Intro To Clinical Exam Flashcards

1
Q

what is the general clinical exam

A
  1. history taking
  2. general clinical exam –> subjective observations “over the gate” –> objective observations “hands on” –> specific components (ortho, optho, neuro)
  3. is each observation normal (but what is normal) or abnormal
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2
Q

what is SOAP

A

subjective, objective, assessment, plan

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3
Q

what are the steps of SOAP

A

step 1: make subjective and objective observations (systemic and therefore repeatable)

step 2: carry out an assessment based on the results of your observations (is the finding normal/abnormal? make a problem list, make a differential diagnosis)

step 3: make a plan –> what further actions need to be taken, including diagnostic tests

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4
Q

what is SNAPPS

A

S: summarize history & findings and summary statement

N: narrow the differential to 2-3 relevant possibilities

A: analyze the differential by comparing & contrasting possibilites

P: probe the preceptor by asking about uncertanties or difficulties

P: plan management for patient

S: select a case related issue for self-directed learning

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5
Q

how do you consider what is “normal”

A

signalment and environment must be considered

some normal values are numeric

reference values are confusing

some normal values are less defined and come with experience

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6
Q

what is the temp range for a dog in C and F

A
  1. 9 - 39.9C
  2. 2-103.8F
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7
Q

what is the normal temp range of the cat

A
  1. 1-39.2C
  2. 5-102.5F
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8
Q

what is the pulse for a young dog

A

110-120

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9
Q

what is the pulse for the adult dog

A

70-120

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10
Q

what is the pulse of young cat

A

130-140

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11
Q

what is the pulse of an adult cat

A

120-140

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12
Q

what is the normal resp rate of dog

A

18-34

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13
Q

what is the normal resp rate of cat

A

16-40

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14
Q

what body language are you watching for cats when stressed during exam

A
  1. shedding
  2. tail flicking
  3. ears (down)
  4. low intensity growls/hiss
  5. pupils dilated

**cats turn very quickly –> air on side of caution (everything you need should be in the room already)

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15
Q

what are objective observations

A

nose –> tail

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16
Q

what is body condition scores

A

1 to 9 (much more descriptive)

or 1 to 5

5/9 or 3/5

17
Q

what do you examine on the face (7)

A
  1. facial symmetry
  2. nose and nostrils (blood, clear discharge, coloured discharge (mucoid), brachycephalic nostrils obstructed)
  3. eye(s) and third eyelid (conjuctivitis will be red and inflamed, entropion, ectropion, cherry eye, discharge)
    - left eye OS, right eye OD, both eyes OU
    - third eyelid easy to expose in dog or cat
  4. ears (various position and shape, airflow, waterdogs,
  5. teeth and gums (on both sides)
  6. capillary refil time (CRT) (perfusion to peripheral tissues should be >2 seconds –> what about dog with black gums? where do you look –> conjuctiva of eyes, or underside of lip some will have pink patches)
  7. opening the mouth (cats –> only get one shot)
18
Q

how do you check hydration

A

prolonged skin tent

check the cervical region, over rib cage, top of head

**older animals have less skin elasticity, breed differences

19
Q

what are palpable lymph nodes

A

mandibular

popliteal

prescapular

20
Q

what lymph nodes can you not palpate

A

axillary

illiac

inguinal

21
Q

what do you need to report about pulse

A

rate (bmp)

weak or strong

rhythm (regular, regularly irregular –> increase with inspiration, or irregularly irregular)

**cats hate femoral pulse

dogs have sinus arrhythmia, abnormal in cats

22
Q

how do you auscultate the heart

A
  1. panting or purring (how to stop it –> turn water tap on, surgical spirit on a cotton swab and put on table near them, hold finger over nostrils briefly, pick them up)
  2. listen
  3. remember the anatomy
  4. compare with femoral pulse
23
Q

where do you start when auscultating the heart

A

find the apex beat of the base of the heart

and move cranial and dorsal

important to palpate first with hand and then start auscultation

*firm contact, no petting

24
Q

what do you need to report with auscultation

A
  1. rate
  2. adventitious breath sounds (crackles, wheezes, pleural rub, stridor, stretor)
25
Q

how is abdominal palpation done

A
  1. know what should be where
  2. use fingers or flat of hand, do not dig fingertips in
  3. dorsal to ventral
  4. be gental
26
Q

what area of genitals need to be examined

A

mammary chain

intact males palpate testes

27
Q

how is the rectal exam done

A

warn owner

restraint by assistant (apply muzzle if needed)

lubrication

gentle and thorough

28
Q

what other areas should be examined

A

feet and limbs

skin