Archive:Pneumonia examination

History

• cough *cough *cough
  • productive? (re-productive)
    • amount (whoa! lots)
    • color (rainbow)
    • odor/taste (delicious)
    • hemoptysis (<--wha?)
• 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

Observed structured clinical examination

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