Clin Skills Pathologies Flashcards
resp: end of the bed
environment:
- inhalers
- oxygen
- walking aids
- sputum pots
- medications
patient:
- alert and comfortable at rest
- tachypnoeic or dyspnoeic
- obvious cyanosis
resp: hands
- clubbing
- peripheral cyanosis
- tar staining
- CO2 retention tremor
resp: face
eyes:
- conjunctival pallor
- Horner’s syndrome (anhydrosis, ptosis and miosis)
mouth:
- central cyanosis
resp: neck
- raised JVP
- tracheal deviation
- scars (tracheotomy etc)
resp: chest
- scars e.g. lateral thoracotomy or sternotomy
- chest wall movement (symmetrical?)
- chest wall deformities
resp: back
- exaggerated kyphosis
- scars
cardio: end of bed
environment:
- GTN spray and other medications
- oxygen
patient:
- alert and comfortable at rest
- pale, sweaty, flushed
- breathlessness
- mechanical ticking of a pacemaker
cardio: hands
- capillary refill
- tar staining
- bruising
- splinter haemorrhages
- other peripheral stigmata of endocarditis
- such as: jane way lesions (palms not painful) and osler’s nodes (fingers painful)
cardio: arms
- scars
- bruising
cardio: face
- malar flush
eyes:
- xanthelasma
- corneal arcus
- conjunctival pallor
mouth:
- central cyanosis
- good dentition
cardio: neck
- raised JVP
cardio: chest
- scars (e.g. lateral thoracotomy or sternotomy)
- pacemaker
- visible apex beat
abdo: end of bed
environment:
- nil by mouth signs
- feeding paraphenalia
- vomit bowls
patient:
- alert and comfortable at rest
- obvious abdominal distension
- obvious jaundice
- nasogastric tubes
abdo: hands
- dupuytren’s contracture
- palmar erythema
- bruising
- leukonychia
- koilonychia
- clubbing
- asterixis (liver flap)
abdo: arms
- AV fistula
- excoriations
abdo: face
eyes:
- jaundiced sclera
- conjunctival pallor
- keiser fleischer rings
- xanthelasma
mouth:
- oral hydration
- ulcers
- dentition
abdo: neck
- supraclavicular lymph nodes
abdo: chest
- gynaecomastia
- spider naevi
- excoriations
abdo: abdomen 😃
- abdominal distension
- caput medusa
- stoma
- scars
- grey turner’s/cullen’s signs
peripheral vascular: end of bed
environment:
- medications
- prosthesis
- waling aids/wheelchair
patient:
- alert and comfortable at rest
- amputations
- dressings
peripheral vascular: hands and arms
- colour
- hair loss
- ulcers
- gangrene
- scars
- shiny skin
- tar staining
CHUGSS + T
peripheral vascular: abdomen
- scars
- visible pulsation
peripheral vascular: lower limb
- colour
- hair loss
- ulcers
- gangrene
- shiny skin
- scars
- tar staining
CHUGSS + T
extras:
- varicose veins
- ‘no signs of venous insufficiencies’
DRE: inspection
anus and surrouding skin:
- skin tags
- external haemorrhoids
- fissures
- fistula
- abscess
- prolapse
- rash, excoriations
bear down:
- incontinence/leakage
- internal haemorrhoids