Hypoglycemia physical examination: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 9: Line 9:


===Appearance===
===Appearance===
* [[Macrosomia]] in [[infancy]] may indicate [[congenital hyperinsulinism|hyperinsulinism]].
* [[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]]. The symptoms of a single person do tend to be similar from episode to episode.


Line 36: Line 36:
*[[Cyanosis]] may be present in newborns
*[[Cyanosis]] may be present in newborns


=== Neurologic <ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155  }}</ref> ===
=== Neurologic ===
* Mental status may be altered
* [[Mental status]] may be altered<ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155  }}</ref>
*[[Myoclonus]]
*[[Myoclonus]]
*[[Hypotonia]]
*[[Hypotonia]]
Line 47: Line 47:


=== Neonatal Physical examination ===
=== Neonatal Physical examination ===
* [[Large for gestational age]]
* [[Large for gestational age]]<ref name="pmid24685363" />
* [[Beckwith-Wiedemann syndrome]] signs: [[hemihypertrophy]], [[hepatomegaly]] and [[macroglossia]]
* [[Beckwith-Wiedemann syndrome]] signs: [[hemihypertrophy]], [[hepatomegaly]] and [[macroglossia]]
* [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]]
* [[21-hydroxylase deficiency|Congenital adrenal insufficiency]]: [[ambiguous genitalia]], [[hypertension]], [[hyponatremia]], and [[hyperkalemia]]

Revision as of 14:27, 2 October 2017

Hypoglycemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoglycemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypoglycemia physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypoglycemia physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypoglycemia physical examination

CDC on Hypoglycemia physical examination

Hypoglycemia physical examination in the news

Blogs on Hypoglycemia physical examination

Directions to Hospitals Treating Hypoglycemia

Risk calculators and risk factors for Hypoglycemia physical examination

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

  • Rhythm: The pulse is usually regular.
  • Ventricular arrhythmia is fatal if occurred.[2]

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.