PEs

Question 1

what needs to be noted for the pulse

Answer 1

rate
rhythm (regularly irregular - faster w. inspiration; irregular, irregular)
amplitude (strong, normal, bounding)

Question 2

what needs to be noted for respiration

Answer 2

rate
depth
rhythm
use of accessory muscles

Question 3

what condition presents with a pulse of regular rate w. varying amplitude?

Answer 3

LCHF

Question 4

what is pulses paradoxus? is this normal?

Answer 4

drop in pulse amplitude with inspiration

common and normal.

Question 5

what needs to be noted for respiration

Answer 5

rate (14-20 normal)
depth
rhythm
use of accessory muscles

Question 6

what condition presents with a pulse of regular rate w. varying amplitude?

Answer 6

LCHF

Question 7

what is pulses paradoxus? is this normal?

Answer 7

drop in pulse amplitude with inspiration

common and normal.

Question 8

what is the definition of tachypnea?

Answer 8

> 20 bpm

Question 9

hyperpnea is? it’s commonly seen in?

Answer 9

rapid deep respirations, seen with DIABETIC KETOACIDOSIS

Question 10

hypopnea is? it’s associated with?

Answer 10

shallow respirations, associated with obesity hypoventilation

Question 11

apnea

Answer 11

absence of respirations for 20s

associated with airway obstruction during sleep

Question 12

which conditions are associated with relapsing fever?

Answer 12

tuberculosis
malaria
lyme disease
brucellosis

Question 13

hectic fevers are what? They are associated with?

Answer 13

hectic fevers are characterized by an afternoon spike with FACIAL FLUSHING
seen with ACTIVE TB

Question 14

hectic fevers are what? They are associated with?

Answer 14

hectic fevers are characterized by an afternoon spike with FACIAL FLUSHING
seen with ACTIVE TB

Question 15

each degree of temperature increase is generally associated with a ___ hr increase - when this isn’t the case, which conditions are associated?

Answer 15

10 bpm increase in HR with each increasing degree of temperature

if this isn’t the case:

• salmonella
• typhoid
• brucellosis
• legionella
• mycoplasma pneumonia
• iatrogenic causes (beta blockers, digitalis)

Question 16

Pulse oximetry is normally what %? which conditions does pulse ox assist in DX?

Answer 16

pulse ox > 95%, normal

conditions this is used in

• COPD
• Asthma
• Acute Respiratory Infection

Question 17

assess for pallor of anemia

Answer 17

look for decreased redness

• palpebral conjunctiva
• nail beds
• palm and palmar creases
• lips and tongue

Question 18

assess for jaundice

Answer 18

check sclera
check buccal mucosa
blanche the red color from the lips w. glass slide

Question 19

assess for carotenemia

Answer 19

hands, soles of feet

face

Question 20

what does central cyanosis tell you? what about peripheral?

Answer 20

central - lips, buccal mucosa, tongue (COPD, heart disease)

peripheral - nail beds (Raynauds)

Question 21

what 6 things need to be noted for lesions??

Answer 21

location
configuration
morphology (type - macules? papules? etc)
color
side and shape
borders

Question 22

what are the malignant melanoma warning signs to assess?

Answer 22

ABCDE!

asymmetry
borders
color variation
diameter
evolution

Question 23

a wood’s lamp will help dx which conditions and how will they appear?

Answer 23

vitiligo - bright white, mb blue tinge
post inflammatory hyperpigmentation - purplish brown
pseudomonas infection - blue or blue-green
erythrasma - coral pink, red
tinea versicolor - yellow to golden orange

Question 24

what helps visualize fungal infections?

Answer 24

KOH wet preps

Question 25

which conditions present with nail clubbing?

Answer 25

heart disease

pulmonary disease

Question 26

examination of the head involves what 5 areas?

Answer 26

hair - quality, quantity, distribution, baldness, texture
scalp - nits, lice, redness, scaling
skull - size, lumps, tender spots
face - expression, symmetry
skin - color, texture, thickness and hair distribution

Question 27

when performing the nose exam, what are you inspecting?

Answer 27

turbinates - color, swelling, polyps
mucosa - color
septum - deviation, perforation

Question 28

when palpating the sinus, what do you ask your patient?

Answer 28

is there any pain or tenderness?

- these could indicate - fluid, mass or mucosal thickening

Question 29

when examining the mouth, what are you observing?

Answer 29

ulcers, nodules, leukoplakia, candidiasis, swelling, bleeding, discolorations

lips - color, moisture, cracks, lesions
buccal mucosa - color, pigmentation, ulcers, nodule
gums and teeth - caries, bleeding, retraction
roof of mouth - soft and hard palate
tongue - stick out tongue, side to side (CN XII) - inspect lateral margins and inferior surface

Question 30

examination of the pharynx includes:

Answer 30

assessment of the soft palate and hard palate (torus?)
pillars
tonsils
uvula

- assess for: 
color
swelling
symmetry
exudate

Question 31

when inspecting the neck.. what are pertinent negatives?

Answer 31

swelling
symmetry
deviation of the trachea
lymph and submandibular glands

Question 32

when palpating lymph nodes.. what are you noting? (5)

Answer 32

size, shape, mobility, consistency, tenderness

Question 33

thyroid - what are we noting?

Answer 33

enlargement
nodules

IF enlarged, listen for bruits (toxic goiter)

Question 34

how are tonsils graded?

Answer 34

0-4

(0) Tonsils are entirely within the tonsillar fossa.
(1+) Tonsils occupy less than 25 percent of the lateral dimension of the oropharynx as measured between the anterior tonsillar pillars.
(2+) Tonsils occupy less than 50 percent of the lateral dimension of the oropharynx.
(3+) Tonsils occupy less than 75 percent of the lateral dimension of the oropharynx.
(4+) Tonsils occupy 75 percent or more of the lateral dimension of the oropharynx.

Question 35

Centor Criteria - go! (4)

Answer 35

fever
NO cough
tonsillar exudate
lympadenopathy (ant. cervical chain)