General examination

Question 1

Hands

Answer 1

colour (e.g. tar staining)

temperature

Nails (compare with mine):

colour

shape (spoon-shaped/ pitting)

splinter haemorrhages

clubbing

capillary refill (no more than 2 secs)

Palms:

palpate for swelling. wasting, pain, tenderness

colour of palms + palmar creases

sweating

compare them to each other

joint mobility - make a fist

tremor/ flapping tremor

Question 2

Arms

Answer 2

scars

venous damage

bruising

pigmentation

rashes

pinch for dehydration

Question 3

face

Answer 3

abnormalities (facies)

swelling/ puffiness

hair loss

examine the ears

examine the eyes:

eyelids

symmetry of pupils

colour of whites and conjunctivae (ask patient to look up and pull down lower lids with thumbs)

examine the mouth:

ask patient to say “Ah”

use torch and (if necessary) toungue depressor

check tonsils, teeth, gums and tongue

Question 4

Lymph Nodes

Answer 4

under chin

in front of ear

behind ear

down side of neck

Question 5

Anterior chest

Answer 5

spider naevi

Campbell de Morgan spots

Question 6

lower limbs and ankles

Answer 6

temperature

oedema

colour

hair

*compare sides

Question 7

feet

Answer 7

bunions/ corns

joint swelling

temperature

capillary refill time

soles

Question 8

order of examination

Answer 8

hands

upper limbs

face

lymph nodes

anterior chest

lowe limbs

feet