Physical exam

You perform a physical exam, and discover the following:

General appearance: Older pleasant gentleman, appearing his stated age

Vital signs: T 98.7, HR 78, BP 110/74, RR 16, O2 saturation 98% on room air

Head and neck: Icteric sclerae without jaundice; conjunctival pallor

Chest: Clear to auscultation; breathing comfortably on room air

CVS: S1, S2, no extra heart sounds, no murmurs

Abdomen: Soft, nontender, nondistended; no organomegaly

CNS: Alert and oriented; no focal deficits in strength or sensations

Lymph: No palpable cervical or supraclavicular lymphadenopathy

While performing a careful exam of his extremities, you observe the findings shown in the two images below:

What is the best term to describe the above exam finding ?

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Acrocyanosis. Learn more here

What is the best term to describe the above exam finding ?

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Livedo reticularis. Learn more here.

You noted scleral icterus on this patient’s exam, and he reported prior alcohol use to you. His wife is concerned about cirrhosis. Which exam findings would concern you for cirrhosis?

Findings of chronic liver disease are absent on his exam.

Interested in further reading? Refer to the Stanford Medicine page on physical exam findings in liver disease.