Completing the Examination

00:01 demonstrated and an auscultation bowel sounds are present and normal. To complete my examination, what sort of thing would you want to do? Urine dipstick? Yeah. So when you’re talking about what you do after the exam, try and talk about examinations first and then investigation. So yeah, urine dip is good. Say that again? But not first. Hernias? Hernia. So we said hernias, PR, external genitalia.

00:26 Yeah. You could look at the calves for erythema nodosum and stuff like that. Potentially, yeah.

00:34 That’s a rare sort of thing. The other thing I mention is doing an exam of the lymph nodes as well because the liver and spleen, big lymph nodes. Okay. Then you go and say what investigations you do. Urine dip? Yeah. FBC, U&E, abdominal X-ray, if it’s normal, potentially abdominal ultrasound, have a look at the values for the rest of the labs.

01:09 Absolutely, yeah. Some bedside observations will be good.

01:14 Again, take it all in the clinical picture of what they’ve given you to examine. So, that’s fine. You can sit out. Thank you very much. I remember when I have my finals, you tend to get patients that are stable or have fixed conditions that their signs can be replicated over and over. I remember revising a lot about colostomies and ileostomies and things. In our actual exam, we end up getting a peritoneal dialysis catheter. So it’s just being able to recognize and comment on the health of it. Does it look clean? Is there any odor? What does the skin look like around it? Is it cellulitic? Does the abdomen look distended? And it’s just picking upon those kinds of cues. He also had a scar as well in the flank. So it’s important to make sure you’re looking at the flanks as well. Okay.

02:01 Did you do the full abdomen exam? Say that again? At that station, did you do a full abdomen exam? Yes. So, you can just stand into the bed and say, “I’m going to comment on the most obvious thing.” I can see it as a tube coming out of this part of the abdomen, but I’m going to go through systematic just to make sure I don’t miss anything and it’s just a tick in the box to show that yeah you picked from the obvious thing. But don’t let it throw you because that was the thing when you see a colostomy bag, it’s something like, “I know what it is and I know what’s going on” but just make sure you don’t miss anything else. Are you guys happy? What do you do in the full abdomen exam, does