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History taking and physical examination 

History taking and physical examination
Chapter:
History taking and physical examination
Author(s):

José M. Ribera-Casado

DOI:
10.1093/med/9780198701590.003.0020
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date: 18 October 2019

In geriatric medicine, history taking and physical examination differ from the way that these clinical skills are traditionally recommended for younger patients. The definitive approach to a full diagnostic appraisal is through a ‘comprehensive geriatric assessment’. This takes time, and may need modification of the use of language and of the physical setting. Social situation, physical and mental function, and bioethical personal values are essential components of this approach. The findings from a careful, systematic, and detailed physical examination can never be replaced by biological or clinical tests. Physical findings typical for some clinical conditions in younger patients may be absent in older patients and some significant findings are particular to older patients. Certain aspects of assessment tend to be more commonly overlooked, including full medication history including self-medicating habits, nutritional status, and evidence suggesting physical, sexual, or mental abuse.

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