Love Findings on Physical Exam
A Rearrangement
MARA FEINGOLD-LINK
“HEENT: There is a tubular structure that is thickening. I have not felt it before. Patient thinks it might be new. LUNGS: Clear. HEART: Normal. ABDOMEN: Benign without tenderness, masses, hepatosplenomegaly or ascites. EXTREMITIES: Good pulses and power without edema, cyanosis, clubbing, varicosities, cords or Homan’s signs. NEUROLOGIC: Intact.”
–Doctor’s report from a yearly physical of a healthy patient
Initial Visit
HEENT: Eyes are without edema. Head is clear.
LUNGS: Normal.
EXTREMITIES: Good power.
ABDOMEN: Benign.
NEUROLOGIC: Good pulses.
HEART: Intact – has not felt it before.
Sick Visit
HEENT: Eyes tender. Head is without mass.
LUNGS: Clear.
EXTREMITIES: Normal.
ABDOMEN: New structure.
NEUROLOGIC: She has not felt this pulse before. Patient thinks it might be new.
HEART: Power.
Followup
HEENT: Eyes show edema. Head is pulsing.
LUNGS: Benign.
EXTREMITIES: Intact.
ABDOMEN: Mass without power.
NEUROLOGIC: Does not feel.
HEART: Without tenderness. Thickening.