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  #1  
Old 06-15-2013
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Hammer and Otoscope PE in LOC

what would be the focused PE in LOC.

Bruits of neck
eyes
2-12 CN, DTR, Strength, Sensation of Upper and lower,
Clapping hand alternatively
CVS- for murmur

is this good.
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Old 06-15-2013
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Me:
A&O, DTR, strength, sensation (dull, sharp), CN, CV w/neck, PERRLA, Fundus. I'd leave the cerebellum in peace if I'm running out of time or I don't think the cases points to cerebellum.
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Old 06-16-2013
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Originally Posted by shima View Post
what would be the focused PE in LOC.

Bruits of neck
eyes
2-12 CN, DTR, Strength, Sensation of Upper and lower,
Clapping hand alternatively
CVS- for murmur

is this good.
This is good, I had a LOC case and I did all of this.

Just remember.. if the patient is a young lad (less than 40, for both women and men) then I would start with general exam and CVS for murmur.. this because the MCC of LOC on this age group is either dehydration/hypoglycemia/Vasovagal or HOCM.

Your plan is good! also I wouldn't do the clapping hand alternatively because thats cerebellum and it doesnt pertain to the Reticular ascending system (which controls mentation and consciousness per se), with the Cranial nerves it should be enough to test for Brain stem function.
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Old 06-16-2013
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Quote:
Originally Posted by XpaezX View Post
This is good, I had a LOC case and I did all of this.

Just remember.. if the patient is a young lad (less than 40, for both women and men) then I would start with general exam and CVS for murmur.. this because the MCC of LOC on this age group is either dehydration/hypoglycemia/Vasovagal or HOCM.

Your plan is good! also I wouldn't do the clapping hand alternatively because thats cerebellum and it doesnt pertain to the Reticular ascending system (which controls mentation and consciousness per se), with the Cranial nerves it should be enough to test for Brain stem function.
so when do we actually ask the patient to clap hands alternatively
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Old 06-16-2013
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Originally Posted by shima View Post
so when do we actually ask the patient to clap hands alternatively
H/o Tremor, Parkinson, ataxia, vertigo, dizziness, falls...(for example)

But I think this has to be correlated w/the history.
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Old 06-17-2013
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Originally Posted by Dr. Mexito View Post
H/o Tremor, Parkinson, ataxia, vertigo, dizziness, falls...(for example)

But I think this has to be correlated w/the history.
Exactly, I have seen First aid and other books that they want you to do almost everything without stopping to think.

I did exactly everything you did except cerebellum because thats just incoherent.. If you think about it.

I did the PE that I thought best correlated with the Patient I was seeing.. I didnt just memorized a PE and vomited it the day of the exam (Im not saying you are doing that, but a lot of people do that without stopping to think).

Also remember.. you wont be able to do everything you want or plan because the day of the exam time flies so fast is not even funny, and also remember you gotta leave from 2.5 to 3 minutes in the end for closure and counseling!
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