Doctor Quest

global medicine

Practical Medical Tips

A scale for tenderness on examination

During initial and follow up examinations of painful body organ, I found that a more objective and an easy way of assessing the tenderness related to palpation is to ask the patient to give a number from a scale 1 to 10 similar to the scale of pain used in assessing the patient's subjective feeling of pain.


Smile and I'll give you a million dollar

During neurological examination of patients with suspected brain injury, I usually ask them to smile to help reveal one sided mouth deviation or other subtle facial asymmetries. Of course, it is not emotionally easy for a patient devastated with brain injury to have a good smile. One trick that I found works well is to tell the patient a joke such as: If you smile, I'll give you a million dollars and often I see the biggest smile ever.


Good in moderation, Bad in excess

One simple advice that you do when treating a patient with fluids overload related to congestive heart failure exacerbation or renal failure and help to prevent recurrent hospitalizations is to tell these patients not to drink too much of fluids. I am still surprised how many of these patients think that drinking too much water is good for them.


Do not miss the bedtime snack

One simple advice to help in managing diabetic patients with labile glucose readings between very low readings to high readings is to remind patients to always have a small bedtime snack and not to miss any of the three daily meals. Remind them also to restrict consumption of fruit juices or sodas.