Abnormal Finding

• Grooming and personal hygiene (Depression, schizophrenia, obsessive-compulsive disorder)
• General appearance (Most of Endocrine diseases are diagnosable by first look)
  • Myxedema (Puffy face, coarse hair, loss of hair in outer eyebrow)
  • Thyrotoxicosis (Wide eye stair)
  • Gigantism
• Sex
  • Females 
    • Breast, uterine, Ovarian and Vaginal diseases are unique to this sex
    • Delayed puberty
    • Precocious puberty
    • Virilism
    • Osteoporosis
  • Males 
    • Testicular, penile and Prostate diseases  are unique
    •  COPD, Lung cancer, Coronary artery disease more common in men. (Related to socio-economic patterns)
• Race
  • True
    • Black (Sickle cell anemia)
    • Jews (Tay-Sach's disease)
    • (Thalassemia)
  • False
    • Many other diseases are related to socio-economic status and environmental factors than due to race
• Body build
  • Weight
    • Obesity (Sleep apnea syndrome)
    • Emaciation (Malignancy, chronic infections, malabsorption, etc.)
    • Weight loss (Many diseases)
  • Height
    • Unusually short (Turner's syndrome, achondroplastic, hypopituitarism, Fanconi anemia)
    • Unusually tall (Gigantism)
    • Slender, tall and lanky (Marfan's)
• Deformities or distinguishing characteristics
  • Kyphoscoliosis
  • Surgical scars (clue to a past event)
  • Gibbus (Patient with Tb Spine)
• Chronological age
  • Younger than stated age (Sickle cell anemia)
  • Older than stated age (Progeria)
• Apparent state of health
  • Healthy as related to marked CXR abnormalities (sarcoidosis)
  • Acutely ill (Ashen with sweaty face/Shock)
  • Chronically ill
• State of comfort
  • Respiratory distress
    • Orthopnea
    • Platypnea
  • Pain
• Mental status
  • Comatose
  • Confused
  • Anxious
  • Depressed (Slow, slumped posture, shabby, disinterested, gloomy)
  • Maniacal
  • Hostile
• Assessing function
  • Activities of daily living (ADL)
  • Instrumental activities of daily living
• In Hospital setting
  • Isolation (Contagious infections)
  • Reverse isolation (Immunocompromised patient)
  • Sputum (Nature helpful) Note Three layered sputum/Bronchiectasis
  • Odor (anaerobic infection of oropharynx and Lungs)
  • Position of bed: Orthopnea
  • On Oxygen (Low flow/COPD  vs. High flow clues to diagnosis)