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 and sclerae (white part of the eye) [Delayed wound healing, pruritus (itching), recurrent therapy-resistant infections for example dermatomycosis; Poorly healing wounds, bacterial or mycotic skin infections (furunculosis (repeated occurrence of numerous boils in different parts of the body), candidamycosis (fungal infection)); balanitis (acorn inflammation; periodontal disease (periodontitis; inflammation of the periodontium)]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Auscultation (listening) of the heart [due tosecondary diseases such as: coronary heart disease (CHD)].
- Auscultation of the lungs
- Examination of the abdomen
- Auscultation of the abdomen [vascular or stenotic sounds?]
- Percussion (tapping) of the abdomen.
- 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 of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding?, hernial orifices?, renal bed tenderness?).
- Palpation of the pulses [due tosecondary disease: peripheral arterial occlusive disease (pAVK)]
- Inspection (viewing).
- Ophthalmological examination – if necessary due tovisual disturbances [retinopathy; annual examination].
- ENT medical examination – due topossible secondary disease: sensorineural hearing loss.
- Neurological examination – due toe.g. paresthesias in the area of the feet and lower legs [neuropathy].
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.