DIAGNOSIS - Medicine for Mountaineering and Other Wilderness Activities - page 4

Heart and Lungs: Chest pain, palpitations, shortness of breath (greater than that experi-
enced by others during similar exercise at the same altitude), cough, amount and
character of material that is coughed up, coughing up blood
Gastrointestinal: Loss of appetite, nausea, vomiting, vomiting blood or material that
looks like coffee grounds, indigestion, gas, pain, constipation, laxative use, diarrhea,
bloody or tarry or black stools, pale or clay-colored stools, hemorrhoids, jaundice
Genitourinary: Increase or decrease in frequency of voiding; color of urine (light yellow,
orange); back pain, pain with voiding; passage of blood, gravel, or stones; sores, pur-
ulent discharge, venereal disease, or sexual contact; menstrual abnormalities such as
irregular periods, increased bleeding with periods, bleeding between periods, cramps
Neuromuscular: Fainting whether total or incomplete ( Chapter 17: Heart and Blood Ves-
sel Disorders ) , unconsciousness from other causes, dizziness or vertigo, twitching,
convulsions; muscle cramps, shooting pains, muscular or joint pain; total or partial
loss of sensation, tingling sensations, weakness, incoordination, or paralysis
Skin: Rashes, abscesses or boils
General: Fever, chills, weakness, easy fatigability, dizziness, weight loss
PHYSICAL EXAMINATION
If a physical examination is to provide useful information, the examiner must have some
priorexperience, particularly forexamining thechest andabdomen. Fortheinexperienced,
comparisonwithanormalindividualmaybehelpful,butnothingcansubstitutefortutelage
by a physician.
Athoroughphysicalexamination isessential intheevaluationofanyonewithamedical
disorder. Even a person with traumatic injuries must be completely examined to ensure no
wounds are overlooked, particularly in the presence of an obvious injury. For the examin-
ation the individual should be made comfortable and protected from wind and cold. The
examiner'shandsshouldbewarm,andtouchmustbegentle.Anyroughnessmakesobtain-
ing diagnostic information more difficult and could aggravate the individual's disorder.
To ensure that all areas of the body are examined, a definite routine should always be
followed. The following outline is relatively complete and is adequate for both traumatic
and nontraumatic disorders. The examination of some anatomical areas, particularly the
chest and abdomen, is described in more detail in the chapters dealing with those areas.
PHYSICAL EXAMINATION
General (Vital Signs): Pulse rate, respiratory rate, temperature, blood pressure, general
appearance
Skin: Color, texture, rashes, abscesses or boils