Lin, a 5-year-11-month-boy visited the outpatient clinic of a hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response,...


Lin, a 5-year-11-month-boy visited the outpatient clinic of a hospital, and physical<br>examination in the department shows: well physical development, conscious, steady<br>breathing, well mental response, no anaemic face, temperature 37.5°C. No<br>superficial lymph nodes were obviously enlarged, skin mucosa had no petechia,<br>purpura and ecchymosis. Skin rash (-). Clear breathing sound is heard in both lungs,<br>no rale. Rhythmic, normal heart sound is heard, but no heart murmur- Abdomen is<br>soft, no muscle guarding, tenderness and rebound tenderness. The liver was<br>palpated 1.0cm below the rib with a soft texture but not palpated under the xiphoid<br>process. The spleen was palpable 1.0cm below rib with a soft texture, tenderness (-)<br>and rebounds tenderness (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign<br>(-), Babinski's sign (-). All joints had no swollen and tenderness.<br>1. What do liver and spleen palpated 1cm below the rib mean respectively?<br>2. What is the next stop do you think would the doctor do, according to the<br>situations and laboratory results obtained in the outpatient clinic?<br>3. What are the differences in a paediatric physical examination compared to the<br>others? What are the main contents in the examination?<br>

Extracted text: Lin, a 5-year-11-month-boy visited the outpatient clinic of a hospital, and physical examination in the department shows: well physical development, conscious, steady breathing, well mental response, no anaemic face, temperature 37.5°C. No superficial lymph nodes were obviously enlarged, skin mucosa had no petechia, purpura and ecchymosis. Skin rash (-). Clear breathing sound is heard in both lungs, no rale. Rhythmic, normal heart sound is heard, but no heart murmur- Abdomen is soft, no muscle guarding, tenderness and rebound tenderness. The liver was palpated 1.0cm below the rib with a soft texture but not palpated under the xiphoid process. The spleen was palpable 1.0cm below rib with a soft texture, tenderness (-) and rebounds tenderness (-). No neck stiffness, Kernig's sign (-), Brudzinski's sign (-), Babinski's sign (-). All joints had no swollen and tenderness. 1. What do liver and spleen palpated 1cm below the rib mean respectively? 2. What is the next stop do you think would the doctor do, according to the situations and laboratory results obtained in the outpatient clinic? 3. What are the differences in a paediatric physical examination compared to the others? What are the main contents in the examination?

Jun 10, 2022
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