Mr A is 60 year old gentleman presents with 1 month history of dyspnoea. Please examine him.
Obviously this is a respiratory station... before you start examining him, you would have to INSPECT him and guest probably diagnosis, ie. bronchiectasis, lung fibrosis, COAD, pleural effusion and pulmonary tuberculosis...
Therefore, from the start of the examination, you would start looking for signs to exclude or include your diagnosis, at the same time looking for aetiology, current status and presence/absence of complications.
Examination techniques.. oh well.. for that you just have to practise till perfect and doesn't show at all on your face that you are thinking while examining. 6 minutes to finish off everything in a respiratory station might not be enough. A tips I had was... once I feel for the trachea, if it is central, I can either go straight to the back first then come back to the front or do the front part quickly. If trachea is central, the pathology most likely won't be detected anteriorly.
Coming back to the case.. this gentleman actually has pleural effusion.. So I leave you with that for now and share with us how you would want to present it, when the examiner tells you.. "Tell me your diagnosis."
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