Skip to main content

Physical Examination in Case of Alcohol Use Disorder

Image
By

Physical Examination in Case of Alcohol Use Disorder

The examination begins with an inspection of the general demeanour and physique. 

General Physical Examination 

On general physical examination, observe signs of agitation, sweating, and bruises and note the respiratory rate. 

  • Agitation or restlessness  
  • Sweating  
  • Bruises 
  • Respiratory rate  

Examination of hands and arms

Examine the arms and hands for signs of hepatic disease or cerebellar dysfunction (tremor/dysdiadokokinesia and finger-nose test). 

Inspect for
  • Palmar erythema
  • Dupuytren’s contracture  
  • Clubbing  
  • Koilonychia  
  • Nicotine stains 
Then examine 
  • Then examine tremor and dysdiadokokinesia (by asking the patient to tap the palm of one hand with the fingers of the other, then rapidly turn over the fingers and tap the palm with the back of them, repeatedly). 
  • Perform finger-nose test
  • For hepatic flap-ask the patient to hold arms straight with hyper-extended hands. Look for an intermittent loss of tone in the wrists, with the appearance of a flap. 
  • Check pulse rate and blood pressure  

Examination of eyes  

Check extraocular muscles and rule out nystagmus  

  • Jaundice  
  • Pallor 

Mouth  

Examine the patient's mouth for any signs of oral thrush, which can indicate impaired immune function, as well as any evidence of alcoholic stomatitis, which is a condition characterized by painful ulcers in the mouth. 

Chest examination  

  • Spider naevi  
  • Gynecomastia  
  • Loss of body hair  
  • Auscultate for heart sounds  

Abdominal examination 

Palpate the patient's abdomen to assess for any tenderness or masses, which may indicate liver disease or pancreatitis.
  • Scratch marks  
  • Caput medusae  
  • Umbilicus everted/inverted  
  • Palpate liver and spleen  
  • Check for ascites  
  • Ask to check the external genitalia for testicular atrophy  

Neurological examination  

Perform a neurological examination to assess for any signs of peripheral neuropathy, such as muscle weakness, impaired coordination, and loss of sensation in the extremities.
  • Check reflexes  
  • Check for peripheral neuropathy and proximal myopathy  
  • Perform heel-shin
  • Assess gait


Labels:

Comments

Post a Comment

Your Thoughts?

Popular posts from this blog

ADVOKATE: A Mnemonic Tool for the Assessment of Eyewitness Evidence

By
ADVOKATE: A Mnemonic Tool for Assessment of Eyewitness Evidence A tool for assessing eyewitness  ADVOKATE is a tool designed to assess eyewitness evidence and how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologists, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (college.police.uk)
Post a Comment
Read more

ICD-11 Criteria for Attention Deficit Hyperactivity Disorder (ADHD) 6A05

By
ICD-11 Criteria for Attention Deficit Hyperactivity Disorder (ADHD) 6A05 Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that re...
Post a Comment
Read more

ICD-11 Criteria for Depression (Recurrent Depressive Disorder) 6A71

By
ICD-11 Criteria for Depression (Recurrent Depressive Disorder) 6A71 Recurrent depressive disorder is characterised by a history or at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a Bipolar disorder. Inclusions:                Seasonal depressive disorder Exclusions:    ...
Post a Comment
Read more