physical exams near/musc

Question 1

back pain

Answer 1

gait heel to toe
inspection scoliosis seats, palpation, rom
neuro: lower limb, motor, sensory DTRs, peripheral pulses
straight leg test Babinski

Question 2

arm pain

Answer 2

musc- inspection palpation, rom - elbow shoulder wrist joint

neuro: motor, sensory DTRs, peripheral pulses

Question 3

calf pain

Answer 3

musc- inspection palpation, rom - hip, knee, elbow, peripheral pulses, dorsalis pedis pulse posterior tibial pulse
extremities - inspection palpation

Question 4

neck pain

Answer 4

musc- inspection palpation, rom neck special tests
spurling test, lhermitte test
upper limb neuro: neuro: motor, sensory DTRs, peripheral pulses

Question 5

headache

Answer 5

HENT: fundoscopic temporal mandibular joint, sinuses.NECK!
neuro: cranial nerves, motor +babinksi, DTR

Question 6

hearing loss

Answer 6

back turned hearing test + HENT+ webber + rinnes test
fundoscopic, nystagmus
optional full neuro+ heel to shin/ finger to nose + cranial nerves

Question 7

dizziness

Answer 7

HENT:+ webber + rinnes test
fundoscopic, nystagmus

neuro: CN, motor, sensory, DTR +babinski, Romberg gait, dixhallpike

Question 8

knee pain

Answer 8

musc : lower limb +upper limb inspection palpation, rom effusion, crepitus, peripheral pulses

blood culture systemic arthritis systemic symptoms present
anti-ccpRA + xray hands
pelvic axam cervical culture
xray knee
knee aspiration culture stain analysis
ANA antiDsdna cbc with differentials

Question 9

Heel pain

Answer 9

foot: inspection- non weight bearing , weight bearing, walking. palpation, achilles tendon, retrocalcaneal bursitis , medial calcaneal tuberosity, plantar fasciitis, ROM- ankle knee, hip.
neuro: motor, sensory, dtr peripheral pulses * great toe extension

Question 10

heel pain differential

Answer 10

plantar fasciitis- pain with dorsiflexion, worse morning gradual onset, worse first steps, tenderness medial calcaneal tuberosity, overuse, excessive weight tx analgesic orthotics, night splinting

calcneal fracture- jumping running athlete, repatitive use diffuse heal pain , osteopenia risk factor, refactory to conservative treatment

achilles tendonitis: pain with dorsiflexion, posterior heel pain, tender achilles
retrocalcaneal bursitis- ill fitting shoe poster heel pain
tarsal tunnel- pain went, reproducible with percussion, dorsiflexion of foot
foreign body

ankle sprain - popping
xray ankle/foot
MRI ankle/foot

Question 11

forgetfulness/ confusion

Answer 11

neuro: mini mental, cn, motor +babinksi sensory, DTR, gait, heel toe

Question 12

hallucination

Answer 12

neuro: mini mental cn, motor+ Babinski sensory, DTR, gait heel toe

Question 13

LOC

Answer 13

cardiovascular: palpation, auscultation, orthostatic vitals

neuro- only 3x orientation, cranial nerves, motor sensory, DTR cerebellum, Romberg, gait

Question 14

DM follow up

Answer 14

HENT: eyes fundoscopic exam,
CV: palpation, auscultation
musc- inspect feet peripheral pulses
neuro: motor+ Babinski, sensory, vibration sense, position sense

Question 15

HTN follow up

Answer 15

cv- carotid auscultation, auscultation, palpation
HENT: eyes fundoscopic exam
neuro : lower limb motor+ Babinski sensory, DTR, peripheral pluses- could do all

Question 16

pre-employent

Answer 16

cv- auscultation 
pulmonary auscultato
hent:  inside mouth +palpate lymph nodes
extremities: inspect
abdoment : auscultate + palpate
neuro-cranial nerves, motor, DTR, gait

Question 17

menstrual irregular

Answer 17

eyes: visual field EOM
neck exam : thyroid
extremities inspection
neuro: DTR

Question 18

sexual assault

Answer 18

inspection, palpation 
CV- auscultation 
Pulmonary exam : inspection, palpation, percussion auscultation 
abdominal exam 
musc - inspection, palpation 

pelvic exam
XR skeletal survey
Urine HCG
wet mount, KOH prep, cervical culture, gonorrhoea chlamydia, HIV antibody, VDRL, HBV antigens