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| {{Basal cell carcinoma}} | | {{Basal cell carcinoma}} |
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| {{CMG}}; {{AE}} {{JH}} | | {{CMG}}; {{AE}}{{M.N}} |
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| ==Overview== | | ==Overview== |
| The physical examination of basal cell carcinoma is based on a clinical exam.
| | [[Patients]] with basal cell carcinoma usually have normal general appearance. [[Skin]] [[examination]] usually show [[papules]], [[plaques]], [[central]] [[ulceration]] with rolled borders, [[telangiectasias]]. |
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| _NOTOC_
| | ==Physical Examination== |
| | *[[Physical examination]] of [[patients]] with basal cell carcinoma is usually normal except some [[skin]] findings: |
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| | ===Appearance of the Patient=== |
| | *[[Patients]] with basal cell carcinoma are usually normal |
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| | ===Vital Signs=== |
| | *[[Vital signs]] of [[patients]] with basal cell carcinoma are usually within normal limits |
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| | ===Skin=== |
| | * [[Skin]] [[examination]] of [[patients]] with basal cell carcinoma usually varies like<ref name="CameronLee2019">{{cite journal|last1=Cameron|first1=Michael C.|last2=Lee|first2=Erica|last3=Hibler|first3=Brian P.|last4=Barker|first4=Christopher A.|last5=Mori|first5=Shoko|last6=Cordova|first6=Miguel|last7=Nehal|first7=Kishwer S.|last8=Rossi|first8=Anthony M.|title=Basal cell carcinoma|journal=Journal of the American Academy of Dermatology|volume=80|issue=2|year=2019|pages=303–317|issn=01909622|doi=10.1016/j.jaad.2018.03.060}}</ref><ref name="pmid25134314">{{cite journal |vauthors=Sehgal VN, Chatterjee K, Pandhi D, Khurana A |title=Basal cell carcinoma: pathophysiology |journal=Skinmed |volume=12 |issue=3 |pages=176–81 |date=2014 |pmid=25134314 |doi= |url=}}</ref> |
| | **Waxy [[papules]] or [[plaques]] |
| | **Crusting |
| | **Rolled borders |
| | **Central [[ulceration]] |
| | **[[Telangiectasias]] over the surface |
| | **Shiny and pearly |
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| | ===HEENT=== |
| | *HEENT [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Neck=== |
| | *[[Neck]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal |
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| | ===Lungs=== |
| | *[[Pulmonary examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Heart=== |
| | *[[Cardiovascular]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| ==Physical Examination== | | ===Abdomen=== |
| The physical examination of basal cell carcinoma is based on a clinical exam.
| | *[[Abdominal examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Back=== |
| | *[[Back]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Genitourinary=== |
| | *[[Genitourinary]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Neuromuscular=== |
| | * [[Neuromuscular]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| | ===Extremities=== |
| | *[[Extremities]] [[examination]] of [[patients]] with basal cell carcinoma is usually normal. |
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| ====Face==== | | ===Image gallery=== |
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| <gallery> | | <gallery> |
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52> | | <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52> |
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| </gallery>
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| ====Neck====
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| <gallery>
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| Image:Basal_cell_carcinoma _16.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| </gallery>
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| ====Extremities====
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| <gallery>
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| Image:Basal_cell_carcinoma_31.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| </gallery>
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| ====Perineal area====
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| <gallery>
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| Image:Basal_cell_carcinoma_36.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| </gallery>
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| ====Skin====
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| <gallery>
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| Image:Basal_cell_carcinoma _06.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma _07.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma _08.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma _17.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma _18.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_23.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_25.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_26.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_27.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_28.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_30.jpeg|Basal cell carcinoma. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_39.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| Image:Basal_cell_carcinoma_40.jpeg|Basal cell carcinoma.
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| <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=52>
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| </gallery>
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| ==Overview==
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| Patients with basal cell carcinoma usually have normal general appearance.
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| ==Physical Examination==
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| Physical examination of patients with [disease name] is usually normal.
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| OR
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| Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
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| OR
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| The presence of [finding(s)] on physical examination is diagnostic of [disease name].
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| OR
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| The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
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| ===Appearance of the Patient===
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| *Patients with [disease name] usually appear [general appearance].
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| ===Vital Signs===
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| *High-grade / low-grade fever
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| *[[Hypothermia]] / hyperthermia may be present
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| *[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
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| *[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
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| *Tachypnea / bradypnea
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| *Kussmal respirations may be present in _____ (advanced disease state)
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| *Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
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| *High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
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| ===Skin===
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| * Skin examination of patients with [disease name] is usually normal.
