|
|
| (11 intermediate revisions by the same user not shown) |
| Line 4: |
Line 4: |
|
| |
|
| ==Overview== | | ==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 [[Hamman-Rich syndrome|acute interstitial pneumonitis]] usually appear ill. Physical examination shows [[tachypnea]], [[tachycardia]], [[Rales|crackles]], [[Wheeze|wheezing]] and signs of [[hypoxemia]]. |
| | |
| 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== |
| * Physical examination of patients with [disease name] is usually normal. | | * Physical examination of patients with acute interstitial pneumonitis will show tachypnea, tachycardia, cyanosis, crackles, and wheezes on auscultation. |
| 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=== | | ===Appearance of the Patient=== |
| Line 34: |
Line 18: |
| *[[Tachypnea]] | | *[[Tachypnea]] |
|
| |
|
| ===Ski=== | | ===Skin=== |
| *[[Cyanosis]] because of hypoxemia. | | *[[Cyanosis]] because of hypoxemia. |
| | |
|
| |
|
| ===HEENT=== | | ===HEENT=== |
| * HEENT examination of patients with [disease name] is usually normal. | | *Flared nares |
| OR
| |
| * Abnormalities of the head/hair may include ___
| |
| * 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=== |
| * Neck examination of patients with [disease name] is usually normal. | | * Neck examination of patients with [[Hamman-Rich syndrome|acute interstitial pneumonitis]] is usually normal. |
| OR
| | |
| *[[Jugular venous distension]] | | ===Heart=== |
| *[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope | | *Tachycardia |
| *[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
| | *Examine heart for findings of congestive heart failure to exclude the diagnosis. |
| *[[Thyromegaly]] / thyroid nodules
| |
| *[[Hepatojugular reflux]]
| |
|
| |
|
| ===Lungs=== | | ===Lungs=== |
| * Pulmonary examination of patients with [disease name] is usually normal. | | * Diffuse [[crackles]] upon auscultation of the lungs bilaterally<ref name="pmid11144035">{{cite journal |vauthors=Vourlekis JS, Brown KK, Cool CD, Young DA, Cherniack RM, King TE, Schwarz MI |title=Acute interstitial pneumonitis. Case series and review of the literature |journal=Medicine (Baltimore) |volume=79 |issue=6 |pages=369–78 |date=November 2000 |pmid=11144035 |doi= |url=}}</ref> |
| OR
| |
| * Asymmetric chest expansion / Decreased chest expansion
| |
| *Lungs are hypo/hyperresonant
| |
| *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 | | *[[Wheezing]] may be present |
| *[[Egophony]] present/absent | | *Prolonged expiration |
| *[[Bronchophony]] present/absent | | *Persistent scattered rhonchi |
| *Normal/reduced [[tactile fremitus]]
| |
| | |
| ===Heart===
| |
| * Cardiovascular examination of patients with [disease name] is usually normal.
| |
| OR
| |
| *Chest tenderness upon palpation
| |
| *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.
| |
| | |
| OR
| |
| *[[Abdominal distention]]
| |
| *[[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.
| |
| 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.
| |
| OR
| |
| *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=== |
| * Extremities examination of patients with [disease name] is usually normal. | | *[[Clubbing]] is not usually present in [[Hamman-Rich syndrome|acute interstitial pneumonitis]]. Presence of [[clubbing]] indicates exacerbation of preexisting fibrotic lung disease. |
| OR
| | *[[Cyanosis]] due to hypoxemia |
| *[[Clubbing]]
| |
| *[[Cyanosis]]
| |
| *Pitting/non-pitting [[edema]] of the upper/lower extremities | |
| *Muscle atrophy
| |
| *Fasciculations in the upper/lower extremity
| |
|
| |
|
| ==References== | | ==References== |