Churg-Strauss syndrome physical examination: Difference between revisions

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===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
*Skin examination of patients with eosinophilic granulomatosis with polyangiitis may show:
OR
**Petechiae
*[[Cyanosis]]
**Ecchymosis
*[[Jaundice]]
**Purpura
* [[Pallor]]
**Nodules
* Bruises
 
<gallery widths="150px">
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
*Sinusitis
OR
*Rhinitis
* Abnormalities of the head/hair may include ___
*Nasal polyps
* Evidence of trauma
*Otitis media
* Icteric sclera
*Hearing acuity may be reduced
* [[Nystagmus]]
*[[Weber test]] may be abnormal  
* Extra-ocular movements may be abnormal
*[[Rinne test]] 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
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
*Facial tenderness
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
===Neck===
===Neck===
* Neck examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal.
* Neck examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal.
===Lungs===
===Lungs===
* [[Wheeze|Wheezing]]
The examination may show signs of:
* Expiratory ronchi
*Asthma
OR
**[[Wheeze|Wheezing]]
* Asymmetric chest expansion / Decreased chest expansion
**Expiratory ronchi
*Lungs are hypo/hyperresonant
*Pleural effusion
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*Pulmonary hypertension(Basilar crackles)
*[[Wheezing]] may be present
 
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
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* Patient is usually oriented to persons, place, and time.
* Patient is usually oriented to persons, place, and time.
* [[Peripheral neuropathy]]
* [[Peripheral neuropathy]]
* [[Mononeuritis multiplex]] - [[foot drop]], [[wrist drop]]
* [[Mononeuritis multiplex]] - [[foot drop]], [[wrist drop]]<ref name="pmid20050889">{{cite journal |vauthors=Wolf J, Bergner R, Mutallib S, Buggle F, Grau AJ |title=Neurologic complications of Churg-Strauss syndrome--a prospective monocentric study |journal=Eur. J. Neurol. |volume=17 |issue=4 |pages=582–8 |date=April 2010 |pmid=20050889 |doi=10.1111/j.1468-1331.2009.02902.x |url=}}</ref>
* [[Nerve palsy|Cranial nerve palsy]]
* [[Nerve palsy|Cranial nerve palsy]]
* Stroke


===Extremities===
===Extremities===

Revision as of 15:04, 6 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

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].

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 of patients with [disease name] is usually normal.

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

  • Patients with [disease name] 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 eosinophilic granulomatosis with polyangiitis may show:
    • Petechiae
    • Ecchymosis
    • Purpura
    • Nodules

HEENT

  • Sinusitis
  • Rhinitis
  • Nasal polyps
  • Otitis media
  • Hearing acuity may be reduced
  • Weber test may be abnormal
  • Rinne test may be abnormal
  • Inflamed nares / congested nares
  • Facial tenderness

Neck

Lungs

The examination may show signs of:

  • Asthma
  • Pleural effusion
  • Pulmonary hypertension(Basilar crackles)


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
  • 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 otoscope

Abdomen

Abdominal examination of patients with eosinophilic granulomatosis with polyangiitis may show :

Back

Genitourinary

===Neuromuscular===[1]

Extremities

References

  1. 1.0 1.1 Wolf J, Bergner R, Mutallib S, Buggle F, Grau AJ (April 2010). "Neurologic complications of Churg-Strauss syndrome--a prospective monocentric study". Eur. J. Neurol. 17 (4): 582–8. doi:10.1111/j.1468-1331.2009.02902.x. PMID 20050889.

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