Positive signs Flashcards
1
Q
Whatre you looking at the legs for in varicose veins
A
Varicosities Venous eczema Oedema Lipodermatosclerosis Haemosiderin deposition Venous ulceration Scars
2
Q
What are you looking at the hands for in a respiratory exam
A
Clubbing
Wasting of the intrinsic muscles
Tar staining
3
Q
What would cause wasting of the intrinsic muscles of the hand
A
Apical lung cancer invading T1
4
Q
Fine respiratory tremor cause
A
Beta agonists
5
Q
Respiratory Flapping asterixis cause
A
Respiratory failure
6
Q
What is pulsus paradoxus
A
Exaggerated decrease in blood pressure during inspiration
7
Q
What causes pulsus paradoxus
A
Severe obstructive airways disease and cardiac tamponade
8
Q
What does a raised JVP suggest
A
Cor pulmonale
9
Q
What does a raised non pulsatile JVP suggest
A
SVC obstruction due to lung cancer
10
Q
Respiratory: What are you looking for in the eyes
A
Horners syndrome
Chemosis
11
Q
What is, and what causes horners syndrome
A
Damaged sympathetic nerves cause reduced pupil size, drooping eyelid and reduced sweating
12
Q
What is chemosis and what causes it (resp)
A
Conjunctival pallor secondary to COPD
13
Q
Respiratory: what are you looking at the face and mouth for
A
Facial swelling
Dental carries
Central cyanosis
14
Q
Resp: What causes facial swelling
A
SVC obstruction
15
Q
Resp: why are you looking for dental carries
A
Lung abscesses from aspiration
16
Q
Resp: What are you inspecting the chest for
A
Shape Symmetry Scars Muscle wasting Chest vs diaphragmatic breathing Use of accessory muscles Recession
17
Q
What are recessions during breathing a sign of
A
Laryngeal/tracheal obstruction
18
Q
How does the trachea move in fibrosis or collapse
A
Toward
19
Q
How does the trachea move in pneumothorax or effusion
A
Away
20
Q
What does a silent chest suggest
A
Pneumothorax
21
Q
What does tactile vocal fremitus test
A
Whispers are transmitted more loudly across consolidation
22
Q
Why do you ask the patient to cough and then listen again
A
Crackles from secretions change but crackles from fibrosis dont
23
Q
Are the lymph nodes tender in malignany or infection
A
Infection
24
Q
What are you assessing the sputum pot fro
A
Volume, consistency, colour, odour, any haemoptysis
25
DF: What are you inspecting gait for
Symmetry, balance, abnormalities, turning
26
DF: What are you inspecting the shoes for
Size, pattern of wear, abnormalitis
27
DF: What are you inspecting the skin of the feet for
```
Trophic changes
Rubor at pressure points
Skin ulceration
Diabetic dermopath
Cellulitis or gangrene
Cracked, cut or dry web spaces
Dystrophic, ingrown toe nails
```
28
What trophic changes might you see on a diabetic foot
Hairlessness, pallor, decreased sweating, dry skin, pigment changes, atrophy blanche, pallor, cyanosis or erythema
29
DF: What deformities are you inspecting for
Intrinsic muscle wasting
Pes planus
Pes cavus
Charcot deformity
30
What is pes planus
Flat foot
31
What is pes cavus
High arch
32
What is charcot foot
Neuropathy
hot painful erythema
Minor trauma history
Intense inflammatory response
33
What is the first sense to be lost in diabetic foot
Vibration
34
How to treat charcot foot
XRay
Mobilise
Change pot weekly as neuropathy increases ulcer risk
35
Cardio: What are you doing a general inspection for
```
GTN spray, walking aids
Patinet
-colour
-breathing
-comfort
-position
-build
```
36
Cardio: What are you examining the hands for
```
Tar staining
Temperature
Sweating
Pallor of palmar creases
Peripheral cyanosis
Clubbing
Koilonychia
Oslers nodes and janeaway lesions
Tendon xanthomas
Diabetic finger pricks
Splinter haemorrhages
```
37
Cardio: what causes sweating
Increased sympathetic drive
38
Cardio: what causes pallor of palmar creases
Anaemia
39
Cardio: What causes clubbing
IE
Cyanotic heart disease
Atrial myxoma
40
Cardio: What causes koilonychia
Iron deficiency
41
How to differentiate oslers nodes and janeaway lesions
Janeaway lesions are on the palms and soles
| Oslers nodes are on the tips and are painful
42
What are causes of collapsing pulse
Aortic regurgitation
Fever, pregnancy
Patent ductus arteriosus
Thryoid disease
43
What is radio-radial delay suggestive of
Coarctation of the aorta
44
Cardiac: What are you looking in the eyes for
Subjunctival pallor
Corneal arcus
Xanthelasmata
45
Cardiac: What are you looking at the face and mouth for
```
Malar flush
Central cyanosis
High arched palate
Dental caries
Angular stomatitis
```
46
What is subjunctival pallor suggestive of
Anaemia
47
What is corneal arcus and xanthelasmata suggestive of
Hyperlipidaemia
48
What is malar flush suggestive of
Mitral stenosis
49
What is a high arched palate suggestive of
Marfans
50
Cardiac: What do dental caries increase your risk of
