History and Physical Examination

Through the patient s history and physical examination, the physicians will identify any specific factor such as medications, prior procedures and medical conditions that can affect... 

Patient Encounter 1, Part 2 The Medical History and Physical Examination... 

A diagnosis can be made only at autopsy therefore the diagnosis is established following an extensive history and physical examination, and by ruling out other potential causes of dementia. 

Typically presents in late adolescence or early adulthood. Onset in older adults increases suspicion of relationship to medical disorders or substance use. Laboratory evaluation must be driven by history and physical examination. 

The assessment of patients for thyroid disorders entails a history and physical examination. In many patients with subclinical or mild thyroid disease, there may be an absence of specific signs and symptoms, and the physical examination may be normal. Various diagnostic tests can be used, including serum thyroid hormone(s), TSH, and thyroid antibody levels and imaging techniques to evaluate patients for thyroid disorders. Normal values for selected laboratory tests are given in Table 41-1. 

Obtain a thorough history and physical examination that may indicate the possible presence of GH deficiency. Exclude other identifiable causes of growth failure, such as hypothyroidism, chronic illness, malnutrition, genetic syndromes, and skeletal disorders. 

Such an approach should include an initial comprehensive medical history and physical examination, firm documentation that nonopioid therapy has failed, clearly defined treatment goals, an understanding between the provider and the patient of the true benefits and pitfalls of long-term opioids, use of a single provider and pharmacy whenever possible, and comprehensive follow-up. 

There is no universal guideline for follow-up care for MM. The National Comprehensive Cancer Network recommends annual skin examination for all patients.61 Educate patients with stage IA disease to have a history and physical examination every 3 to 12 months as clinically indicated and an annual skin examination for life. For stage IB to III disease, schedule a history and physical examination every 3 to 6 months for 3 years, every 4 to 12 months for 2 years, and then annually as indicated. It is optional to obtain a chest x-ray, LDH, complete blood count (CBC), and liver function tests (LFTs) every 3 to 12 months. CT scan can be obtained as indicated clinically.61 For NMSC, educate patients to schedule follow-up visits with... 

Evaluate severity and duration Obtain history and physical examination Treat dehydration Report suspect outbreaks Check all that apply ... 

A diagnosis of HF should be considered in patients exhibiting characteristic signs and symptoms. A complete history and physical examination with appropriate laboratory testing are essential in the initial evaluation of patients suspected of having F1F. 

A complete history and physical examination should assess (1) presence or absence of cardiovascular risk factors or definite cardiovascular disease in the individual (2) family history of premature cardiovascular disease or lipid disorders (3) presence or absence of secondary causes of hyperlipidemia, including concurrent medications and (4) presence or absence of xanthomas, abdominal pain, or history of pancreatitis, renal or liver disease, peripheral vascular disease, abdominal aortic aneurysm, or cerebral vascular disease (carotid bruits, stroke, or transient ischemic attack). 

The success of therapeutic regimens to treat IBDs can be measured by patient-reported complaints, signs and symptoms, direct physician examination (including endoscopy), history and physical examination, selected laboratory tests, and quality of life measures. 

The diagnosis of menopause should include a comprehensive medical history and physical examination, complete blood count, and measurement of serum FSH. When ovarian function has ceased, serum FSH concentrations exceed 40 international units/L. Altered thyroid function and pregnancy must be excluded. 

When colorectal carcinoma is suspected, a careful personal and family history and physical examination should be performed. 

All patients must have a thorough history and physical examination to detect signs and symptoms of the primary tumor, regional spread of the tumor, distant metastases, paraneoplastic syndromes, and ability to withstand aggressive surgery or chemotherapy. 

Patients with suspected AD should have a history and physical examination with appropriate laboratory and other diagnostic tests, neurologic and psychiatric examinations, standardized rating assessments, functional evaluation, and a caregiver interview. 

The history and physical examination should be obtained while initial therapy is being provided. A history of previous asthma exacerbations (e.g., hospitalizations, intubations) and complicating illnesses (e.g., cardiac disease, diabetes) should be obtained. The patient should be examined to assess hydration status use of accessory muscles of respiration and the presence of cyanosis, pneumonia, pneumothorax, pneumomediastinum, and upper airway obstruction. A complete blood count may be appropriate for patients with fever or purulent sputum. 

Other important components of the initial evaluation include a medical evaluation including both a medical history and physical examination. This can identify medical consequences of substance abuse, such as liver impairment from chronic alcohol abuse or sinus complications from cocaine use, as well as reveal needle tracks from a variety of self-injection sites that might not be readily apparent to casual observation. 

Physical examination and follow-up Take a complete medical history and physical examination prior to the implantation or re-implantation of levonorgestrel implants and at least annually during its use. Carefully monitor women with a strong family history of breast cancer or who have breast nodules. 

Physical examination The pretreatment and annual history and physical examination should include special reference to breast and pelvic organs, as well as a Papanicolaou smear. 

Erectiie dysfunction Undertake thorough medical history and physical examination to diagnose erectile dysfunction, determine potential underlying causes, and identify appropriate treatment. 

Because of early dissemination, staging of patients with small-cell lung cancer is more extensive than for patients with NSCLC. It is important to rule out distant metastasis because it will change the role of thoracic radiation in the treatment of these patients. Staging should include a complete history and physical examination, CAT scans of chest and upper abdomen to include the liver and adrenal glands, brain MRI scan, bone scan, complete blood count, and a possible bone marrow aspiration and biopsy. 

This syndrome is characterized by proteinuria >3.5 g/day, hypoalbuminuria <3 g/dl, hyperlip-idaemia with an elevation of serum cholesterol, edema and oval fat bodies and fatty casts in the urinary sediment. A variety of disorders may produce nephrotic syndrome but, in the majority of cases, no cause is found. It is appropriate to define the selection of studies from the history and physical examination. Tests to order are antinuclear antibody, rheumatoid factor, cryoglobulins, serum complement, HBsAg VDRL serology (syphilis), protein electrophoresis of the serum and urine and HIV. If the cause is unclear a renal biopsy is done to define the glomerular lesion as treatment may on the underlying glomerular lesion. 

Cardiovascular Dizziness, hypotension, QTc interval prolongation, tachycardia a -adrenergic, muscarinic Careful medical history and physical examination Electrocardiogram at baseline and at therapeutic dosage Blood pressure and pulse monitored at baseline and after dosage increases... 

No additional work-up, apart from what is indicated by the history and physical examination, is needed before starting BZs. However, because of the rare occurrence of disinhibition, it is important to carefully document behavior patterns for future comparison before starting a BZ (Commander et al., 1991). In the treatment of anxiety, multiple daily doses are recommended to maximize effects and minimize sedation and withdrawal. This recommendation holds true even for BZs with relatively long half-lives (Baldessarini, 1996). 

A complete medical history and physical examination by a pediatrician or primary care provider should have been completed since the onset of symptoms or within the past year. Chronic medical illnesses such as asthma, cancer, diabetes mellitus, and neurologic disorders increase the risk for psychiatric disorders, par-... 

Medical history and physical examination Food diary Elimination diet Skin prick testing... 

The diagnostic approach to suspected adverse food reactions begins with medical history and physical examination (Sampson, 1999a Burks, 2000). 

History and physical examination, positive prick test... 

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