11 topics with brief reviews: definitions, key facts, and class questions.
General physical examination is the foundation of clinical assessment. This is where the diagnostic search begins as you first evaluate the patient's status, consciousness, habitus, and posture in bed. Sometimes a single glance at facial expressions is enough to unmistakably suspect a severe pathology.
This section brings together the key elements of the initial patient assessment. We will analyze the gradations of impaired consciousness up to comatose states, constitutional types, and temperament features. Special attention is paid to objective measurable parameters: the rules of clinical anthropometry, the calculation of body mass index (BMI) in assessing obesity, and fever analysis with the classification of temperature curve types.
In practical classes and exams, the differentiation of types of coma, temperature curve charts, and the ability to logically link a patient's forced posture to a specific syndrome are scrutinized most strictly. I recommend starting your study with these topics.
Why is artificial lighting not recommended when looking for jaundice?
Evening or artificial light has a specific spectrum that masks icterus (yellowing) of the skin and sclera, which may cause a doctor to miss this important symptom.
How to quickly distinguish stupor from coma during an initial examination?
The main criterion is the response to pain. In stupor, the patient does not respond to speech, but reacts to painful stimuli. In coma, reactions to absolutely any stimuli disappear.
How to quickly distinguish hypoglycemic coma from diabetic (ketoacidotic) coma?
A key clinical sign is the state of the skin: in hypoglycemia, the skin is pronouncedly moist, whereas in ketoacidosis, marked skin dryness is observed.
Why does a patient having a bronchial asthma attack firmly press their hands against the edge of a table or bed?
This posture allows for the rigid fixation of the shoulder girdle. As a result, the accessory respiratory muscles are actively engaged in the act of breathing, significantly facilitating difficult expiration for the patient.
Can a diagnosis be made based solely on body build?
No. The constitution is merely a risk factor and indicates a predisposition to certain pathological processes, but it does not replace a clinical diagnosis.
What does Hippocratic facies look like and when does it occur?
These are sharpened features, deeply sunken eyes, grayish-pale skin, and large drops of cold sweat on the forehead. It is characteristic of severe peritonitis and terminal states.
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