Archive:Pneumonia examination: Difference between revisions
wikademia>JWSchmidt {{OSCE2}} |
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History | ==History== | ||
*cough | *cough | ||
**productive? | **productive? | ||
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*underlying conditions: smoker, diabetes, cystic fibrosis, immunocomprimised, asthma, COPD, TB | *underlying conditions: smoker, diabetes, cystic fibrosis, immunocomprimised, asthma, COPD, TB | ||
Physical Exam | ==Physical Exam== | ||
===Inspection=== | |||
**ill-looking | **ill-looking | ||
**SOB | **SOB | ||
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**chills/rigors | **chills/rigors | ||
**respiratory distress | **respiratory distress | ||
===palpation=== | |||
**decreased chest expansion or asymetry | **decreased chest expansion or asymetry | ||
**lymphadenopathy | **lymphadenopathy | ||
**tactile fremitus | **tactile fremitus | ||
===percussion=== | |||
**dull | **dull | ||
**decreased diaphragmatic excursion | **decreased diaphragmatic excursion | ||
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**decreased air entry | **decreased air entry | ||
**crepitations | **crepitations | ||
**bronchophony -voice heard abnormally clearly over consolidated lung | **'''bronchophony''' -voice heard abnormally clearly over consolidated lung | ||
**egaphony - listen to patient's chest as they make "e" sound, if +'ve will hear an "a" sound | **'''egaphony''' - listen to patient's chest as they make "e" sound, if +'ve will hear an "a" sound | ||
**whispering pectoriloquay - pt whispers "1, 2, 3, 4", if clear then extreme consolidation | **'''whispering pectoriloquay''' - pt whispers "1, 2, 3, 4", if clear then extreme consolidation | ||
Investigations to order | ==Investigations to order== | ||
*CBC | *CBC | ||
*Blood cultures | *Blood cultures | ||
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**typical: discrete/lobar consolidation, air bronchograms | **typical: discrete/lobar consolidation, air bronchograms | ||
**atypical: diffuse/patchy/interstitial infiltrates | **atypical: diffuse/patchy/interstitial infiltrates | ||
==Other OSCE modules== | ==Other OSCE modules== | ||
{{OSCE2}} | {{OSCE2}} | ||
[[Category:OSCE]] | [[Category:OSCE]] | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
Revision as of 01:08, 18 May 2007
History
- cough
- productive?
- amount
- color
- odor/taste
- hemoptysis
- productive?
- fever, chills, rigors, SOB, chest pain (worse on inspiration), diaphoresis
- travel, infectious exposure, medications, EtOH
- underlying conditions: smoker, diabetes, cystic fibrosis, immunocomprimised, asthma, COPD, TB
Physical Exam
Inspection
- ill-looking
- SOB
- diaphoresis
- chills/rigors
- respiratory distress
palpation
- decreased chest expansion or asymetry
- lymphadenopathy
- tactile fremitus
percussion
- dull
- decreased diaphragmatic excursion
- auscultation
- bronchial breath sounds in periphery
- decreased air entry
- crepitations
- bronchophony -voice heard abnormally clearly over consolidated lung
- egaphony - listen to patient's chest as they make "e" sound, if +'ve will hear an "a" sound
- whispering pectoriloquay - pt whispers "1, 2, 3, 4", if clear then extreme consolidation
Investigations to order
- CBC
- Blood cultures
- mantoux (TB)
- serology (mycoplasma, viruses)
- sputum
- gram stain, C&S
- CXR
- typical: discrete/lobar consolidation, air bronchograms
- atypical: diffuse/patchy/interstitial infiltrates
Other OSCE modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence