Key Physical Exam

Question 1

Headache

Answer 1

Vital signs; inspection and palpation of the entire head; ENT inspection; complete neurologic exam, including fundoscopic exam

Question 2

Confusion / Memory Loss

Answer 2

Vital signs; complete neurologic exam, including mini-mental status exam and gain; general physical exam, including ENT, heart, lungs, abdomen, and extremities.

Question 3

Depressed Mood

Answer 3

Vital signs; head and neck exam; neurologic exam; mental status exam, including documentation of appearance, behavior, speech, mood, affect, thought process, thought content, cognition (measured by the 30-point mini-mental status exam), insight, and judgement.

Question 4

Psychosis

Answer 4

Vital signs; mental status exam.

Question 5

Dizzyness

Answer 5

Vital signs; complete neurologic exam, including Romberg test, nystagmus, tilt test (Dix-Hallpike maneuver), gait, hearing, and Weber and Rinne tests;ENT exam; cardiovascular exam.

Question 6

Loss of Consciousness (LOC)

Answer 6

Vital signs, including orthostatics; complete neurologic exam; carotid and cardiac exam, lung exam; exam of the lower extremities

Question 7

Numbness/Weakness

Answer 7

Vital signs; neurologic and musculoskeletal exams; relevant vascular exam.

Question 8

Fatigue and Sleepiness

Answer 8

Vital signs;ENT exam (conjunctival pallor, oropharynx/palate, lymphadenopathy, thyroid exam); heart, lung, abdominal, neurologic, and extremity (pallor, coolness at distal extremities) exams; consider rectal exam and occult blood testing.

Question 9

Night sweats

Answer 9

Vital signs; HEENT exam, including throat inspection for lymphadenopathy; heart and lung exam; abdominal exam for hepatosplenomegaly; skin exam; musculoskeletal exam for joint pain.

Question 10

Insomnia

Answer 10

Vital signs;mental status exam.

Question 11

Sore Throat

Answer 11

Vital signs;ENT exam including oral thrush, tonsillar exudate, and lymphadenopathy; lung, abdominal, and skin exams.

Question 12

Cough/Shortness of Breath

Answer 12

Vital signs pulse oximetry; exam of nasal mucosa, oropharynx, heart, lungs, lymph nodes, and extremities (clubbing, cyanosis, edema)

Question 13

Chest Pain

Answer 13

Vital Signs +- BP both arms; complete cardiovascular exam (JVD, PMI, chest wall tenderness, heart sounds, pulses, edema); lung and abdominal exam.

Question 14

Palpitations

Answer 14

Vital signs; endocrine/thyroid exam, including exophthalmos, lid retraction, lid lag, gland size, bruit, and tremor; complete cardiovascular exam.

Question 15

Weight Loss

Answer 15

Vital signs; complete physical

Question 16

Weight Gain

Answer 16

Vital signs; complete exam, including signs of Cushing syndrome (hypertension, central obesity, mood face, buffalo hump, supraclavicular fat pads, purple abdominal striae).

Question 17

Dysphagia

Answer 17

Vital signs; head and neck exam,; heart, lung, and abdominal exams; skin exam (for signs of scleroderma/CREST)

Question 18

Nausea/Vomiting

Answer 18

Vital signs; ENT; consider funduscopic exam (increased intracranial pressure); complete abdominal exam; consider heart, lung, and rectal exams.

Question 19

Abdominal Pain

Answer 19

Vital signs; heart and lung exams; abdominal exam, including guarding, rebound, Murphys sign, psoas and obturator signs, and CVA palpation; rectal exam; pelvic exam (women).

Question 20

Constipation / Diarrhea

Answer 20

Vital signs; relevant thyroid/endocrine exam;abdominal and rectal exams; female pelvic exam.