Thrombocytopenia: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

General physical examination – including blood pressure, pulse, body weight, height; furthermore:

• Inspection (viewing):
  • Skin, mucous membranes, and sclerae (white part of the eye) [purpura (spontaneous, small-spot skin, subcutaneous, or mucosal hemorrhages), petechiae (spontaneous, pinpoint skin and mucosal hemorrhages/flea-like, hematomas (bruises), and bleeding]
  • Lymph node stations (cervical, axillary, supraclavicular, inguinal including palpation (palpation).
  • Abdomen (abdomen):
    • Shape of the abdomen?
    • Skin color? Skin texture?
    • Efflorescences (skin changes)?
    • Pulsations? Bowel movements?
    • Visible vessels?
    • Scars? Hernias (fractures)?
  • Mobility testing of the spine
  • Genitals and anal region
• Auscultation (listening) of the heart.
• Auscultation of the lungs
• Examination of the abdomen
  • 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?).
• Digital rectal examination (DRU): examination of the rectum and adjacent organs with the finger by palpation.