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Poor orał hygiene in a patient A with infeclive endocardhs

Jugular vonous pulsc

(see opposite) a Height ^ Waveform

Jugular venous pulse A

Carolid pulscs

Voiume Character Bruits (see opposite)

Blood prossure ^

Radial pulse

Ratę

Rhythm

Hands

Dubbing

Splinter haemorrhages ^ and other stigmata ot inłectrve endocarditis /-

Splinter haemorrhageA

Cyanosis and dubbing in a A

patient with complex cyanotic congenitai heart disease

Face. mouth and cycs

^ Paiior

Central cyanosis Malar flush Dental caries Fundi (retinopathy) Stigmata of hyperlipidaemia and thyroid disease

Obscrvation

A Xanthelasma

A Malar flush

Precordium

Inspect Palpate (seo opposite)

Auscultation

(see opposite)

Back

Lung crepitations Sacrai oedema

Abdomcn

Hepatomegaly

Asotes

AorttC aneurysm Bruits

Tendon xanthomas

(hyperlipidaemia)

Fcmoral pulscs

Radio-femorai delay Bruits

Legs

Peripherai pulses

Oedema

Symptoms and well-being

•    Breathiessness

•    Distress etc.

Body habitus

•    Body mass (obesity. cachexia)

•    Martans and other syndromes Tissue pcrfusion

•    Skin temperaturo

•    Sweatmg

•    Urine output

A Vasculitis in a patient with infective endocarditis

A Peripherai oedema in a patient with congesthre cardiac tailure

<2> Elsevier. Boon et al.: DayidKWs Principles and Practice of Medicine 20e - wwv/.studentconsult.com