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Old 04-09-2013
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Hammer and Otoscope Question regarding CS physical exam

I have a question concerning the physical exam. If a pt is presenting with some kind of heart abnormality (Aortic stenosis, Pericarditis) there is no way we can gauge that they have a murmur or Kussmaul sign on an actor acting as the patient. Same goes for Abd pain, we won't be able to assess absent Bowel sounds on someone who is completely normal. My question is what if that actor has some kind of underlying pathology like a mild murmur (A lot of people do) and we are able to pick it up. Would I discard it or include it in my patient note?

I am not sure how 'real' the exam simulation is. I am assuming they wouldn't present actors sick enough that they are showing signs of the disease (for example Kussmaul's sign for pericarditis). Sorry if this seems like a silly question, just trying to clear up some concerns.

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