Hemoptysis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes. Patients with hemoptysis usually appear anxious and depend on the severity of [[bleeding]] they might be critically ill. Patients with hemoptysis usually have abnormal [[vital signs]] indicating [[dehydration]], other signs of [[mucosal bleeding]], purulent bloody [[sputum]], and abnormal [[Respiratory examination|lung exam]] indicating underlying [[Lung|pulmonary]] causes.
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


==Physical Examination==
==Physical Examination==
* Physical examination of patients with [disease name] is usually normal.
*Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes.<ref name="LeeKim2015">{{cite journal|last1=Lee|first1=Myoung Kyu|last2=Kim|first2=Sang-Ha|last3=Yong|first3=Suk Joong|last4=Shin|first4=Kye Chul|last5=Kim|first5=Hyun Sik|last6=Yu|first6=Tae-Sun|last7=Choi|first7=Eun Hee|last8=Lee|first8=Won-Yeon|title=Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization|journal=The Clinical Respiratory Journal|volume=9|issue=1|year=2015|pages=53–64|issn=17526981|doi=10.1111/crj.12104}}</ref><ref name="KhalilFedida2015">{{cite journal|last1=Khalil|first1=A.|last2=Fedida|first2=B.|last3=Parrot|first3=A.|last4=Haddad|first4=S.|last5=Fartoukh|first5=M.|last6=Carette|first6=M.-F.|title=Severe hemoptysis: From diagnosis to embolization|journal=Diagnostic and Interventional Imaging|volume=96|issue=7-8|year=2015|pages=775–788|issn=22115684|doi=10.1016/j.diii.2015.06.007}}</ref><ref name="BruzziRémy-Jardin2006">{{cite journal|last1=Bruzzi|first1=John F.|last2=Rémy-Jardin|first2=Martine|last3=Delhaye|first3=Damien|last4=Teisseire|first4=Antoine|last5=Khalil|first5=Chadi|last6=Rémy|first6=Jacques|title=Multi–Detector Row CT of Hemoptysis|journal=RadioGraphics|volume=26|issue=1|year=2006|pages=3–22|issn=0271-5333|doi=10.1148/rg.261045726}}</ref>
OR
*Patients with hemoptysis usually appear anxious and depend on the severity of [[bleeding]] they might be critically ill.  
*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*Patients with hemoptysis usually have abnormal [[vital signs]] indicating [[dehydration]], other signs of [[mucosal bleeding]], purulent bloody [[sputum]], and abnormal [[Respiratory examination|lung exam]] indicating underlying [[Lung|pulmonary]] causes.
*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 [disease name] usually appear [general appearance].  
*Patients with hemoptysis usually appear anxious.
*Patients with massive hemoptysis usually appear critically ill.


===Vital Signs===
===Vital Signs===
 
*Low-grade [[fever]]
*Low-grade fever
*[[Tachycardia]] with regular [[pulse]]
*[[Hypothermia]] / hyperthermia may be present
*[[Tachypnea]]
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Hypotension|Low blood pressure]] with normal [[pulse pressure]]
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


===Skin===
===Skin===
*Bruises  
*[[Bruise|Bruises]]
*Telangiectasia  
*[[Telangiectasia]]
*Palpable purpura  
*Palpable [[purpura]]
*Rash  
*[[Rash]]


===HEENT===
===HEENT===
* Purulent bloody sputum
* Purulent bloody [[sputum]]


===Neck===
===Neck===
* Neck examination of patients with [disease name] is usually normal.
OR
*[[Jugular venous distension]]
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Asymmetric chest expansion
*Decreased [[Respiratory examination|chest expansion]]
* Decreased chest expansion
*Coarse [[crackles]] upon [[auscultation]] of the [[lung]] bases unilaterally or bilaterally
*Fine/coarse [[crackles]] upon auscultation of the lung bases unilaterally or bilaterally
*Decreased [[breath sounds]]
*Rhonchi
*Decreased breath sounds
*[[Wheezing]] may be present
*[[Wheezing]] may be present


===Heart===
===Heart===
*[[systolic murmur]] / [[diastolic murmur]]
*[[Heart murmur|Systolic murmur]] / [[diastolic murmur]]


===Abdomen===
===Abdomen===
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===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
* [[Human back|Back]] examination of patients with hemoptysis is usually normal.
===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with hemoptysis is usually normal.
* [[Genitourinary system|Genitourinary]] examination of patients with hemoptysis is usually normal.
===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with hemoptysis is usually normal.
* Neuromuscular examination of patients with hemoptysis is usually normal.
===Extremities===
===Extremities===
* Peripheral edema
* [[Pedal edema|Peripheral edema]]
* Joint effusions
* [[Clubbing]] of the digits
* [[Joint]] effusions
* Periarticular warmth
* Periarticular warmth


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 22:03, 29 July 2020

Hemoptysis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes. Patients with hemoptysis usually appear anxious and depend on the severity of bleeding they might be critically ill. Patients with hemoptysis usually have abnormal vital signs indicating dehydration, other signs of mucosal bleeding, purulent bloody sputum, and abnormal lung exam indicating underlying pulmonary causes.

Physical Examination

  • Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes.[1][2][3]
  • Patients with hemoptysis usually appear anxious and depend on the severity of bleeding they might be critically ill.
  • Patients with hemoptysis usually have abnormal vital signs indicating dehydration, other signs of mucosal bleeding, purulent bloody sputum, and abnormal lung exam indicating underlying pulmonary causes.

Appearance of the Patient

  • Patients with hemoptysis usually appear anxious.
  • Patients with massive hemoptysis usually appear critically ill.

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

  • Back examination of patients with hemoptysis is usually normal.

Genitourinary

  • Genitourinary examination of patients with hemoptysis is usually normal.

Neuromuscular

  • Neuromuscular examination of patients with hemoptysis is usually normal.

Extremities

References

  1. Lee, Myoung Kyu; Kim, Sang-Ha; Yong, Suk Joong; Shin, Kye Chul; Kim, Hyun Sik; Yu, Tae-Sun; Choi, Eun Hee; Lee, Won-Yeon (2015). "Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization". The Clinical Respiratory Journal. 9 (1): 53–64. doi:10.1111/crj.12104. ISSN 1752-6981.
  2. Khalil, A.; Fedida, B.; Parrot, A.; Haddad, S.; Fartoukh, M.; Carette, M.-F. (2015). "Severe hemoptysis: From diagnosis to embolization". Diagnostic and Interventional Imaging. 96 (7–8): 775–788. doi:10.1016/j.diii.2015.06.007. ISSN 2211-5684.
  3. Bruzzi, John F.; Rémy-Jardin, Martine; Delhaye, Damien; Teisseire, Antoine; Khalil, Chadi; Rémy, Jacques (2006). "Multi–Detector Row CT of Hemoptysis". RadioGraphics. 26 (1): 3–22. doi:10.1148/rg.261045726. ISSN 0271-5333.