Health Questions and Answers

Archive for October, 2007

Question: How can I perform a brief, directed physical examination on a patient with altered consciousness?

Wednesday, October 31st, 2007

Answer: The goal of the physical examination is to differentiate structural focal CNS problems from diffuse metabolic processes. Pay special attention to vital signs, general appearance, mental status, eye findings, and the motor examination. The general appearance should be noted before examining the patient. Are there signs of trauma? Is there symmetry of spontaneous movements? […]

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Question: What important historical facts should be obtained from the patient with altered mental status or coma?

Wednesday, October 31st, 2007

Answer: This seems like a stupid question because the patient with altered consciousness cannot give you a reliable history, and the comatose patient cannot give any history at all! You should question carefully prehospital personnel and attempt to contact the patient’s friends or family. Ask about the onset of symptoms (acute or/gradual), recent neurologic symptoms […]

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