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Old 04-29-2013
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Question Qs regarding physical exam

Hello guys , I just have some qs regarding PE

1. Regarding repeating painful maneuvers ( appendicitis for ex, we have to elicit tenderness and then rebound tenderness and crossed tenderness (Rovsing) and then obturator & psoas test . These are 5 tests to elicit pain
Shall I do all of them (what to tell the patient?) or do just one & apologize

2. Chest examination ( in chest case for ex as cough or hemoptysis)
Do I have to do chest expansion & percussion or just do auscultation & tactile vocal fremitus)

3.In knee ex (case of trauma) , should I do Varus & valgus test , Ant drawer & post drawer or just range of motion & reflexes.

Well That's all Thanks a lot in Advance
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Old 05-06-2013
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i have nt taken the exam yet but for appendicitis i just do two maneuvers like rosving n psoas sign.for the chest examination if the pt complain is related to it i will do the whole examination it take only 2-2.5 mins..its better u do that rather then do other examination becaz u hv to do relevant examination.as for no 3...i just do inspection,palpation,rom,muscle strength,reflexes,sensation of the distal joint, pulse and gait if possible...i hv not dn other sign in practise bcaz of time management bt u cn do them if u hv time..but theses are imp stuff u hv to do first.
anyone who finds anything wrong plz correct me
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Old 05-06-2013
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For any painful maneuver(s), just do them all and then say " I understand that these special tests caused you pain but they were essential for me to reach a diagnosis to provide you with the best treatment". I will not do it again.
NEVER APOLOGIZE since you did not do anything wrong. Only apologize if you did something wrong i.e. if you were late (own responsibility) or you accidently hit the patient.

1. I will elicit tenderness/ rebound tenderness and Rovsing's as well as obturator sign. I will not do psoas test since it coveys the same information as obturator test and will amount to causing unnecessary pain.

2. I'll do complete examination.

3. I'll do complete examination.
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Old 05-06-2013
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Quote:
Originally Posted by Novobiocin View Post
For any painful maneuver(s), just do them all and then say " I understand that these special tests caused you pain but they were essential for me to reach a diagnosis to provide you with the best treatment". I will not do it again.
NEVER APOLOGIZE since you did not do anything wrong. Only apologize if you did something wrong i.e. if you were late (own responsibility) or you accidently hit the patient.

1. I will elicit tenderness/ rebound tenderness and Rovsing's as well as obturator sign. I will not do psoas test since it coveys the same information as obturator test and will amount to causing unnecessary pain.

2. I'll do complete examination.

3. I'll do complete examination.
You're not supposed to do a complete examination though; it repeatedly says focused examination
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Old 05-06-2013
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Quote:
Originally Posted by cheesewarrior View Post
You're not supposed to do a complete examination though; it repeatedly says focused examination
I think you misunderstood.

2. Complete Chest exam
3. Complete knee exam
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