CASES - PEx Flashcards
Case 1 — Chest pain:
- Neck ==> JVD, carotid.
- CV.
- Pulmonary.
- Abdo.
- Extremities ==> Pulses, BP, edema/cyanosis.
Case 2 — Bloody urine:
- Abdo.
- CV.
- Pulmonary.
- Extremities ==> inspection.
Case 3 — Back pain:
- MSK (back) ==> Inspection, palpation, ROM.
- Extremities ==> Inspection, pulses, hip exam.
- Neuro ==> Motor, DTRs, babinski, gait (toe-to-heel), passive straight leg raising, sensory exam.
Case 4 — MVA:
- CV.
- Pulmonary.
- Abdo.
- HEENT.
- Neuro ==> Mental status, motor/sensory, CNs.
- Skin ==> inspection.
Case 5 — Positive pregnancy test:
- Abdominal.
- HEENT ==> inspection, palpation of thyroid.
- CV
- Lungs.
- Skin ==> rashes, pallor, pigmentation.
Case 7 — Right arm pain:
- Head and neck exam ==> Bruises, neck movements.
- MSK ==> both arms in terms of strength, ROM (shoulder, elbow, wrist), joint stability, DTRs, pulses.
- CV.
- Lungs.
Case 8 — 56yo DM f/u:
- HEENT ==> Fundoscopy.
- CV.
- Neuro ==> DTRs, babinski, strength, sharp and dull sensations, vibration sense, position sense in lower extremities.
- Pulmonary.
- Abdo.
Case 9 — 25yo F assaulted:
- HEENT ==> inspection/palpation.
- CV ==> auscultation.
- Lungs.
- Abdo.
- MSK ==> Inspection/palpation.
- Neuro ==> mental status, CNs, gross motor.
Case 10 — 35yo F right calf pain:
- Joint exam ==> Inspection, palpation, ROM.
- Extremities ==> Inspection, palpation, checked for Homan’s sign.
- CV/pulmonary exam.
- Neuro ==> Sensory, motor, reflexes.
Case 11 — Hoarseness:
- HEENT ==> conjunctivae, sclerae, mouth, and throat. Palpated LNs + thyroid.
- Pulmonary.
- CV.
- Abdo.
- Extremities ==> Inspection, DTRs.
Case 12 — Neck pain:
- Neck ==> Inspection, palpation, ROM, Lhermitte sign, Spurling test.
- Neuro ==> Motor, DTRs, sensory, Kernig, Brudzinski.
- MSK ==> Inspection, palpation of peripheral pulses, ROM.
Case 13 — Abdo pain:
- Abdo.
2. CV/lungs.
Case 14 — Headache:
- HEENT ==> Palpation (sinuses, TMJ), fundoscopy, inspected nose, mouth, throat.
- Neck ==> Inspection, palpation.
- Neuro ==> CNs, muscle strength, DTRs.
- CV/lungs.
Case 15 — Amenorrhea:
- Neck ==> thyroid.
- Extremities ==> Inspection.
- Neuro ==> Visual fields, EOMI, DTRs.
- CV/lungs.
Case 16 — Dyspareunia:
- Abdo.
2. CV/Lungs.
Case 17 — Hearing loss:
- HEENT ==> Tested hearing by speaking with back turned/ inspected sinuses, nose, mouth, and throat. Fundoscopic exam and otoscopy. Rinne/weber and whisper test.
- Neuro ==> CNs, sensation/motor, reflexes, cerebellar—finger to nose, heel to shin.
- CV/lungs.
Case 20 — Cough:
- Lungs.
- CV.
- HEENT ==> mouth, LNs, throat.
- Extremities ==> Inspection.
Case 21 — Yellow eyes and skin 52yo:
- HEENT ==> sclerae + under the tongue.
- Abdo ==> I + A + P (Murphy), percussion, liver span, palpation or percussion for splenomegaly, fluid wave for shifting dullness.
- Skin ==> telangiectasias, palmar erythema.
- CV/lungs.
- Extremities ==> asterixis, edema.
Case 22 — Dizziness:
- HEENT ==> nystagmus, fundoscopy, otoscopy, assessed hearing, Rinne/weber, mouth and throat.
- CNs, motor, DTRs, gait, Romberg, Dix-Hallpike maneuver.
- CV.
Case 23 — Knee pain:
- MSK ==> Inspection and palpation (both knees, including ROM). Examined other joints.
- Mouth ==> ulcers.
- CV/lungs.
- Hair and skin ==> Inspection.
- Abdo.
