overload]] form [[renal failure]]


===Cardiovasvular===
===Cardiovasvular===
*Patients with hypercalcemia and other complications may have:
*Patients with [[hypercalcemia]] and other complications may have:
**Palpitations due to arrhythmias
**[[Palpitation|Palpitations]] due to [[arrhythmias]]
**Shortened QT interval
**Shortened [[QT interval]]
**Chest pain due to fluid overload form renal failure
**[[Chest pain]] due to [[fluid overload]] form [[renal failure]]
**Rales and S3 due to fluid overload form renal failure
**[[Rales]] and [[S3]] due to [[fluid overload]] form [[renal failure]]


===Abdomen===
===Abdomen===
*Patients with hypercalcemia and other complications may have:
*Patients with [[hypercalcemia]] and other complications may have:
**Nausea and vomiting
**[[Nausea and vomiting]]
**Anorexia  
**[[Anorexia]]
**Fecal impaction (from constipation)
**[[Fecal impaction]] (from [[constipation]])
**Epigastric pain and tenderness due to development of pancreatitis
**[[Epigastric pain]] and [[tenderness]] due to development of [[pancreatitis]]
**Flank pain and tenderness due to nephrolithiasis
**[[Flank pain]] and [[tenderness]] due to [[nephrolithiasis]]


===Genitourinary===
===Genitourinary===
*Patients with severe hypercalcemia and other complications may have:
*Patients with severe [[hypercalcemia]] and other complications may have:
**Alteration in urinary habits
**Alteration in [[urinary]] habits
**Volume depletion
**[[Volume depletion]]
**Signs of renal failure
**Signs of [[renal failure]]


===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time.
*Patient is usually oriented to persons, place, and time.
*Patients with severe hypercalcemia and other complications may have:
*Patients with severe [[hypercalcemia]] and other complications may have:
**Anxiety
**[[Anxiety]]
**Fatigue and weakness due to renal failure
**[[Fatigue]] and [[weakness]] due to [[renal failure]]
**Lethargy
**[[Lethargy]]
**Sleep disturbances
**[[Sleep disturbances]]
**Muscle twitch and cramps
**[[Muscle twitch]] and [[cramps]]
**Signs of depression
**Signs of [[depression]]
**Confusion
**[[Confusion]]
**Memory disturbances
**[[Memory]] disturbances
**Hypotonia
**[[Hypotonia]]
**Hyporeflexia
**[[Hyporeflexia]]
**Paresis
**[[Paresis]]
**Coma
**[[Coma]]


===Extremities===
===Extremities===
*Swelling of feet and ankles due to renal failure
*Swelling of feet and [[Ankle|ankles]] due to [[renal failure]]
*Arthralgia due to bone resoprtion
*[[Arthralgia]] due to bone [[resorption]]


==References==
==References==
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[[Category:Disease]]
[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Parathyroid disorders]]
[[Category:Up-To-Date]]

Latest revision as of 22:16, 29 July 2020

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

Overview

Physical examination of patients with hyperparathyroidism is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.

Physical Examination

Appearance of the Patient

  • Patients with hyperparathyroidism usually appear well.

Vital Signs

Skin

HEENT

Lungs

Cardiovasvular

Abdomen

Genitourinary

Neuromuscular

Extremities

References

  1. Pallan S, Khan A (2011). "Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care". Can Fam Physician. 57 (2): 184–9. PMC 3038812. PMID 21321169.
  2. Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J (2001). "Unique clinical characteristics of primary hyperparathyroidism in India". Br J Surg. 88 (5): 708–14. doi:10.1046/j.0007-1323.2001.01775.x. PMID 11350446.

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