A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin, mucous membranes [accompanying symptom: dry scaly skin].
- Oral cavity [accompanying symptoms: sialosis (enlargement of the salivary glands); dental caries] [due topossible sequelae: tooth damage up to the fall out of the teeth].
- Hairiness [concomitant symptom: alopecia; lanugo hairiness]
- Extremities [Associated symptoms: Circulatory disturbances; acrocyanosis (blue discoloration of body end limbs such as the fingers); peripheral edema]
- Abdomen (abdomen):
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Inspection and palpation (palpation) of the thyroid gland [due todifferential diagnosis: hyperthyroidism (hyperthyroidism)].
- Auscultation of the heart [due toaccompanying symptoms: Bradycardia (too slow heartbeat: < 60 beats per minute); cardiac arrhythmias] [due topossible sequelae: heart failure; cardiac arrhythmias].
- Auscultation of the lungs
- Examination of the abdomen (belly)
- Percussion (tapping) of the abdomen [attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?]
- Palpation of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?)
- Digital rectal examination (DRU): examination of the rectum (rectum) [due todifferential diagnoses: inflammatory bowel disease such as ulcerative colitis or Crohn’s disease].
- Inspection (viewing).
- Gynecological examination [due toleading symptom: amenorrhea (absence of menstruation); due toaccompanying symptom: absence of breast development in young girls]
- If necessary, orthopedic examination [due topossible secondary diseases:
- Osteoporosis (bone loss)
- Growth disorders]
Psychiatric examination [due toaccompanying symptoms:
- Depression
- Psychic compulsions
- Sleep disorders]
[due todifferential diagnoses:
- Acute adjustment disorders
- Alcohol abuse (heavy drinking; alcohol abuse).
- Anxiety disorders
- Substance abuse
- Personality disorders
- Schizophrenia (psychiatric disorder with multiple manifestations).
- Obsessive-compulsive disorder]
[due topossible sequelae:
- Other addictive diseases
- Anxiety disorders
- Bulimia (binge eating disorder)
- Depression
- Personality disorders
- Recurrence (recurrence) of anorexia nervosa
- Obsessive-compulsive disorder]
- Health Check
Square brackets [ ] indicate possible pathological (pathological) physical findings.