Megaloblastic Anemia: Examination

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) [jaundice (yellowing of the skin), smooth red tongue, cheilosis (redness and swelling of the lips), glossitis (inflammation of the tongue)]
  • Auscultation (listening) of the heart.
  • Examination of the abdomen (abdomen)
    • 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 (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?).
• Cancer prevention
• Neurological examination – including assessment of reflex activity and sensitivity [due topossible sequelae: Ataxia (gait disturbances), dementia, impaired sensation of position, impaired sensation of vibration, muscle weakness, paresis (paralysis) in extremities, psychosis, numbness in extremities, forgetfulness, decreased or increased reflexes]
• Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.