A woman with ascites and abdominal masses

Hui, Jyh; Woo, Patrick C. Y.; Kan, PS; Tang, Apy

doi:10.1016/s0140-6736(99)09107-2

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The lungs were clear. There was ++ peripheral oedema' [6]; or 'There was a moderate amount of ascites…' [7] or 'There was slight oedema in both legs' [8]. Whilst such statements suggest a level of confidence and accuracy in the results of a physical examination, the reality is quite different.…”

Section: Introductionmentioning

confidence: 99%

Impact of clinical experience on quantification of clinical signs at physical examination

Drager¹,

Abe²,

Martins³

et al. 2003

Journal of Internal Medicine

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Purpose. Although physical examination is a fundamental component of medical decision making, relatively few studies have evaluated how physicians quantify clinical signs and whether different methods of assessment have different effects on clinical practice. Objectives. To evaluate a possible impact of clinical experience when attending physicians, medical residents and medical students quantify qualitative signs of physical examination in a teaching hospital. Setting. Hospital das Clínicas, University of São Paulo, Brazil. Subjects. A total of 244 randomly selected physicians and medical students completed a reliable and consistent eight-item questionnaire. Main outcome measures. To compare how they quantified clinical signs of cyanosis, anaemia, jaundice, oedema and dehydration, why they used the method(s) they described, and whether the method used could affect diagnosis, further testing or patient management. A chi-square test was used to calculate differences between the groups. Results. Whilst the majority of those surveyed tended to use a four-level evaluation for these clinical signs, attending staff physicians were more likely to employ two-level evaluations than were residents or medical students. For all five signs, attending physicians' use of dichotomous evaluations was significantly higher than that of residents or medical students: anaemia (P ¼ 0.004), cyanosis (P < 0.001), oedema (P ¼ 0.005), dehydration (P < 0.001) and jaundice (P ¼ 0.002). Conclusion. Although medical students and residents are routinely taught to use a four-level evaluation for these clinical signs, many of those surveyed tend to abandon this experience for a dichotomous approach. Given that the clinicians in this survey tended not to change their initial approach to a patient based on the intensity of this semi-quantitative method, increased emphasis on teaching dichotomous approach evaluations in medical school should be encouraged.

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Section: Introductionmentioning

confidence: 99%

Impact of clinical experience on quantification of clinical signs at physical examination

Drager¹,

Abe²,

Martins³

et al. 2003

Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…An eosinophilia may be present and occurs in response to larval antigens. Occasionally, the diagnosis is made incidentally, when the nematode is spotted in the stool, on endoscopic examination, or is vomited up after general anesthetic (4,5). Treatment is with mebendazole 100 mg orally for 3 days or albendazole 400 mg by mouth as a single dose.…”

Section: Discussionmentioning

confidence: 99%