Focussed Physical - drpadvadd

[ArchivalUser]

What does a "Focussed" physical exam exactly mean? What is mandatory and what are optionals. How do we prioritize one over the other. Can any one help giving examples.
Thanks.

[ArchivalUser]

Focussed physical exam means:

C/O ankle pain
PE: focussed only!
you do not waste time checking my neck, head, mouth, lungs, heart or abdomen.
you go to my ankles and do:
inspection: Comparing both ankles
palpation: in both ankles
ROM: flexion, extension, adduction, abduction. internal rotation, external rotation. comparing both ankles
focussed cardio and neuro of extremities: peripheral pulses, sensation, motor, strength and reflexes.

That is a focussed PE.
Hope you get the idea

[ArchivalUser]

Forgot to mention in the above sample that at the end you would ask the patient to walk.
that ends your focussed PE.
If you do that and you still have time do mini cardio and respiratory, but remember that if you leave the room earlier you have more time to do a NICE PATIENT NOTE. That should be your goal.

[ArchivalUser]

Focus it on the patient's chief complaint.

[ArchivalUser]

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[ArchivalUser]

Thanks for your time. Also what would be a focused PE in the following cases. The list is long but I have grey zones specially with these Non pain cases. I feel since DDs have to be explicit PE can afford only to be focused anymore.

a) Blood in Stool....Abdomen?
b) jaundice suggestive of Obstructive cause
c) Fatigue with depression
d) Memory loss .....MME?

If No Physical signs....?
with hx of Focal neuro deficiets......Neuro? + MME?
e) Blood in Urine
f) Diabetes with
P.Neuropathy
Controlled DM for drug refill

g) Fatigue with Domestic violence
h) Hypertension (Uncontrolled) +SE of Meds
i)Parkinsons (Hx Suggestive of)
j) Passing out with Palpitations Hypertensive Pt........Cardiac/Neuro or both? Time enough?!
k) Weight gain after quitting smoking(Hx not suggestive of Thyroid)
l) Pregnancy/ Dyspareunia/ PID HX.....Abdomen or ?
j)Amenorrhea Galactorrhea...
k) Sexual assault with generalized pains/discomfort
l) Visual Hallucinations +Hx of illicit drug
m) Hx suggestive of Hyperthyroidism
n)Preemployment check in a healthy individual
o) Hoarseness with Heart burn......Throat ? Abdomen too?