general exam

Question 1

what are the 9 broad parts of the general exam

Answer 1

initial assessment

intro, consent

examination of hands

examination of arms

examination of face

examination of lymph nodes

examination of front of chest

examination of lower limbs

closure

Question 2

what are you looking for in your initial assessment

Answer 2

conciseness level

are they fit enough - DR ABC

is the patient in pain or distress

inspect immediate environment

Question 3

what should you cover in the introduction

Answer 3

name status

name and dob of patient

consent

ask if they are in pain

height of trolley!!!

Question 4

what are the board categories of things to be looked at on the hands (10)

Answer 4

colour

nails

capillary refill time

shape of joints

muscle wasting

palms

temperature

contractures

radial pulse

tremor

Question 5

why are you looking at the colour of the hands

Answer 5

to check for tar staining

Question 6

what are you looking for on the nails

Answer 6

pitting 
splinter haemorrhages 
leukonychia 
peripheral cyanosis 
koilonychia 
finger clubbing

Question 7

what is leukonychia

Answer 7

where marks appear on the nails looking like white lines or milk spots

Question 8

what is koilonychia

Answer 8

where the nails look like spoons and are indented - associated with anaemia

Question 9

what are you looking for on the joints

Answer 9

and deformities or swollen areas

ask patient to open shut hands to see movement and if it is pain free

Question 10

what are you looking for on the palms

Answer 10

stretching the palmer creases - should be red and flush

temperature

sweatiness

Question 11

what are contractures

Answer 11

when the hands tighten (and look kind of like claws)

Question 12

what are the 3 types of tremor to be looked for

Answer 12

fine

coarse

flapping

Question 13

what is to be looked for on examination of the arms

Answer 13

joint deformity

bruises/ pigmentation/ rashes

spider naevi

scars/wounds

venous damage (track marks)

hydration status

Question 14

what are spider naevi

Answer 14

red pinpoint blood vessels

originating out from a centre po like a web

Question 15

how would you check hydration status

Answer 15

skin turgor

pull skin
severely dehydrated - elasticity is lost

Question 16

what is to be examined when looking at the face

Answer 16

over all symmetry

ears

eyes

lips

buccal mucosa

fauces

gum margins

tounge

Question 17

what is gout

Answer 17

the defective metabolism of uric acid causes arthritis and chalk stones

Question 18

what are you looking for on they eyes

Answer 18

unequal pupils
yellow jaundiced sclerae
conjunctivae

Question 19

what are you checking the ears for

Answer 19

shape, swelling and gout

Question 20

what are you checking the lips for

Answer 20

the colour (should be pink/red)

Question 21

what are you checking the buccal mucosa

what is the buccal mucosa

Answer 21

looking for any ulceration or pigmentation

the inside, side of your mouth

Question 22

what are you examining in the fauces

Answer 22

the tonsils

Question 23

what are you examining on the toungue

Answer 23

abnormal size, shape, surface texture

Question 24

what are you looking for when examining the front of the chest

Answer 24

palpate any skin lesions - spider naevi should become flush?

check for gynaecomastia

Question 25

what is gynaecomastia

Answer 25

males possibly developing breast tissue

Question 26

what are things to be examined when looking at the lower limbs

Answer 26

skin

swelling

deformities

toes and feet - joints and ankles

soles and backs of heels for lesions/ ulcers

Question 27

what thinks should be looked at on the skin of the legs

Answer 27

hair distribution, ulceration , varicose veins temperature down the legs, odema

Question 28

what is the normal range for body temperature

Answer 28

36.0 to 37.5