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
- Hair [due tosecondary disease: alopecia (hair loss)]
- Nails [due tosecondary disease: brittle nails]
- Extremities [obstetric position of the lower extremities; due tosequelae: brachymetacarpy (shortening of single or multiple metacarpals)?]
- Auscultation (listening) of the heart.
- Examination of the abdomen (abdomen)
- Inspection (viewing).
- Ophthalmological examination [due tosecondary disease: cataract (lens opacity)].
- Neurological examination [due tosequelae: Anxiety disorders, bipolar disorder (mental disorder in which depressive and manic phases occur)]
* Following signs may indicate tetany:
- Chvostek’s sign – after tapping the facial nerve trunk (1-2 cm in front of the earlobe/jaw joint), there is subsequently a contraction (twitching) of the facial muscles.
- Trousseau sign – paw position that occurs when the upper arm is compressed (for example, after pumping a blood pressure cuff above systolic blood pressure).
