Clinical examination sequence

Question 1

Examination of lump

Answer 1

1. Site
2. Size
3. Shape
4. Surface
5. Depth
6. Colour
7. Characteristic
8. Temp
9. Tenderness
10. Edge
11. Reducibility
12. Relation to surrounding (mobile/fix)

Question 2

Examination of ulcer

Answer 2

1. Base (slough/granulation tissue/inflammation)
2. Edge (sloping/punchout/undermined/rolled/everted)
3. Discharge
4. Depth
5. Relation (involvement; tendon/periosteum/bone)
6. Surrounding

Question 3

Examination of breast`

Answer 3

History

• Menarche, development, menopause, change during mense, pregnancy, lactation, family hx, drug hx

Examination

1. Expose all top half of trunk down to waist
2. Inspect the breast: size, symmetry, skin (peau d’ orange, nodule, discolouration, ulcer), nipple
3. Axillae and areaolae
4. Supraclavicular fossae
5. Abdomen: organomegaly, asctes, nodules in POD
6. Lumbar spine: percussion, movement, SLR, ankle jerk

Question 4

Signs of splenomegaly (5)

Answer 4

• Splenic notch
• Enlarged inferomedially
• Dull Traube’s space
• Move with respiration
• LUQ pain

Question 5

Examination of stoma bag

Answer 5

1. Site
2. Flush or spout
3. Content
4. Functioning (water vapour? gaseous?)
5. Types (end-loop, defunctioning/trephine)
6. System; one piece/double(base)
7. Stoma health (red/bluish-ischemia?)
8. Complications; IO, cellulitis, retraction, skin excoration, parastomal prolapse herniation

Question 6

Colonoscopy indications (5)

Answer 6

1. Trace primary leson
2. Syncronous lesion (other site)
3. Extension
4. Biopsy
5. Surgery (therapeutic)

Question 7

Examination of hernia

Answer 7

1. Temperature
2. Surrounding colour
3. Tenderness
4. Presence of cicatrix (paraumbilical/umbilical)
5. Other palpable abd mass