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; further:
- Inspection (viewing).
- Skin, mucous membranes, and sclerae (white part of the eye) [disorders in skin pigmentation; uveitis (inflammation of the middle skin of the eye)]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Extremities [polyarthritis (inflammation of multiple joints)]
- Inspection and palpation (palpation) of lymph node stations [lymphadenitis (inflammation of lymph nodes)]
- Auscultation (listening) of the heart [due topossible symptom or secondary disease: pericarditis (pericarditis)][due todifferential diagnosis: endocarditis (pericarditis)]
- Auscultation of the lungs
- Examination of the abdomen (belly)
- 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 (abdominal) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain? [Abdominal pain (abdominal pain)? ]
- Percussion (tapping) of the abdomen
- Inspection (viewing).
- If necessary, ophthalmological examination [due topossible secondary disease: uveitis (inflammation of the middle eye skin)].
- Neurological examination [due topossible neurological symptoms with amnesia (memory loss), dementia, gaze paralysis, epilepsy (seizures), gait disturbances, disturbed sleep-wake rhythm, polydipsia (abnormally increased water intake; more than 4 liters of fluid intake per day)][due todifferential diagnosis: dementia][due topossible sequelae:
- Amnesia (memory loss)
- Ataxia (gait disturbance)
- Gaze paralysis
- Dementia
- Epilepsy (seizures)
- Disturbed sleep-wake rhythm]
- If necessary, orthopedic/rheumatological examination [due topossible secondary diseases:
- Polyarthritis (inflammation of multiple joints).
- Synovitis (inflammation of the synovial membrane)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.