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; further:
- Inspection (viewing).
- Skin, mucous membranes and sclerae (white part of the eye) [pallor] [due topossible sequelae: edema (water retention in the tissues)].
- 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 neck [due todifferential diagnosis: hyperthyroidism (hyperthyroidism)].
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation of the abdomen (belly) with the search for resistances and defensive tension (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial gates?, kidney bearing knocking pain?) [meteorism (flatulence); abdominal pain] [due todifferential diagnoses:
- Appendicitis (inflammation of the appendix).
- Ulcus ventriculi (gastric ulcer)]
[due topossible secondary diseases:
- Chronic hepatitis (inflammation of the liver).
- Ulceration (ulceration) of the gastrointestinal tract]
- Digital rectal examination (DRU): examination of the rectum (rectum) [due todifferential diagnoses:
- Ulcerative colitis (inflammatory bowel disease (IBD).
- Crohn’s disease (inflammatory bowel disease (IBD))]
- Inspection (viewing).
- Cancer screening [due todifferential diagnoses:
- Familial polyposis (synonym: familial adenomatous polyposis) – is an autosomal dominant inherited disorder. This leads to polyps in the colon (large intestine), which degenerate if left untreated and lead to colon carcinoma (colorectal cancer)
- Colon carcinoma (colon cancer)
- Lymphoma (malignant disease originating in the lymphatic system)]
[due toPossible secondary diseases:
- Lymphoma, especially in the small intestine.
- Neoplasms (neoplasms) outside the gastrointestinal tract (GI tract) that are not closely described
- Tumors of the gastrointestinal tract such as esophageal carcinoma (cancer of the esophagus)]
- If necessary, ophthalmological examination [due topossible secondary disease: nyctalopia (night blindness)]
- If necessary, dermatological examination [due topossible secondary disease: dermatitis herpetiformis Duhring – chronic skin disease with herpes-like blisters and usually severe itching]
- If necessary, gynecological examination [due todifferential diagnoses:
- Adnexitis (inflammation of the so-called adnexa (engl. : appendage formation))]
- Extrauterine pregnancy – pregnancy outside the uterus; extrauterine pregnancy is present in about 1 to 2% of all pregnancies: Tubalgravidity (tubal pregnancy), ovariangravidity (pregnancy in the ovary), peritonealgravidity or abdominalgravidity (abdominal pregnancy), cervicalgravidity (pregnancy in the cervix)]
- If necessary, orthopedic examination [due topossible secondary diseases:
- Arthritis (inflammation of the joints)
- Muscle cramps
- Muscle atrophy
- Osteomalacia (softening of the bones)
- Osteoporosis
- Rickets (English disease) – disease of the skeletal system usually caused by vitamin D deficiency; the main symptom is bone deformities]
- If necessary, psychiatric examination [due topossible symptoms: psychological changes, listlessness, fatigue, lack of concentration and performance and depression].
- Urological examination [due todifferential diagnosis: ureteral stones (ureteral stones)]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.