A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
- Inspection (viewing).
- Skin, mucous membranes and sclerae [pale skin color, sweating].
- Lymph node stations (cervical, axillary, supraclavicular, inguinal) [lymphadenopathy (lymph node enlargement)?]
- Abdomen:
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Genital [due todifferential diagnosis: other forms of leukemia, e.g. acute lymphoblastic leukemia (ALL), which is accompanied by painless, usually unilateral swelling of the testis].
- Extremities [bone pain; arthralgia (joint pain)]
- Palpation (palpation) of lymph node stations (cervical, axillary, supraclavicular, inguinal) [lymphadenopathy (lymph node enlargement)?]
- Auscultation (listening) of the heart [due topossible sequelae: cardiomyopathy].
- Auscultation of the lungs [dyspnea (shortness of breath); cough]
- Examination of the abdomen (belly)
- Percussion (tapping) of the abdomen
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
- Percussion (tapping) of the abdomen
- Inspection (viewing).
- If necessary, urological / nephrological examination [due topossible sequelae: renal insufficiency / uremia (kidney weakness / kidney failure)].
- Health check (as an additional follow-up measure).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
