Hepatopulmonary syndrome physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with | Patients with hepatopulmonary syndrome usually appear [general appearance]. Physical examination of patients with hepatopulmonary syndrome is usually remarkable for [finding 1], [finding 2], and [finding 3]. | ||
OR | OR | ||
Common physical examination findings of | Common physical examination findings of hepatopulmonary syndrome include [finding 1], [finding 2], and [finding 3]. | ||
OR | OR | ||
The presence of [finding(s)] on physical examination is diagnostic of | The presence of [finding(s)] on physical examination is diagnostic of hepatopulmonary syndrome. | ||
OR | OR | ||
The presence of [finding(s)] on physical examination is highly suggestive of | The presence of [finding(s)] on physical examination is highly suggestive of hepatopulmonary syndrome. | ||
==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients with | Physical examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
Physical examination of patients with | Physical examination of patients with hepatopulmonary syndrome is usually remarkable for [finding 1], [finding 2], and [finding 3]. | ||
OR | OR | ||
The presence of [finding(s)] on physical examination is diagnostic of | The presence of [finding(s)] on physical examination is diagnostic of hepatopulmonary syndrome. | ||
OR | OR | ||
The presence of [finding(s)] on physical examination is highly suggestive of | The presence of [finding(s)] on physical examination is highly suggestive of hepatopulmonary syndrome. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with | *Patients with hepatopulmonary syndrome usually appear [general appearance]. | ||
===Vital Signs=== | ===Vital Signs=== | ||
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===Skin=== | ===Skin=== | ||
* Skin examination of patients with | * Skin examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*[[Cyanosis]] | *[[Cyanosis]] | ||
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===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with | * HEENT examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
* Abnormalities of the head/hair may include ___ | * Abnormalities of the head/hair may include ___ | ||
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===Neck=== | ===Neck=== | ||
* Neck examination of patients with | * Neck examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*[[Jugular venous distension]] | *[[Jugular venous distension]] | ||
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===Lungs=== | ===Lungs=== | ||
* Pulmonary examination of patients with | * Pulmonary examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
* Asymmetric chest expansion OR decreased chest expansion | * Asymmetric chest expansion OR decreased chest expansion | ||
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===Heart=== | ===Heart=== | ||
* Cardiovascular examination of patients with | * Cardiovascular examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*Chest tenderness upon palpation | *Chest tenderness upon palpation | ||
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===Abdomen=== | ===Abdomen=== | ||
* Abdominal examination of patients with | * Abdominal examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*[[Abdominal distension]] | *[[Abdominal distension]] | ||
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===Back=== | ===Back=== | ||
* Back examination of patients with | * Back examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*Point tenderness over __ vertebrae (e.g. L3-L4) | *Point tenderness over __ vertebrae (e.g. L3-L4) | ||
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===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with | * Genitourinary examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*A pelvic/adnexal mass may be palpated | *A pelvic/adnexal mass may be palpated | ||
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===Neuromuscular=== | ===Neuromuscular=== | ||
* Neuromuscular examination of patients with | * Neuromuscular examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*Patient is usually oriented to persons, place, and time | *Patient is usually oriented to persons, place, and time | ||
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===Extremities=== | ===Extremities=== | ||
* Extremities examination of patients with | * Extremities examination of patients with hepatopulmonary syndrome is usually normal. | ||
OR | OR | ||
*[[Clubbing]] | *[[Clubbing]] | ||
Revision as of 21:09, 26 July 2019
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Hepatopulmonary syndrome Microchapters |
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Differentiating Hepatopulmonary syndrome from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatopulmonary syndrome physical examination On the Web |
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American Roentgen Ray Society Images of Hepatopulmonary syndrome physical examination |
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Risk calculators and risk factors for Hepatopulmonary syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Patients with hepatopulmonary syndrome usually appear [general appearance]. Physical examination of patients with hepatopulmonary syndrome is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of hepatopulmonary syndrome include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of hepatopulmonary syndrome.
OR
The presence of [finding(s)] on physical examination is highly suggestive of hepatopulmonary syndrome.
Physical Examination
Physical examination of patients with hepatopulmonary syndrome is usually normal.
OR
Physical examination of patients with hepatopulmonary syndrome is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of hepatopulmonary syndrome.
OR
The presence of [finding(s)] on physical examination is highly suggestive of hepatopulmonary syndrome.
Appearance of the Patient
- Patients with hepatopulmonary syndrome usually appear [general appearance].
Vital Signs
- High-grade / low-grade fever
- Hypothermia / hyperthermia may be present
- Tachycardia with regular pulse or (ir)regularly irregular pulse
- Bradycardia with regular pulse or (ir)regularly irregular pulse
- Tachypnea / bradypnea
- 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 hepatopulmonary syndrome is usually normal.
OR
-
Description (Adapted from Dermatology Atlas)
-
Description (Adapted from Dermatology Atlas)
HEENT
- HEENT examination of patients with hepatopulmonary syndrome is usually normal.
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 examination of patients with hepatopulmonary syndrome is usually normal.
OR
- 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 hepatopulmonary syndrome is usually normal.
OR
- Asymmetric chest expansion OR decreased chest expansion
- Lungs are hyporesonant OR hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- Rhonchi
- Vesicular breath sounds OR distant breath sounds
- Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
- Wheezing may be present
- Egophony present/absent
- Bronchophony present/absent
- Normal/reduced tactile fremitus
Heart
- Cardiovascular examination of patients with hepatopulmonary syndrome 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
- S1
- S2
- S3
- S4
- 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 stethoscope
Abdomen
- Abdominal examination of patients with hepatopulmonary syndrome is usually normal.
OR
- Abdominal distension
- 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 hepatopulmonary syndrome 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 hepatopulmonary syndrome 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 hepatopulmonary syndrome 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 examination of patients with hepatopulmonary syndrome is usually normal.
OR
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity