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{{Cryptogenic organizing pneumonia}}
{{Cryptogenic organizing pneumonia}}


{{CMG}}
{{CMG}} {{AE}} {{MKK}}


==Overview==
==Overview==
Patients with [[cryptogenic organizing pneumonia]] usually appear in mild distress. On examination, the patient is usually febrile, in [[tachypnea]], [[tachycardia]] with the regular [[pulse]]. On lung auscultation there are bilateral vesicular [[breath sounds]], fine [[crackles]] and [[wheezing]] is heard.


==Physical Examination==
==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.<ref name="pmid9201006">{{cite journal| author=Lohr RH, Boland BJ, Douglas WW, Dockrell DH, Colby TV, Swensen SJ et al.| title=Organizing pneumonia. Features and prognosis of cryptogenic, secondary, and focal variants. | journal=Arch Intern Med | year= 1997 | volume= 157 | issue= 12 | pages= 1323-9 | pmid=9201006 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9201006  }} </ref>
{| style="border: 0px; margin: 3px; width: 70%" align=center
! style="background: #4479BA; width: 15%;" | {{fontcolor|#FFF|Sign}}
! style="background: #4479BA; width: 28%;" | {{fontcolor|#FFF|Cryptogenic Organizing Pneumonia}}
! style="background: #4479BA; width: 28%;" | {{fontcolor|#FFF|Secondary Organizing Pneumonia}}
! style="background: #4479BA; width: 29%;" | {{fontcolor|#FFF|Focal Organizing Pneumonia}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Tachypnea
| style="padding: 5px 5px; background: #F5F5F5;" |65%
| style="padding: 5px 5px; background: #F5F5F5;" |70%
| style="padding: 5px 5px; background: #F5F5F5;" |-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Crackles
| style="padding: 5px 5px; background: #F5F5F5;" |85%
| style="padding: 5px 5px; background: #F5F5F5;" |95%
| style="padding: 5px 5px; background: #F5F5F5;" |10%
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Wheezing
| style="padding: 5px 5px; background: #F5F5F5;" |10%
| style="padding: 5px 5px; background: #F5F5F5;" |10%
| style="padding: 5px 5px; background: #F5F5F5;" |10%
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Clubbing
| style="padding: 5px 5px; background: #F5F5F5;" |-
| style="padding: 5px 5px; background: #F5F5F5;" |5%
| style="padding: 5px 5px; background: #F5F5F5;" |-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Cyanosis
| style="padding: 5px 5px; background: #F5F5F5;" |5%
| style="padding: 5px 5px; background: #F5F5F5;" |5%
| style="padding: 5px 5px; background: #F5F5F5;" |-
|}
==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===
===Appearance of the Patient===
*Patients with cryptogenic organizing pneumonia usually appear in mild distress.
*Patients with [[cryptogenic organizing pneumonia]] usually appear in mild distress.<ref name="pmid10926343">{{cite journal |vauthors=Cazzato S, Zompatori M, Baruzzi G, Schiattone ML, Burzi M, Rossi A, Ratta L, Terzuolo G, Falcone F, Poletti V |title=Bronchiolitis obliterans-organizing pneumonia: an Italian experience |journal=Respir Med |volume=94 |issue=7 |pages=702–8 |year=2000 |pmid=10926343 |doi=10.1053/rmed.2000.0805 |url=}}</ref><ref name="pmid2805873">{{cite journal |vauthors=Cordier JF, Loire R, Brune J |title=Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients |journal=Chest |volume=96 |issue=5 |pages=999–1004 |year=1989 |pmid=2805873 |doi= |url=}}</ref>


===Vital Signs===
===Vital Signs===
*Low-grade fever
*Low-grade [[fever]]
*[[Tachycardia]] with regular pulse
*[[Tachycardia]] with regular pulse
*Tachypnea  
*[[Tachypnea]]
*Normal blood pressure with normal pulse pressure
*Normal [[blood pressure]] with normal [[Pulse pressure|pulse pressure.]]<ref name="pmid3965933">{{cite journal |vauthors=Epler GR, Colby TV, McLoud TC, Carrington CB, Gaensler EA |title=Bronchiolitis obliterans organizing pneumonia |journal=N. Engl. J. Med. |volume=312 |issue=3 |pages=152–8 |date=January 1985 |pmid=3965933 |doi=10.1056/NEJM198501173120304 |url=}}</ref><ref name="pmid8313672">{{cite journal |vauthors=Cordier JF |title=Cryptogenic organizing pneumonitis. Bronchiolitis obliterans organizing pneumonia |journal=Clin. Chest Med. |volume=14 |issue=4 |pages=677–92 |date=December 1993 |pmid=8313672 |doi= |url=}}</ref>


===Skin===
===Skin===
*Skin examination of patients with cryptogenic organizing pneumonia is usually normal.
*Skin examination of patients with [[cryptogenic organizing pneumonia]] is usually normal.


===HEENT===
===HEENT===
*HEENT examination of patients with cryptogenic organizing pneumonia is usually normal.
*HEENT examination of patients with [[cryptogenic organizing pneumonia]] is usually normal.


===Neck===
===Neck===
*Neck examination of patients with cryptogenic organizing pneumonia is usually normal.
*Neck examination of patients with [[cryptogenic organizing pneumonia]] is usually normal.


===Lungs===
===Lungs===
*On examination patient is in mild dyspnea
*On examination patient is in mild [[dyspnea]].
*Lungs are hyperresonant
*Lungs are hyperresonant.
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices bilaterally depending upon the consolidation.
*Coarse [[crackles]] upon auscultation of the lung bases/apices bilaterally depending upon the [[Consolidation (medicine)|consolidation]].
*Vesicular breath sounds  
*Vesicular breath sounds.
*[[Wheezing]] may be present
*[[Wheezing]] may be present.
 
===Heart===
*Cardiovascular examination of patients with cryptogenic organizing pneumonia is usually normal.
 
===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==
==References==

Latest revision as of 22:11, 6 March 2018

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

Overview

Patients with cryptogenic organizing pneumonia usually appear in mild distress. On examination, the patient is usually febrile, in tachypnea, tachycardia with the regular pulse. On lung auscultation there are bilateral vesicular breath sounds, fine crackles and wheezing is heard.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Lungs

  • On examination patient is in mild dyspnea.
  • Lungs are hyperresonant.
  • Coarse crackles upon auscultation of the lung bases/apices bilaterally depending upon the consolidation.
  • Vesicular breath sounds.
  • Wheezing may be present.

References

  1. Cazzato S, Zompatori M, Baruzzi G, Schiattone ML, Burzi M, Rossi A, Ratta L, Terzuolo G, Falcone F, Poletti V (2000). "Bronchiolitis obliterans-organizing pneumonia: an Italian experience". Respir Med. 94 (7): 702–8. doi:10.1053/rmed.2000.0805. PMID 10926343.
  2. Cordier JF, Loire R, Brune J (1989). "Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients". Chest. 96 (5): 999–1004. PMID 2805873.
  3. Epler GR, Colby TV, McLoud TC, Carrington CB, Gaensler EA (January 1985). "Bronchiolitis obliterans organizing pneumonia". N. Engl. J. Med. 312 (3): 152–8. doi:10.1056/NEJM198501173120304. PMID 3965933.
  4. Cordier JF (December 1993). "Cryptogenic organizing pneumonitis. Bronchiolitis obliterans organizing pneumonia". Clin. Chest Med. 14 (4): 677–92. PMID 8313672.