Positive physical exam findings

After examining hundreds of normal people finding something on physical exam that isn't right is sort of a novelty. Today I had a couple of them in one poor old guy who had a problem list extending to number 18:

1) AAA actually does feel like a pulsitile mass in the abdomen...but I knew about that one
2) Bruits in almost every large vessel...knew about the PVD and carotid stenosis too
3) I definitely hear crackles in the RLL...you didn't hear those medicine resident? Never mind...you wrote the worst admitting H&P ever! Lemme go read the official CXR report...he's got an infiltrate to match his findings...maybe there's something to the physical exam crap.
4) Stage 1 decubitus ulcers look like some redness that doesn't blanch...noted.
5) Contracture vs lead-pipe rigidity...I couldn't tell the difference, but he's on cimetedine so he has Parkinsons in someones mind.

It really helped that I was on the Geri floor and had time to mess around with this poor demented old fellow...some cool findings that I might not ever see again.

1 comment:

Albinoblackbear said...

Good that some interesting moments shone through the darkness of this rotation! :) How many days left?

You must have had some fun this summer at least...


P.S I am a medical student now...not a pre med! :)
I finally threw out all of my MCAT stuff yesterday. I guess I wanted to ensure I had a few weeks under my belt in case someone came into a lecture shouting 'impostor!' and I had to re-descend into the pit of hell/getting into medical school again...hahaha