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,
- Inspection (viewing)
- Skin
- Erythema (extensive reddening of the skin), especially on the face and chest, which can be pushed away; often with “white dermographism” (skin reaction visible a few seconds to minutes after moderate mechanical irritation (e.g., by a wooden spatula))
- Exanthema (rash) – veiny / scarlet, sparing the face (truncal).
- Conjunctivitis (conjunctivitis).
- Petechiae – punctate skin hemorrhages; if no punctate skin hemorrhages are present Perform the Rumpel-Leede test (to check for capillary stability (vasculopathy?) and platelet/platelet functionality)Procedure: apply a blood pressure cuff to the patient’s upper arm and inflate to a pressure between diastolic and systolic blood pressure (optimal: 90 mmHg). The cuff is removed after 10 minutes and the arm is examined for petechial hemorrhages (flea-like bleeding).If more than 10 petechiae are detectable below the tourniquet, a positive test result is present. [Test is not specific.]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Skin
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Abdominal (stomach) examination [splenomegaly (splenomegaly)?]
- 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.
- Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
- Percussion (tapping) of the abdomen.
- Inspection (viewing)