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| OR
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| *[[Cyanosis]]
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| *[[Jaundice]]
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| * [[Pallor]]
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| * Bruises
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| <gallery widths="150px">
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| UploadedImage-01.jpg | Description {{dermref}}
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| UploadedImage-02.jpg | Description {{dermref}}
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| </gallery> | | </gallery> |
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| ===HEENT===
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| * HEENT examination of patients with [disease name] is usually normal.
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| OR
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| * Abnormalities of the head/hair may include ___
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| * Evidence of trauma
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| * Icteric sclera
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| * [[Nystagmus]]
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| * Extra-ocular movements may be abnormal
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| *Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
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| *Ophthalmoscopic exam may be abnormal with findings of ___
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| * Hearing acuity may be reduced
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| *[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
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| *[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
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| * [[Exudate]] from the ear canal
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| * Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
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| *Inflamed nares / congested nares
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| * [[Purulent]] exudate from the nares
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| * Facial tenderness
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| * Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
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| ===Neck===
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| * Neck examination of patients with [disease name] is usually normal.
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| OR
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| *[[Jugular venous distension]]
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| *[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
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| *[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
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| *[[Thyromegaly]] / thyroid nodules
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| *[[Hepatojugular reflux]]
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| ===Lungs===
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| * Pulmonary examination of patients with [disease name] is usually normal.
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| OR
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| * Asymmetric chest expansion OR decreased chest expansion
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| *Lungs are hyporesonant OR hyperresonant
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| *Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
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| *Rhonchi
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| *Vesicular breath sounds OR distant breath sounds
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| *Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
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| *[[Wheezing]] may be present
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| *[[Egophony]] present/absent
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| *[[Bronchophony]] present/absent
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| *Normal/reduced [[tactile fremitus]]
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| ===Heart===
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| * Cardiovascular examination of patients with [disease name] is usually normal.
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| OR
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| *Chest tenderness upon palpation
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| *PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
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| *[[Heave]] / [[thrill]]
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| *[[Friction rub]]
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| *[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
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| *[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
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| *[[Heart sounds#Third heart sound S3|S3]]
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| *[[Heart sounds#Fourth heart sound S4|S4]]
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| *[[Heart sounds#Summation Gallop|Gallops]]
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| *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 stethoscope
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| ===Abdomen===
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| * Abdominal examination of patients with [disease name] is usually normal.
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| OR
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| *[[Abdominal distension]]
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| *[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
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| *[[Rebound tenderness]] (positive Blumberg sign)
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| *A palpable abdominal mass in the right/left upper/lower abdominal quadrant
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| *Guarding may be present
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| *[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
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| *Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
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| ===Back===
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| * Back examination of patients with [disease name] is usually normal.
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| OR
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| *Point tenderness over __ vertebrae (e.g. L3-L4)
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| *Sacral edema
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| *Costovertebral angle tenderness bilaterally/unilaterally
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| *Buffalo hump
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| ===Genitourinary===
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| * Genitourinary examination of patients with [disease name] is usually normal.
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| OR
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| *A pelvic/adnexal mass may be palpated
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| *Inflamed mucosa
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| *Clear/(color), foul-smelling/odorless penile/vaginal discharge
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| ===Neuromuscular===
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| * Neuromuscular examination of patients with [disease name] is usually normal.
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| OR
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| *Patient is usually oriented to persons, place, and time
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| * Altered mental status
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| * Glasgow coma scale is ___ / 15
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| * Clonus may be present
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| * Hyperreflexia / hyporeflexia / areflexia
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| * Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
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| * Muscle rigidity
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| * Proximal/distal muscle weakness unilaterally/bilaterally
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| * ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
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| *Unilateral/bilateral upper/lower extremity weakness
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| *Unilateral/bilateral sensory loss in the upper/lower extremity
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| *Positive straight leg raise test
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| *Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
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| *Positive/negative Trendelenburg sign
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| *Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
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| *Normal finger-to-nose test / Dysmetria
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| *Absent/present dysdiadochokinesia (palm tapping test)
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| ===Extremities===
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| * Extremities examination of patients with [disease name] is usually normal.
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| OR
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| *[[Clubbing]]
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| *[[Cyanosis]]
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| *Pitting/non-pitting [[edema]] of the upper/lower extremities
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| *Muscle atrophy
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| *Fasciculations in the upper/lower extremity
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| ==References== | | ==References== |
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| {{Reflist|2}} | | {{Reflist|2}} |
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| [[Category:Needs content]]
| | {{WH}} |
| [[Category:Disease]]
| | {{WS}} |
| [[Category:Dermatology]]
| | [[Category:Up-To-Date]] |
| [[Category:Types of cancer]]
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| [[Category:Pathology]]
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| [[Category:Up-To-Date]]
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| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Medicine]] | | [[Category:Medicine]] |
| [[Category:Dermatology]] | | [[Category:Dermatology]] |
| [[Category:Surgery]] | | [[Category:Surgery]] |
