When to stabilize and when to do a focused PE?

[lifetime]

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Hi Guys. One of uworld's cases had a young pt present with VS of BP = 90/60, HR = 128, Temp = 100F, RR = 30.

The history points to DKA. Uworld starts off with a PE first, but wouldn't IVA, NS, pulse ox, oxy, glucose check be warranted before that? Then do a focused PE.

Also, any general principles on how to decide which to do first? Thanks.

 

[fahimaz7]

In real life, unless this person is altered and in the critical care bay, you should have plenty of time to take a brief history and physical prior to shotgunning labs. Perhaps the DKA patient is in DKA b/c they have pneumonia, PID, bad cellulitis, or gangrene. Stuff comes out in the physical's that shape how you run the case.