Infective endocarditis
51
What is angular stomatitis suggestive of
Low iron
52
What is a narrow pulse pressure suggestive of
Aortic stenosis
53
What is a wide pulse pressure suggestive of
Aortic regurgitation
54
Causes of high JVP
Fluid overload
RV failure
Tricuspid regurgitation
55
Cardiac: What are you inspecting the precardium for
Sternotomy scar
Severe pectus excavatum
Severe kyphoscoliosis
Visible cardiac pulsation
56
What is a sternotomy scar suggestive of
CABG/ Valve repair
57
What is severe pectus excavatum
Indented
58
What is severe kyphoscoliosis
Curved spine
59
Systolic murmurs are louder when
On held expiration
60
How does aortic sclerosis differ from aortic stenosis
Same murmur but not at carotids
61
What should you do if coarctation of the aorta is suspected
Listen to left of the spine and the 3rd intercostal space
62
Cardiac: What does hepatomegaly suggest
Tricuspid regurgitation
63
When do you get radiofemoral delay
Coarctation of the aorta
64
GI: What is your general inspection looking for
```
Colour
Perspiration
Build
Discomfort
Breathing
Conscious level
Distension
Needle marks
Body habitus
```
65
GI causes of clubbing
Hepatic cirrhosis
UC
Crohns
Coeliac
66
GI: What are you looking at the hands for
```
Colour
Temperature
CLubbing
Leukonychia
Koilonychia
Spider naevia
Dupuytrens contracture
Asterixis
```
67
GI: What does hand pallor suggest
Anaemia
68
GI: What does palmar erythema suggest
Increased oestrogen from liver disease
69
GI: What does leukonychia suggest
Hypoalbuminaemia
70
GI causes of hypoalbuminaemia
Nephrotic syndrome, liver failure, protein malabsorption
71
GI: What is koilonychia
Spoon shaped nails
72
GI: What causes koilonychia
Chronic iron deficiency
73
GI: What causes dupuytrens contracture
Family history or alcohol excess
74
GI: What causes asterixis
Renal failure, CO2 retention uraemia
75
GI: What are you inspecting the arms for
Bruising
Petechia
Exacerations
Track marks
76
GI: What are you inspecting the axillae for
Lymphadenopathy
Hair loss
Acanthosis nigricans
77
What causes acanthosis nigricans
GI adenocarcinoma
| Obesity
78
GI: What are you examining the eyes for
```
Jaundice
Anaemia
Xanthelasmata
Corneal arcus
Kaiser Fleischer rings
```
79
What causes keiser fleischer rings
Wilsons disease, copper
80
GI: What are you inspecting the face for and what causes this
Telangectasia (threadlike veins)- hereditary haemorrhagic telangectasia
81
GI: What are you inspecting the mouth for
```
Telangectasia
Pigmentation
Angular stomatitis
Glossitis
Dehydration
Halitosis and dental carries
Ulcers
```
82
Causes of angular stomatitis
B6, B12, Folate or iron deficiency
83
Causes of glossitis
B12, Folate or iron deficiency
84
GI: causes of hair loss
Malnutrition
Iron deficiency
Pseudofeminisation
85
GI: causes of mouth ulcers
B12 deficiency, Iron deficiency,
| Crohns and Coeliac
86
GI: What are you inspecting the chest for
Spider naevi
Gynaecomastia
Hair loss
87
GI causes of gynaecomastia
Liver failure causing increased oestrogen
88
GI: What are you feeling the lymph nodes for
Virchows node
Trossiers sign
Intraabdominal malignancy
89
Causes of abdominal distension
```
Fluid (ascites)
Faeces (constipation)
Flatus (subacute obstruction)
Foetus (pregnancy)
Fat (obesity)
```
90
GI: what are you inspecting the abdomen for
Scars
Shape and symmetry
Diaphragmatic breathing
Swellings and masses
91
What is cullens sign
Periumbilical bruising, pancreatitis
92
What is grey turners sign
Flank bruising, pancreatitis
93
What to do once you find an abdominal mass
Ask the patient to lift their head up
94
What is murphys test
Pain on inspiration- chloecystitis
95
What is rosvigs test
Press down LLQ and then suddenly release= pain. - appendicits
96
What is rebound tenderness a sign of
Peritonitis
97
Tinkling bowel sounds a sign of
SBO
98
Hypothyroidism examination findings
Low temperature
Dry skin
Brittle nails
Loss of outer 1/3 eyebrow
99
Hyperthryoidism examination findings
```
High temperature
Sweating
Palmar erythema
Onycholysis
Fine tremor
Proximal muscle wasting
Tachycardia
AF
```
100
Graves examination findings
Thyroid acropachy
Exopthalmos
Bruit
101
How to test supraspinatus
First 15 degrees of abduction
102
How to test deltoid
Up to 90 degrees of abduction
103
How to test trapezius and serrratus anterior
Beyond 90 degrees of abduction
104
How to test infraspinatus and teres minor
Resisted active external rotation
105
How to test subscapularis
Lift off test
106
How to test for acromioclavicular joint pathology
Scarf test
107
Rinnes louder at mastoid
Conductive hearing loss
108
Rinnes same at both
Sensorineural hearing loss
109
Webers different results depending on side
```
Neural= louder on good side
Conductive= louder on bad side
```
