Physical Exam Key Points

1. Vital signs. Check for hypotension. Patient may be orthostatic (decrease in systolic BP of 10 mm Hg or increase in heart rate of 20 beats/min 1 minute after sudden movement from supine to standing position), suggesting acute blood loss.

2. Skin. Petechiae or purpura may be seen with thrombocytopenia in bone marrow failure or infiltration, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, or autoimmune hemolytic anemia. Telangiectasia, palmar erythema, and jaundice may indicate liver disease. Isolated jaundice suggests hemolysis. Lack of pink coloration of palmar creases indicates severe anemia.

3. Face. Frontal bossing and prominence of maxillary and malar bones are seen with bone marrow hyperplasia in thalassemia major and severe congenital hemolytic anemias.

4. Eyes. Retinal vessel tortuosity, microaneurysms, and hemorrhages can be present in patients with sickle S and C hemo-globinopathies.

5. Oropharynx. Glossitis in vitamin B12 or iron deficiency; angular stomatitis with iron deficiency.

6. Heart. Flow murmurs are common in anemia.

7. Abdomen. Splenomegaly is associated with hemolysis, thalassemias, chronic leukemias, lymphomas, and acute leukemias. Ascites, hepatomegaly, and splenomegaly suggest liver disease (portal hypertension).

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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