A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight [unintentional weight loss], height; furthermore:
- Inspection (viewing).
- Skin, mucous membranes, pharynx (throat), and sclera (white part of the eye) [exanthema (rash), pharyngitis (pharyngitis), mucosal ulcerations (ulcers on the mucous membranes), hairy leukoplakia (whitish raised areas appearing mainly on the tongue); fungal infections, purpura (small hemorrhages of the skin and mucous membranes)]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Inspection and palpation of lymph node stations [lymphadenopathy (lymph node enlargement)?]
- Examination of the lungs [Pneumocystis jiroveci (formerly Pneumocystis carinii pneumonia; at 50%, the most common initial manifestation of AIDS disease)]
- Auscultation (listening) of the lungs.
- Bronchophony (checking the conduction of high-frequency sounds; the patient is asked to pronounce the word “66” several times in a pointed voice while the physician listens to the lungs) [increased sound conduction due to pulmonary infiltration/compaction of lung tissue (e.g. e.g. in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in case of decreased sound conduction (attenuated or absent: e.g. in pleural effusion, pneumothorax, emphysema). The result is, the number “66” is barely audible to absent over the diseased part of the lung, because the high-frequency sounds are strongly attenuated]
- Percussion (tapping) of the lungs [e.g., in emphysema; box tone in pneumothorax]
- Vocal fremitus (checking the conduction of low frequencies; the patient is asked to pronounce the word “99” several times in a low voice while the physician places his hands on the patient’s chest or back) [increased sound conduction due to pulmonary infiltration/compaction of lung tissue (e. e.g., pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; with decreased sound conduction (attenuated: e.g., atelectasis, pleural rind; severely attenuated or absent: with pleural effusion, pneumothorax, emphysema). The result is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
- Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection (viewing).
- Cancer screening [due topossible secondary diseases:
- Anal carcinoma/anal cancer (often arising within a few months from precancerous lesions; frequently associated with human papillomavirus/HVP; another risk factor is smoking).
- Burkitt’s lymphoma (malignant (malignant) lymphoma whose formation is associated with Epstein-Barr virus and is classified as B-cell non-Hodgkin’s lymphoma)
- Cervical carcinoma (cancer of the cervix).
- Kaposi’s sarcoma (pronounced [ˈkɒpoʃi] – “Kaposchi”) – a tumor disease occurring mainly in connection with AIDS, the cause of which is most likely due to human herpes virus type 8 (HHV-8) in conjunction with cofactors (immunosuppression, environmental factors, and oxidative and nitrosative stress). The disease is manifested by the appearance of brownish-bluish tumor nodules mainly in the mucosal and intestinal areas. Men are more frequently affected than women. In the AIDS-associated form, brown-bluish spots appear multifocally usually also on the skin of legs and arms.
- Primary CNS lymphoma]
- If necessary, neurological examination [due tosymptom: peripheral neuropathy (nerve damage, especially occurring in the legs)]
In square brackets [ ] is referred to possible pathological (pathological) physical findings.
