The Medical clinics of North America
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Delirium is an acute and fluctuating disorder characterized by a disturbance in attention and cognition. Delirium is underdiagnosed by clinicians, but there are excellent diagnostic tools using history and physical examination that can assist clinicians in making the diagnosis in multiple settings (ie, CAM, CAM-ICU, 3D-CAM, bCAM, 4AT, and UB-CAM). Delirium is caused by underlying medical conditions and is often multifactorial, so a full diagnosis requires a careful assessment for a wide range of underlying conditions. Physical examination has not been well studied in this regard, but still can provide useful clues to the clinician.
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Med. Clin. North Am. · May 2022
ReviewChronic Obstructive Pulmonary Disease and the Physical Examination.
Performing a hypothesis-driven examination in patients with possible chronic obstructive pulmonary disease (COPD) is an important component of increasing the recognition and diagnosis of this avoidable and costly medical condition. Using known likelihood ratios for various physical examination maneuvers can be combined with known individual risk factors and symptoms to adjust a patient's post-test probability of having COPD and inform appropriate diagnostic work-up. Equally important is intentionality in history-taking and physical examination procedures for patients with known COPD to mitigate the decreased quality of life and mortality and to monitor response to treatment.
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Med. Clin. North Am. · May 2022
ReviewPhysical Examination in Human Immunodeficiency Virus Disease.
Human immunodeficiency virus (HIV)-associated disease is known for its protean manifestations. However, many of the characteristic findings on physical examination are not associated with HIV infection per se but the numerous opportunistic infections (OIs) that are common in patients with advanced HIV disease. ⋯ OIs also cause skin, oropharyngeal, ocular, and neurologic manifestations. A skilled clinician can often recognize HIV disease based on the combination of these findings.