Pertinent Negatives

Question 1

When generally observing, what do we need to be aware of? (3)

Answer 1

distress
pallor
diaphoresis

Question 2

when inspecting (observing) the sclera and conjunctiva of the eye, what negatives need to be reported? (3)

Answer 2

Jaundice
redness (injection)
nodularity

if you need to further inspect, use oblique light

Question 3

how do you assess iris shadow?

Answer 3

tangential light

Question 4

When inspecting the pupils, which accronym are you assessing?

Answer 4

PERRLA

pupils are equal (size, shape, symmetric), round, reactive to light, accommodation

Question 5

What do you need to report for extraoxular movements?

Answer 5

nystagmus
- excessive horizontal or vertical/rotational nystagmus
lid lag

Question 6

When performing a fundoscopic exam, what are your pertinent negatives?

Answer 6

copper/silver wire changes
hemorrhages
exudates
AV crossing 
drusen bodies

don’t forget to report

• red reflex
• cup to disc ratio
• macula visualization

Question 7

when performing an otoscopic exam, what are your pertinent negatives in the external canal? (5)

Answer 7

swelling
redness
foreign bodies
impacted cerumen
discharge

Question 8

What needs to be reported for the Tympanic Membrane? (4)

Answer 8

color
position
cone of light
bony landmarks

Question 9

what is an abnormal test for the whispered voice test?

Answer 9

4/6 incorrect words

Question 10

Weber and Rinne - which determines conductive and which determines sensorineural HL?

Answer 10

Rinne - BC>AC = conductive
Weber
- sound in ABN ear = conductive,
- sound in N ear, better than ABN = SN