Sunday, April 26, 2015

Physical exam for relevant underlying medical conditions and functional status

Underlying diseases, or underlying medical conditions, are frequently not presented in the history taking. Therefore, we do some routine medical exams. However, you should correlate with the complaints.

Dyspnea/chest discomfort - structural heart diseases, lung diseases, cancer, kidney diseases
Dyspepsia - hepatobiliary diseases, DM, previous surgery/trauma
Jaundice - hepatobiliary diseases
Dizziness - same as dyspnea plus DM
Edema - structural heart diseases, cancer, kidney diseases, previous surgery/trauma
Confusion/proximal muscle weakness - neurological deficit/diseases, kidney diseases, any endocrine diseases, cancer

A stepwise approach is physical examination from head to toe, starting at vital signs, general examination, head, neck, chest, abdomen, back, perineum, lower extremities, and upper extremities; and then; further examinations by systems; neurologic examination.

You will have to focus on examination for chief complaints and relevant underlying conditions and revelant physiology/pathophysiology, or you will find only scattering findings which you cannot interpret, and forgetting some important or helpful examinations

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