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| {{Rabies}} | | {{Rabies}} |
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| '''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:'''
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| == Overview[edit | edit source] == | | == 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].
| | Common physical examination findings of rabies include [[hyperpyrexia]] alternating with [[hypothermia]], [[tachycardia]], [[respiratory]] collapse, [[hypersalivation]], [[lacrimation]], [[sweating]], [[Pupillary dilation|dilatation of the pupils]] and [[bradycardia]]. Skin findings may include percussion myoedema, bite marks and [[bruises]]. |
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| | == Physical Examination == |
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| Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
| | === Vital Signs === |
| | * [[Hyperpyrexia]] alternating with [[hypothermia]] |
| | * [[Tachycardia]] |
| | * [[Respiratory]] and [[vascular]] collapse |
| | * [[Bradycardia]] |
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| OR
| | === Skin === |
| | * Percussion myoedema (mounding of the muscle at the percussion site)<ref name="pmid2883526">{{cite journal |vauthors=Hemachudha T, Phanthumchinda K, Phanuphak P, Manutsathit S |title=Myoedema as a clinical sign in paralytic rabies |journal=Lancet |volume=1 |issue=8543 |pages=1210 |year=1987 |pmid=2883526 |doi= |url=}}</ref> |
| | * Bite marks |
| | * [[Bruises]] |
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| The presence of [finding(s)] on physical examination is diagnostic of [disease name].
| | === HEENT === |
| | * [[Hypersalivation]] |
| | *[[Lacrimation]] |
| | *[[Sweating]] |
| | *[[Pupillary dilation|Dilatation of the pupils]] |
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| OR
| | === Neck === |
| | * No abnormal findings |
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| The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
| | === Lungs === |
| | | * Fine/coarse [[crackles]] upon [[auscultation]] of the [[lung]] bases/apices unilaterally/bilaterally, if [[Aspirate|aspirated]]. |
| == Physical Examination[edit | edit source] == | | * [[Wheezing]] may be present due to [[aspiration]] or [[chest]] [[infection]] |
| * Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
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| * The presence of [finding(s)] on physical examination is diagnostic of [disease name].
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| * The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
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| === Appearance of the Patient[edit | edit source] ===
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| * Patients with [disease name] usually appear [general appearance]. | |
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| === Vital Signs[edit | edit source] ===
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| * High-grade / low-grade fever
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| * [[Hypothermia]] / hyperthermia may be present
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| * [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
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| * [[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
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| * Tachypnea / bradypnea
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| * Kussmal respirations may be present in _____ (advanced disease state)
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| * Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
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| * High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
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| === Skin[edit | edit source] ===
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| * Percussion myoedema (mounding of the muscle at the percussion site)
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| * Bruises
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| * UploadedImage-01.jpg Description [http://www.atlasdermatologico.com.br/ (Adapted from Dermatology Atlas)]
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| * UploadedImage-02.jpg Description [http://www.atlasdermatologico.com.br/ (Adapted from Dermatology Atlas)]
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| === HEENT[edit | edit source] ===
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| * Abnormalities of the head/hair may include ___
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| * Evidence of trauma
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| * Icteric sclera
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| * [[Nystagmus]]
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| * Extra-ocular movements may be abnormal
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| * Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
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| * Ophthalmoscopic exam may be abnormal with findings of ___
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| * Hearing acuity may be reduced
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| * [[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".)
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| * [[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
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| * Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
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| * Inflamed nares / congested nares
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| * [[Purulent]] exudate from the nares
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| * Facial tenderness
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| * Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
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| === Neck[edit | edit source] ===
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| * [[Jugular venous distension]]
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| * [[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
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| * [[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
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| * [[Thyromegaly]] / thyroid nodules
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| * [[Hepatojugular reflux]]
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| === Lungs[edit | edit source] ===
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| * Asymmetric chest expansion / Decreased chest expansion
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| * Lungs are hypo/hyperresonant
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| * Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
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| * Rhonchi
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| * Vesicular breath sounds / Distant breath sounds
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| * Expiratory/inspiratory wheezing with normal / delayed expiratory phase
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| * [[Wheezing]] may be present
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| * [[Egophony]] present/absent
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| * [[Bronchophony]] present/absent
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| * Normal/reduced [[tactile fremitus]] | | * Normal/reduced [[tactile fremitus]] |
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| === Heart[edit | edit source] === | | === Heart === |
| * Chest tenderness upon palpation
| | * [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] normal, soft |
| * PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
| | * [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] normal |
| * [[Heave]] / [[thrill]]
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| * [[Friction rub]]
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| * [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] | |
| * [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] | |
| * [[Heart sounds#Third heart sound S3|S3]]
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| * [[Heart sounds#Fourth heart sound S4|S4]]
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| * [[Heart sounds#Summation Gallop|Gallops]]
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| * 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
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| === Abdomen[edit | edit source] ===
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| * [[Abdominal distention]]
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| * [[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
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| * [[Rebound tenderness]] (positive Blumberg sign)
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| * A palpable abdominal mass in the right/left upper/lower abdominal quadrant
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| * Guarding may be present
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| * [[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
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| * Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
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| === Back[edit | edit source] ===
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| * Point tenderness over __ vertebrae (e.g. L3-L4)
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| * Sacral edema
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| * Costovertebral angle tenderness bilaterally/unilaterally
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| * Buffalo hump
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| === Genitourinary[edit | edit source] === | | === Abdomen === |
| * A pelvic/adnexal mass may be palpated | | * [[Guarding]] may be present |
| * Inflamed mucosa
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| * Clear/(color), foul-smelling/odorless penile/vaginal discharge
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| === Neuromuscular[edit | edit source] === | | === Genitourinary === |
| * Patient is usually oriented to persons, place, and time | | * No abnormal findings |
| * Altered mental status
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| * Glasgow coma scale is ___ / 15
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| * Clonus may be present
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| * Hyperreflexia / hyporeflexia / areflexia
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| * Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
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| * Muscle rigidity
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| * Proximal/distal muscle weakness unilaterally/bilaterally
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| * ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
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| * Unilateral/bilateral upper/lower extremity weakness
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| * Unilateral/bilateral sensory loss in the upper/lower extremity
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| * Positive straight leg raise test
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| * Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
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| * Positive/negative Trendelenburg sign
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| * Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
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| * Normal finger-to-nose test / Dysmetria
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| * Absent/present dysdiadochokinesia (palm tapping test)
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| === Extremities[edit | edit source] === | | === Neuromuscular === |
| * [[Clubbing]] | | * [[Opisthotonos]] |
| * [[Cyanosis]] | | * [[Altered mental status]] |
| * Pitting/non-pitting [[edema]] of the upper/lower extremities | | * Increased [[Tendon reflex|tendon reflexes]] with [[Extensor plantar reflexes|extensor plantar responses]] |
| * Muscle atrophy | | *[[Flaccid paralysis]] with generalized [[areflexia]] when patient develops [[coma]] |
| * Fasciculations in the upper/lower extremity | | * [[Nuchal rigidity]] |
| | * Increased [[muscle tone]] |
| | * [[Fasciculations]] |
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| == References[edit | edit source] == | | === Extremities === |
| Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
| | * Bite marks |
| | * Muscle [[atrophy]] |
| | * [[Fasciculations]] in the upper/lower extremity |
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
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| [[Category:Viral diseases]] | | [[Category:Viral diseases]] |
| [[Category:Mononegavirales]] | | [[Category:Mononegavirales]] |
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