demonstrated and an auscultation bowel sounds
are present and normal. To complete my examination,
what sort of thing would you want to do?
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.
Yeah. You could look at the calves
for erythema nodosum
and stuff like that.
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.
Yeah. FBC, U&E, abdominal X-ray, if it’s
abdominal ultrasound, have a look at the values
for the rest of the labs.
Absolutely, yeah. Some bedside observations
will be good.
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.
Did you do the full abdomen exam?
Say that again?
At that station, did you do a full abdomen
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