Clinical skills: haematological exam

Question 1

Parts of the haem exam?

Answer 1

Overall approach
General inspection
Vital signs
Hands and arms
Face
Bones
Abdomen
Legs

Question 2

General inspection?

Answer 2

Question 3

HANDS AND ARMS
Components?

Answer 3

Fingers
Palms
Arms
Epitrochlear lymph nodes
Axillary lymph nodes

Question 4

HANDS AND ARMS
Fingers?

Answer 4

Koilonychia (spoon shaped nails)
Digital infarction
RA/gouty changes

Question 5

HANDS AND ARMS
Palms?

Answer 5

Anaemia

Question 6

HANDS AND ARMS
Arms?

Answer 6

Bruising
Scratch marks

Question 7

HANDS AND ARMS
Lymph nodes?

Answer 7

Epitrochlear lymph nodes
Axillary nodes - central, lateral, anterior, posterior, apical

Question 8

FACE AND NECK
Face?

Answer 8

Jaundice, pallor, fundi
Scleral hemorrhage
Injection

Question 9

FACE AND NECK
Mouth?

Answer 9

Angular stomatitis
Gingivitis/gum hyperplasia
Glossitis
Mouth ulcers
Bleeding

Question 10

FACE AND NECK
Lymph nodes?

Answer 10

• Cervical: submental, submandibular, pre-/post-auricular, anterior/posterior cervical chain, supra-/sub-clavicular, occipital

Question 11

BONES
Which ones to examine for tenderness?

Answer 11

Spine, scapula, clavicles, sternum

Question 12

ABDOMEN
Inspect for

Answer 12

Scars
Swelling
Bulges/masses
Distension
Symmetry

Question 13

ABDOMEN
Palpate/percuss?

Answer 13

• General palpation – light and deep
• Liver: palpate, percuss, measure
• Spleen: palpate and percuss
• Kidneys: ballot
• Inguinal (not at year A level)
• Para-aortic lymph nodes

Question 14

LEGS
Examine?

Answer 14

Bruising
Scratch marks
Pigmentation

Question 15

LEGS
Test for?

Answer 15

Pitting oedema
Light and sharp touch sensation