Rabies physical examination: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(11 intermediate revisions by 4 users not shown)
Line 2: Line 2:
{{Rabies}}
{{Rabies}}


'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:'''
{{CMG}} {{AE}} {{IQ}}


== Overview[edit | edit source] ==
== 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].
Common physical examination findings of rabies include [[hyperpyrexia]] alternating with [[hypothermia]], [[tachycardia]], [[respiratory]] collapse, [[hypersalivation]], [[lacrimation]], [[sweating]], [[Pupillary dilation|dilatation of the pupils]] and [[bradycardia]]. Skin findings may include percussion myoedema, bite marks and [[bruises]].  


OR
== Physical Examination ==


Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
=== Vital Signs ===
 
* [[Hyperpyrexia]] alternating with [[hypothermia]]
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[edit | edit source] ==
* 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[edit | edit source] ===
* Patients with [disease name] usually appear [general appearance].
 
=== Vital Signs[edit | edit source] ===
* Hyperpyrexia alternating with hypothermia
* [[Tachycardia]] 
* [[Tachycardia]] 
* Respiratory and vascular collapse
* [[Respiratory]] and [[vascular]] collapse
* [[Bradycardia]]


=== Skin[edit | edit source] ===
=== Skin ===
* Percussion myoedema (mounding of the muscle at the percussion site)<ref name="pmid2883526">{{cite journal |vauthors=Hemachudha T, Phanthumchinda K, Phanuphak P, Manutsathit S |title=Myoedema as a clinical sign in paralytic rabies |journal=Lancet |volume=1 |issue=8543 |pages=1210 |year=1987 |pmid=2883526 |doi= |url=}}</ref>
* Percussion myoedema (mounding of the muscle at the percussion site)<ref name="pmid2883526">{{cite journal |vauthors=Hemachudha T, Phanthumchinda K, Phanuphak P, Manutsathit S |title=Myoedema as a clinical sign in paralytic rabies |journal=Lancet |volume=1 |issue=8543 |pages=1210 |year=1987 |pmid=2883526 |doi= |url=}}</ref>
*  
* Bite marks
*  
* [[Bruises]]
* Bruises
 
* UploadedImage-01.jpg  Description [http://www.atlasdermatologico.com.br/ (Adapted from Dermatology Atlas)]
* UploadedImage-02.jpg  Description [http://www.atlasdermatologico.com.br/ (Adapted from Dermatology Atlas)]


=== HEENT[edit | edit source] ===
=== HEENT ===
* Hypersalivation
* [[Hypersalivation]]
*Lacrimation
*[[Lacrimation]]
*Sweating
*[[Sweating]]
*Dilatation of the pupils
*[[Pupillary dilation|Dilatation of the pupils]]


=== Neck[edit | edit source] ===
=== Neck ===
* [[Jugular venous distension]]
* No abnormal findings
* [[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[edit | edit source] ===
=== Lungs ===
* Asymmetric chest expansion / Decreased chest expansion
* Fine/coarse [[crackles]] upon [[auscultation]] of the [[lung]] bases/apices unilaterally/bilaterally, if [[Aspirate|aspirated]].
* Lungs are hypo/hyperresonant
* [[Wheezing]] may be present due to [[aspiration]] or  [[chest]] [[infection]]
* Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
* Rhonchi
* Vesicular breath sounds / Distant breath sounds
* Expiratory/inspiratory wheezing with normal / delayed expiratory phase
* [[Wheezing]] may be present
* [[Egophony]] present/absent
* [[Bronchophony]] present/absent
* Normal/reduced [[tactile fremitus]]
* Normal/reduced [[tactile fremitus]]


=== Heart[edit | edit source] ===
=== Heart ===
* Chest tenderness upon palpation
* [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] normal, soft
* PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
* [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] normal
* [[Heave]] / [[thrill]]
* [[Friction rub]]
* [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]]
* [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]]
* [[Heart sounds#Third heart sound S3|S3]]
* [[Heart sounds#Fourth heart sound S4|S4]]
* [[Heart sounds#Summation Gallop|Gallops]]
* A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope
 
=== Abdomen[edit | edit source] ===
* [[Abdominal distention]]
* [[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
* [[Rebound tenderness]] (positive Blumberg sign)
* A palpable abdominal mass in the right/left upper/lower abdominal quadrant
* Guarding may be present
* [[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
* Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
 
=== Back[edit | edit source] ===
* Point tenderness over __ vertebrae (e.g. L3-L4)
* Sacral edema
* Costovertebral angle tenderness bilaterally/unilaterally
* Buffalo hump


=== Genitourinary[edit | edit source] ===
=== Abdomen ===
* A pelvic/adnexal mass may be palpated
* [[Guarding]] may be present
* Inflamed mucosa
* Clear/(color), foul-smelling/odorless penile/vaginal discharge


=== Neuromuscular[edit | edit source] ===
=== Genitourinary ===
* Opisthotonos
* No abnormal findings
* 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[edit | edit source] ===
=== Neuromuscular ===
* [[Clubbing]]
* [[Opisthotonos]]
* [[Cyanosis]]
* [[Altered mental status]]
* Pitting/non-pitting [[edema]] of the upper/lower extremities
* Increased [[Tendon reflex|tendon reflexes]] with [[Extensor plantar reflexes|extensor plantar responses]]  
* Muscle atrophy
*[[Flaccid paralysis]] with generalized [[areflexia]] when patient develops [[coma]]
* Fasciculations in the upper/lower extremity
* [[Nuchal rigidity]]
* Increased [[muscle tone]]
* [[Fasciculations]]


== References[edit | edit source] ==
=== Extremities ===
Please help WikiDoc by adding content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]] to learn about editing.
* Bite marks
* Muscle [[atrophy]]
* [[Fasciculations]] in the upper/lower extremity


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
[[Category:Disease]]
[[Category:Disease]]
[[Category:Viral diseases]]
[[Category:Viral diseases]]
[[Category:Mononegavirales]]
[[Category:Mononegavirales]]
Line 137: Line 70:
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Needs content]]
[[Category:Infectious disease]]
{{WikiDoc Help Menu}}
[[Category:Medicine]]
{{WikiDoc Sources}}

Latest revision as of 23:56, 29 July 2020

Rabies Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Rabies from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Rabies physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Rabies physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Rabies physical examination

CDC on Rabies physical examination

Rabies physical examination in the news

Blogs on Rabies physical examination

Directions to Hospitals Treating Rabies

Risk calculators and risk factors for Rabies physical examination

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

Overview

Common physical examination findings of rabies include hyperpyrexia alternating with hypothermia, tachycardia, respiratory collapse, hypersalivation, lacrimation, sweating, dilatation of the pupils and bradycardia. Skin findings may include percussion myoedema, bite marks and bruises.

Physical Examination

Vital Signs

Skin

  • Percussion myoedema (mounding of the muscle at the percussion site)[1]
  • Bite marks
  • Bruises

HEENT

Neck

  • No abnormal findings

Lungs

Heart

  • S1 normal, soft
  • S2 normal

Abdomen

Genitourinary

  • No abnormal findings

Neuromuscular

Extremities

References

  1. Hemachudha T, Phanthumchinda K, Phanuphak P, Manutsathit S (1987). "Myoedema as a clinical sign in paralytic rabies". Lancet. 1 (8543): 1210. PMID 2883526.

Template:WikiDoc Sources