Archive:Pneumonia examination: Difference between revisions
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==History== | ==History== | ||
*cough | *cough *cough *cough | ||
**productive? | **productive? (re-productive) | ||
***amount | ***amount (whoa! lots) | ||
***color | ***color (rainbow) | ||
***odor/taste | ***odor/taste (delicious) | ||
***hemoptysis | ***hemoptysis (<--wha?) | ||
*fever, chills, rigors, SOB, chest pain (worse on inspiration), diaphoresis | *fever, chills, rigors, SOB, chest pain (worse on inspiration), diaphoresis | ||
*travel, infectious exposure, medications, EtOH | *travel, infectious exposure, medications, EtOH | ||
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==Physical Exam== | ==Physical Exam== | ||
===Inspection=== | ===Inspection=== | ||
**ill-looking | **ill-looking duh | ||
**SOB | **SOB <--- so mean | ||
**diaphoresis | **diaphoresis of the obese intestine | ||
**chills/rigors | **chills/rigors mortises | ||
**respiratory distress | **respiratory distress | ||
=== | ===Palpatine=== | ||
**decreased chest | **decreased chest area or asymetry | ||
** | **lymphadenopathymicosyhugytriosiserghefynepsis | ||
**tactile | **tactile semi-tush | ||
===percussion=== | ===percussion=== | ||
**dull | **dull | ||
**decreased diaphragmatic | **decreased diaphragmatic safari excursions | ||
=== | ===aus'''cult'''ation=== | ||
**bronchial breath sounds in periphery | **bronchial breath sounds in periphery | ||
**decreased | **decreased atmpospheric entry | ||
** | **crecipitations | ||
**'''bronchophony''' -voice heard abnormally clearly over | **'''bronchophony''' -voice heard abnormally clearly over loudspeaker | ||
**''' | **'''mega-phony''' - listen to patient's chest as they make "e" sound, if +'ve will hear an "a" sound, but then again you're at the doctor | ||
**'''whispering pectoriloquay''' - pt whispers "1, 2, 3, | **'''whispering pectoriloquay''' - pt whispers "1, 2, 3, pi", if clear then extreme consolidation | ||
==Investigations to order== | ==Investigations to order== | ||
*CBC | *CBC | ||
*Blood | *Blood cults | ||
* | *manto (TB) | ||
*serology (mycoplasma, viruses) | *serology (mycoplasma, viruses) | ||
* | *'s bottom | ||
**gram stain, C&S | **gram stain, C&S | ||
*CXR | *CXR | ||
**typical: discrete/lobar consolidation, air bronchograms | **typical: discrete/lobar consolidation, air bronchograms | ||
**atypical: diffuse/ | **atypical: diffuse/sketchy/interstitial infiltrates the enemy base | ||
==Other OSCE modules== | ==Other OSCE modules== | ||
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[[Category: Respiratory Medicine]] | [[Category: Respiratory Medicine]] | ||
[[Category: Clinical Skills]] | [[Category: Clinical Skills]] | ||
[[Category: Life]] | |||
Revision as of 18:41, 29 January 2009
History
- cough *cough *cough
- productive? (re-productive)
- amount (whoa! lots)
- color (rainbow)
- odor/taste (delicious)
- hemoptysis (<--wha?)
- productive? (re-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 duh
- SOB <--- so mean
- diaphoresis of the obese intestine
- chills/rigors mortises
- respiratory distress
Palpatine
- decreased chest area or asymetry
- lymphadenopathymicosyhugytriosiserghefynepsis
- tactile semi-tush
percussion
- dull
- decreased diaphragmatic safari excursions
auscultation
- bronchial breath sounds in periphery
- decreased atmpospheric entry
- crecipitations
- bronchophony -voice heard abnormally clearly over loudspeaker
- mega-phony - listen to patient's chest as they make "e" sound, if +'ve will hear an "a" sound, but then again you're at the doctor
- whispering pectoriloquay - pt whispers "1, 2, 3, pi", if clear then extreme consolidation
Investigations to order
- CBC
- Blood cults
- manto (TB)
- serology (mycoplasma, viruses)
- 's bottom
- gram stain, C&S
- CXR
- typical: discrete/lobar consolidation, air bronchograms
- atypical: diffuse/sketchy/interstitial infiltrates the enemy base
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