Course 4, Physical Exam

Question 1

If a pt says their abd feels very painful, can you automatically document “abd tenderness” in the physical exam? Why or why not?

Answer 1

No because “tenderness” is determined by the physician

Question 2

Which physical exam findings could a physician appreciate without auscultating the patient’s lungs
A) no respiratory distress
B) No rales

Answer 2

A.

Question 3

What does PERRL stand for

Answer 3

Pupils are equal, round, and reactive to light

Question 4

What does AT/NC mean

Answer 4

Atraumatic/ Normocephalic

Question 5

What does NAD stand for?

Answer 5

No acute distress

Question 6

If a patient has pale conjunctiva, what does that indicate?

Answer 6

anemia

Question 7

What is sclera icterus, and what does it indicate?

Answer 7

Scleral icterus is yellowish pigmentation of the conjunctival membranes over the sclerae. This indicates liver failure.

Question 8

Name an instrument a physician may use to closely investigate the eyes.

Answer 8

ophthalmoscope, wood’s lamp/ fluorescien

Question 9

In which body system would you document “TM erythema and bulging”?

Answer 9

Ears

Question 10

What is the medical term for a nostril?

Answer 10

nares

Question 11

To describe a “runny nose” would the doctor use the word “epistaxis” or “rhinorrhea”?

Answer 11

rhinorrhea

Question 12

What would dry mucous membranes indicate?

Answer 12

Dehydration

Question 13

Why is midline bony tenderness “worse” than paraspinal tenderness?

Answer 13

Paraspinal tenderness refers to the muscle which could indicate something like kidney stones; while midline bony tenderness could indicate spine damage

Question 14

If you saw RRR written in the cardiac exam, what do you think it might mean? (it is a normal cardiac finding)

Answer 14

Regular Rate and Rhythm- heart sounds normal

Question 15

If the physician checks the pulse on the right wrist and says “the pulses are fine”, what would you document in the physical exam?

Answer 15

Right radial pulse 2+

Question 16

Name two “Peritoneal signs” in the abdominal exam

Answer 16

Voluntary Guarding, Rebound Tenderness, Rigidity (involuntary guarding)

Question 17

What abdominal exam sign is indicative of Cholecystitis?

Answer 17

Murphy’s sign

Question 18

If the doctor takes 1 finger and presses in a specific spot in the RLQ, what is the name of the finding they are investigating?

Answer 18

McBurney’s point tenderness, used to identify appendicities

Question 19

Which of these findings is not a peritoneal sign:

guarding, rebound, tenderness, rigidity

Answer 19

tenderness

Question 20

What would a “Guaiac positive” stool sample diagnose?

Answer 20

blood in the stool, heme positive, GI bleed

Question 21

What phrase do you have to document in the GU exam for every female pelvic exam performed by a male physician?

Answer 21

“female chaperone present”

Question 22

What is bony tenderness a sign of?

Answer 22

A fracture

Question 23

What is CVA tenderness?

Answer 23

Costovertebral Angle Tenderness

Question 24

What is fluctuance a sign of?

Answer 24

An abscess

Question 25

What is the difference between a laceration and abrasion?

Answer 25

A laceration is a cut or splitting of the skin (size in cm) an abrasion is a scrape

Question 26

What procedure is associated with a laceration, but not an abrasion?

Answer 26

Lac repair (suture)

Question 27

What does A&Ox3 mean?

Answer 27

Alert and Oriented person, place, and time

Question 28

What section of the neurological exam would you document “Normal Finger-Nose-Finger test” and “Normal Heel-to-Shin”?

Answer 28

Cerebellar Exam “Coordination”

Question 29

What does DTR stand for?

Answer 29

Deep Tendon Reflex

Question 30

Point to the general area of your body that Cranial Nerves (CN) control

Answer 30

face, head areas

Question 31

In the neurological exam, what do SI and HI stand for?

Answer 31

Suicidal ideation and Homicidal Ideation

Question 32

Is the Glascow Coma Scale (GCS) associated with Trauma pts or Medical Pts?

Answer 32

Trauma points (3=lowest, 15=highest)

Question 33

Would you document “RUE strength 3/5” under the neurological or extremities section of the exam?

Answer 33

neurological

Question 34

What would you guess “TTP” means? (TTP in the RUQ)

Answer 34

Tender to palpation

Question 35

A mother states her child has been extremely tired and drowsy recently; based on that, can you document “Lethargic” in the child’s physical exam?

Answer 35

No, lethargic is an extreme condition.

Question 36

Spell the medical term for “Hives” (allergic reaction rash)

Answer 36

Urticaria

Question 37

What is the medical term for “Swollen lymph nodes”?

Answer 37

Lymphadenopathy

Question 38

If you document “There is right prondator drift” in the neurological exam, can you also document “no neurological deficits”?

Answer 38

No, that is a neurological deficit

Question 39

If you document “NAD” in the constitutional section, would you be contradicting yourself if you wrote “There is mild respiratory distress” in the pulmonary exam?

Answer 39

Yes, NAD= No Acute Distress

Question 40

Do any of the pt’s complaints belong in the physical exam?

Answer 40

No, only objective observations.

Question 41

Name the rhythm that the physician would hear if the patient was in Afib

Answer 41

irregularly irregular rhythm

Question 42

In the neurological exam, what does “Normal gait” mean?

Answer 42

Normal walking