Case 24 — Heel pain:
- Extremities ==> Inspection of both feet and ankles — non-weight bearing/weight bearing, and with ampulation.
Palpation of medial calcaneal tuberosity, Achilles tendon, plantar fascia, retrocalcaneal bursae.
Passive ROM and general strength of ipsilateral knee and hip.
Ankle dorsiflexion and great toe extension and passive ROM.
Strength testing of ankle dorsiflexion and plantar flexion. - Neuro ==> Sensation to light touch for dermatomes of foot and ankle. Assessed Achilles tendon reflex.
- CV ==> +Distal pulses, cap refill of the toes.
- Lungs.
- Abdo.
Case 26 — Persistent cough:
- HEENT ==> inspection of mouth/throat/palpation of neck LNs.
- Lungs ==> A + P + P.
- CV.
- Abdo.
- Extremities ==> inspection.
Case 27 — Fatigue:
- HEENT ==> Inspection of conjunctivae, mouth, and throat. Inspection and palpation of LNs and thyroid gland.
- Abdo ==> A + P + P (incl rebound tenderness and Murphy).
- CV.
- Lungs.
- Extremities ==> Inspection, palpation.
Case 28 — HTN f/u:
- HEENT ==> Fundoscopic exam, carotid auscultation.
- CV ==> + palpation.
- Neuro ==> DTRs, Babinski, sensation + motor in bil lower extremities.
- Lungs.
- Abdo ==> A + P.
- Extremities ==> Inspection, palpation of peripheral pulses.
Case 29 — Sleeping problems:
- HEENT ==> Inspection + palpation + auscultation of thyroid for LAN.
- CV.
- Extremities ==> Check tremor on outstreched fingertips — looked for edema.
- Lungs.
- Abdo ==> I + A + P.
- Skin ==> Inspection.
- Neuro ==> Brisk tendon reflexes.
Case 31 — Abdo pain:
- Abdo ==> Inspection + A + Palpation + Percussion. Psoas, obturator, Rovsing, CVA.
- CV/Lungs.
Case 32 — Forgetfulness and confusion:
- Neuro ==> MMSE + CNs + motor + DTRs + gait + sensory.
- CV/Lungs.
- Abdo ==> Palpation.
- Neck ==> carotid auscultation.
- Eye ==> Inspected pupils, fundus.
Case 33 — Fatigue:
- HEENT ==> Inspected conjunctivae, mouth, and throat, LNs. Examined thyroid gland.
- Lungs/CV.
- Abdo ==> A + P + P.
- Extremities ==> Inspection + DTRs.
Case 34 — Fatigue:
- HEENT ==> Inspected conjunctivae, mouth and throat, LNs. Examined thyroid.
- CV/Lungs.
- Abdo ==> A + P + P.
- Extremities ==> Inspection + motor + DTRs.
- Skin ==> Inspection for bruises + signs of injury.
Case 35 — Strange writing on the wall:
- Eye exam ==> Pupils, checked for reactivity.
- Neuro ==> MMSE, CNs, motor—sensory, DTRs, gait.
- CV/lungs.
- Abdo ==> palpation.
Case 36 — Pre-employment medical checkup:
- CV ==> A.
- Lungs ==> A + P + P.
- HEENT ==> Inspected mouth, throat, palpated LNs.
- Abdo ==> A + P.
- Extremities ==> Inspection.
- Neuro ==> CNs, motor, DTRs, gait.
Case 37 — Bloody stool:
- Abdo ==> A + P + P.
2. CV/lungs.
Case 38 — Tremor:
- Neuro ==> Mental status, CNs, motor (including muscle tone), sensory, cerebellar, gait.
- CV/Lungs.
Case 39 — Weight gain:
- Neck ==> Palpated LNs, thyroid.
- Abdo ==> A + P + P.
- Extremities ==> Inspected for abnormal dryness in skin, edema, checked DTRs.
- CV/lungs.
- Head ==> Inspected hair, conjunctivae, mouth and throat.
Case 43 — Sore throat:
- HEENT ==> Examined nose, mouth, throat, LNs. Checked for sinus tenderness.
- Abdo ==> A + P + P.
- Skin/LNs ==> Rashes, lesions, lymphadenopathy.
- CV/Lungs.
Case 44 — Loss of consciousness:
- Neuro ==> Mental status, CNs (+fundoscopic exam), motor/sensory, DTRs, cerebellar, gait, Romberg.
- CV ==> P + A + Orthostatic VS.
- HEENT. ==> Inspection (head, mouth), carotid auscultation and palpation, thyroid exam.
- Lungs.
- Extremities ==> Peripheral pulses.