NBOME
COMLEX-USA MASTER BLUEPRINT

9. Patient Presentations Related to the Respiratory System

Patient presentations span all relevant age categories, special populations, and varied clinical settings.

9.1 Cough
9.2 Sore Throat
9.3 Shortness of Breath
9.4 Nasal Bleeding
9.5 Airway Obstruction
9.6 Nasal Discharge
9.7 Ear Pain/Ear Discharge
9.8 Respiratory Arrest
9.9 Respiratory Chest Pain
9.10 Respiratory Growths and Malformations
9.11 Physical Exam Findings Related to the Respiratory System
9.12 Laboratory Test Findings and Diagnostic Imaging Related to the Respiratory System

 

The Guide to clinical presentations in this category may include, but is not limited to, the following ways in which patients present for osteopathic medical care:

ear conditions, acute and chronic – trauma (eg, tympanic membrane perforation), cerumen impaction, otitis externa, otitis media, eustachian tube dysfunction • lung/pulmonary diseases and conditions, acute and chronic – acute respiratory distress syndrome; airway foreign body; anaphylaxis; asthma; breath-holding spells; transient tachypnea of newborn; hemoptysis, hemothorax, pneumothorax, chylothorax; pulmonary embolism; pulmonary hypertension; chronic obstructive pulmonary disease; bronchiectasis; sarcoidosis; interstitial lung disease; occupational lung disease; lung and pleural tumors (eg, cancer, nodules); angioedema; pulmonary effusion (eg, from cancer, infections, congestive heart failure); cystic fibrosis; smoke inhalation • mediastinal masses • nose and paranasal sinus conditions – nasal congestion, allergic rhinitis, sneezing, anterior and posterior nosebleeds, rhinorrhea, sinusitis • respiratory tract infections (eg, upper respiratory infections, bronchitis, pneumonia, bronchiolitis, influenza, tuberculosis) • throat conditions, acute – infections (eg, tonsillitis, mononucleosis); hoarseness (eg, inflammatory, infectious, vocal abuse, traumatic dysphonia, vocal cord paralysis) • upper respiratory system disorders and conditions, acute and chronic – laryngomalacia, epiglottitis; tracheitis; neoplasms; structural anomalies (eg, fistulas, webs, malformations); sleep disorders (eg, apnea)

CONSTITUTIONAL SIGNS AND SYMPTOMS
fatigue • fever • generalized weakness • involuntary weight loss • malaise • night sweats • pallor

PHYSICAL EXAM FINDINGS
pulmonary auscultation, percussion, and palpation (eg, egophony, stridor, rale, rhonchus, wheeze, bronchophony, fremitus, chest wall expansion, diaphragmatic excursion)

LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING
arterial blood gases (sweat chloride test) • audiogram • computed tomography imaging • evaluation of pleural effusions (eg, exudate, transudate) • fluoroscopy interpretation of pulse oximetry • magnetic resonance imaging • nuclear medicine imaging • pulmonary function testing • purified protein derivative skin test • radiography • sonography • spirometry • sputum gram stain, culture and sensitivity • tympanometry

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