Tag Archives: Physical exam

Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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Steroid-Refractory Autoimmune Hemolytic Anemia with Massive Splenomegaly

To the Editor: A 63-year-old woman was admitted in January 2012 with a 1-month history of general fatigue and jaundice. Physical examination revealed a pale conjunctiva, icteric sclera, and splenomegaly with no evidence of systemic lymphadenopathy. Laboratory findings revealed normocytic anemia (49 g/L) with increased reticulocyte count, decreased haptoglobin level, normal white cell count without […]

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The Intention-to-Treat Analysis Is Not Always the Conservative Approach

The randomized trial design can be thought of as a means to answer 2 types of general questions: 1) what is the effect of assigning a treatment?; or 2) what is the effect of receiving a treatment? In public health, we are normally concerned with the first question—the effect of assigning a treatment. If we […]

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Dr. Joseph S. Alpert

Will Physicians Stop Performing Physical Examinations?

In the 21st century, debate continues concerning the value of the physical examination.1, 2, 3, 4 That such a hallowed and respected ritual of clinical medicine should even be questioned is the result of the remarkable advances during the last 50 years in imaging technology and laboratory medicine. When I was a student and resident in the late 1960s […]

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doctor gives a physical examination of a patient

The Five-Minute Moment

In today’s hospital and clinic environment, the obstacles to bedside teaching for both faculty and trainees are considerable. As electronic health record systems become increasingly prevalent, trainees are spending more time performing patient care tasks from computer workstations, limiting opportunities to learn at the bedside. Physical examination skills rarely are emphasized, and low confidence levels, […]

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