Cryptogenic organizing pneumonia physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical Examination
- Physical examination of a patient with cryptogenic organizing pneumonia demonstrates signs of bronchospasm, consolidation, and fluid accumulation.
- The prevalence and severity of these findings depends on the extent of parenchymal involvement and the subtype of organizing pneumonia.[1]
Sign | Cryptogenic Organizing Pneumonia | Secondary Organizing Pneumonia | Focal Organizing Pneumonia |
---|---|---|---|
Tachypnea | 65% | 70% | - |
Crackles | 85% | 95% | 10% |
Wheezing | 10% | 10% | 10% |
Clubbing | - | 5% | - |
Cyanosis | 5% | 5% | - |
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 cryptogenic organizing pneumonia usually appear in mild distress.
Vital Signs
- Low-grade fever
- Tachycardia with regular pulse
- Tachypnea
- Normal blood pressure with normal pulse pressure
Skin
- Skin examination of patients with cryptogenic organizing pneumonia is usually normal.
HEENT
- HEENT examination of patients with cryptogenic organizing pneumonia is usually normal.
Neck
- Neck examination of patients with cryptogenic organizing pneumonia is usually normal.
Lungs
- On examination patient is in mild dyspnea
- Lungs are hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices bilaterally depending upon the consolidation.
- Vesicular breath sounds
- Wheezing may be present
Heart
- Cardiovascular examination of patients with cryptogenic organizing pneumonia is usually normal.
Back
- Back examination of patients with [disease name] 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 [disease name] 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 [disease name] 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 [disease name] is usually normal.
OR
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity
References
- ↑ Lohr RH, Boland BJ, Douglas WW, Dockrell DH, Colby TV, Swensen SJ; et al. (1997). "Organizing pneumonia. Features and prognosis of cryptogenic, secondary, and focal variants". Arch Intern Med. 157 (12): 1323–9. PMID 9201006.