The Medical clinics of North America
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Cirrhosis is a chronic condition resulting from inflammation and fibrosis of the liver. Patients with cirrhosis may have a myriad of physical examination findings that reflect the severity of the underlying liver disease. Although many signs and symptoms related to cirrhosis are nonspecific, such as abdominal pain, nausea, and malaise, some findings are more specific and point to complications of liver disease. In this article, key physical findings in patients with cirrhosis, including hepatomegaly, splenomegaly, jaundice, ascites, encephalopathy, dilated abdominal wall veins, spider nevi, palmar erythema, and others, are discussed.
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Many common endocrinopathies have classic physical examination findings that can help lead to the diagnosis and cause of disease. This article will discuss the common signs and symptoms seen in Cushing disease, adrenal insufficiency, hyperthyroidism, hypothyroidism, thyroid nodules, and polycystic ovary syndrome (PCOS). A knowledge of these findings and their corresponding diseases will help the clinician to develop a targeted examination for syndromes of excess or deficient cortisol, excess or deficient thyroid hormone, thyroid nodules, and PCOS.
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Med. Clin. North Am. · May 2022
ReviewThe Physical Examination to Assess for Anemia and Hypovolemia.
Hypovolemia develops with the loss of extracellular fluid volume or blood. Rapidly identifying hypovolemia can be lifesaving. ⋯ Other findings with utility include a dry axilla and dry oral mucosa. With chronic anemia, hemodynamic changes detectable on examination may be minimal, as the body compensates by retaining extracellular volume.
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Patients with valvular heart disease may present with or without symptoms. A thorough cardiac physical examination can identify patients who require further evaluation and management. ⋯ The proper examination of patients with systolic murmurs, the most common murmurs in clinical practice, is fundamental to cost-effective care. We will review the key components of the cardiac examination and findings relevant to functional murmurs, aortic stenosis, mitral valve prolapse and regurgitation, tricuspid regurgitation, hypertrophic cardiomyopathy, aortic regurgitation, and mitral stenosis.
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The physical examination of the patient with diabetes may have revealed findings that confirm the diagnosis, classify the type of diabetes, and begin to evaluate for the macro- and microvascular complications of diabetes and significant comorbid conditions. While screening for the diagnosis of diabetes occurs with assessment for abnormal blood glucose, given the high rates of morbidity and mortality associated with diabetes, utilization of the physical examination plays a key role in identifying patients at risk for the complications of diabetes. The discussion of elements of the physical examination relevant to the patient with diabetes, both type 1 and type 2, will be discussed in this article.