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For many of you, your time at the clinic will be time for you to hone your physical exam skills. Given the time constraints of the clinic, it is worth noting what exams are the highest yield based on national recommendations. Along with the history mentioned previously, be sure to do a review of systems. Discussion of some important ROS questions are included here.

HEENT

Beginning with the head, you may perform a full HEENT exam, but pay particular attention to the mouth exam. Again, good oral hygiene is very important for diabetics.

While you are encouraged to attempt an exam of the retina, realize that many students have difficulty visualizing relevant structures. This need not deter you, but be aware that it is uncomfortable for the patient. You should not spend more than 15 seconds or so per eye.

Also important in the HEENT exam is the neck exam. Check carotid pulses (not simultaneously) and listen for bruits. Examine the thyroid for any enlargement or nodules.