Physical exam

Question 1

Nikolsky’s sign

Answer 1

Slight pressure displaces skin. Seen in Ritter disease (now staphylococcal scalded skin syndrome). Nikolsky sign is negative in bullous impetigo, a localized form of ssss

Question 2

Kernig’s sign

Answer 2

Positive if, with patient supine and hip flexed to 90 degrees, pt is unable to straighten leg due to extreme pain/stiffness in hamstring. Indicates meningitis

Question 3

Brudzinsky’s sign

Answer 3

Positive if, with patient supine, flexion of the neck elicits hip and knee flexion. Indicates meningitis

Question 4

Babinski’s sign

Answer 4

PRESENT (not positive) if testing of the plantar reflex (pulling sharp object from heel up and around the ball of the foot) elicits dorsiflexion of big toe. THIS IS NORMAL IN NEONATES. In adults, indicative of upper motor neuron damage. Asymmetry helps localize damage.