General examination Flashcards
What should be done at the beginning of the consultation?
Wash hands
Introduction
Patient consent
Explanation
How should a patient be positioned for examination?
Positioned at 45 degrees
Abdomen adequately exposed
What should be identified at the end of bed inspection?
Paraphernalia (e.g. walking aids, monitoring machines)
Medication
Composure of patient (e.g. anxious, agitated)
Obvious pain or breathing difficulties
What should be identified when examining the hands?
Temperature Sweating Tremor Palmar erythema Tar staining Capillary refill time
What should be identified when examining the nails?
Clubbing Leuconychia Koilonychia Splinter haemorrhages Peripheral cyanosis
What vital signs should be taken?
Radial pulse (rate/ rhythm) Carotid/ brachial pulse (character/ volume) Offer BP
What should be identified when examining the eyes?
Conjunctivae pallor
Upper sclera jaundice
Corneal arcus
Xanthelasmata
What should be identified when examining the face and mouth?
Malar flush Ulcers Gingivitis Glossitis Central cyanosis Smell (e.g. hepatic foetor, DKA, ethanol)
What should be identified when examining the neck and chest?
Lymph nodes
Spider naevi
Gynaecomastia
Stretch marks / Scars
What should be identified when examining the limbs?
Inguinal lymph nodes (offer)
Lower limb oedema (and sacral if present)
What additional tests should be offered?
Blood glucose
Urine and stool samples
What are splinter haemorrhages indicative of?
Infective endocarditis
What is palmar erythema indicative of?
Liver disease
Pregnancy
What is corneal arcus indicative of?
Hypercholesterolaemia
What is xanthelasmata indicative of?
Hypercholesterolaemia
