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If the client reportsurethral symptoms or urethritis, or if yoususpect inflammation of Skene’s glands,insert your gloved index finger into thesuperior portion of the vagina and milk theurethra from the inside, pushing up and out(Fig. ‘Sausage toe’: a reliable sign ofunderlying osteomyelitis. Complex partial seizures (CPS, temporal lobe epilepsy,psychomotor): attacks of bizarre and confused behaviour andpurposeless movements, emotional changes lasting 1–2 minalong with impairment of consciousness. None of thepatients with a stroke mimic received tissue-type plasmin-ogen activator

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