Lower gastrointestinal bleeding physical examination: Difference between revisions

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==Physical Examination==
==Physical Examination==
 
The most common physical examination finding is the passage of frank blood per rectum (hematochezia).
*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
 
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
*Patients with [disease name] usually appear [general appearance].  
===Vital Signs===
===Vital Signs===
*High-grade / low-grade fever
*High-grade / low-grade fever
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]]
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Low blood pressure with normal pulse pressure.
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
 
===Skin===
===Skin===
*[[Cyanosis]]  
*[[Cyanosis]]  
*[[Jaundice]]
* [[Pallor]]
* Bruises
<gallery widths=150px>
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
</gallery>
===HEENT===
* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[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".)
*[[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".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
===Lungs===
===Lungs===
Normal bilateral vesicular breathe sounds.
Normal bilateral vesicular breathe sounds.
===Heart===
===Heart===
Normal S1S2 sounds with regular rate and rhythm.
Normal S1S2 sounds with regular rate and rhythm.
===Abdomen===
===Abdomen===
Abdominal examination reveals
Abdominal examination reveals
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*Distension
*Distension
*Abdominal mass
*Abdominal mass
===Back===
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump
===Genitourinary===
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
* Altered mental status
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)
===Extremities===
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 23:16, 12 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Physical Examination

The most common physical examination finding is the passage of frank blood per rectum (hematochezia).

Appearance of the Patient

  • Patients with [disease name] usually appear [general appearance].

Vital Signs

  • High-grade / low-grade fever
  • Tachycardia
  • Tachypnea
  • Low blood pressure with normal pulse pressure.

Skin

Lungs

Normal bilateral vesicular breathe sounds.

Heart

Normal S1S2 sounds with regular rate and rhythm.

Abdomen

Abdominal examination reveals

  • Tenderness
  • Distension
  • Abdominal mass

References

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