1.INTRO, RISK ASSESSMENT AND EXAMINATION OF CLOTHED PATIENT

Question 1

Examination that should be done in every visit?

Answer 1

1. Face:
   ► Skin
   ► Eyes:
   · Conjunctiva; pink (normal), pale (anaemia)
   · Sclera; white (normal), yellow (jaundice)
2. Neck
3. Scalp
4. TMJ
5. Mouth

Question 2

Examinations that can be done but not routinely?

Answer 2

1. Hands and wrist (Accessible and doesn’t need to undress the patient)
2. Breathing (without undressing the patient)

Question 3

When and Why would you carry Hand and wrist examination?

Answer 3

When:
a. Pt feels faint and unwell
b. Pt having atrial fibrillation
c. Pt having pacemaker

Why:
a. Examine the pulse

b. Blue fingers (Peripheral cyanosis: increased deoxygenated haemoglobin) (indication of peripheral vascular disease)

c. Finger clubbing (Indication of chest, lung or abdominal disease, protein metabolism problems, cancer)

d. Heberden’s nodes (Signs and deformities of osteoarthritis)

e. Bone erosion and displacement (Signs and deformities of rheumatoid arthritis)

Question 4

When and How would you carry breathing examination? (without undressing the patient)

Answer 4

When:
Pt with short breath (COPD “Pink puffers or blue bloaters”)

How:
Examine their respiratory rate by counting the number of breaths taken per minute

Question 5

As dentists, we should never examine (not part of the routine examination)?

Answer 5

1. Intimate examination (Genitals and Breasts)
2. Upper arms
3. Chest
4. Abdomen
5. Legs

Question 6

What should be considered before examining your patient?

Answer 6

1. ALWAYS ask for permission to examine a patient
2. ALWAYS have a chaperone (nurse or another member of staff)
3. ALWAYS record your findings