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2b > Positive signs > Flashcards

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
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2
Q

What are you looking at the hands for in a respiratory exam

A

Clubbing
Wasting of the intrinsic muscles
Tar staining

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3
Q

What would cause wasting of the intrinsic muscles of the hand

A

Apical lung cancer invading T1

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4
Q

Fine respiratory tremor cause

A

Beta agonists

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5
Q

Respiratory Flapping asterixis cause

A

Respiratory failure

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6
Q

What is pulsus paradoxus

A

Exaggerated decrease in blood pressure during inspiration

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7
Q

What causes pulsus paradoxus

A

Severe obstructive airways disease and cardiac tamponade

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8
Q

What does a raised JVP suggest

A

Cor pulmonale

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9
Q

What does a raised non pulsatile JVP suggest

A

SVC obstruction due to lung cancer

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10
Q

Respiratory: What are you looking for in the eyes

A

Horners syndrome

Chemosis

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11
Q

What is, and what causes horners syndrome

A

Damaged sympathetic nerves cause reduced pupil size, drooping eyelid and reduced sweating

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12
Q

What is chemosis and what causes it (resp)

A

Conjunctival pallor secondary to COPD

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13
Q

Respiratory: what are you looking at the face and mouth for

A

Facial swelling
Dental carries
Central cyanosis

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14
Q

Resp: What causes facial swelling

A

SVC obstruction

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15
Q

Resp: why are you looking for dental carries

A

Lung abscesses from aspiration

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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
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17
Q

What are recessions during breathing a sign of

A

Laryngeal/tracheal obstruction

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18
Q

How does the trachea move in fibrosis or collapse

A

Toward

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19
Q

How does the trachea move in pneumothorax or effusion

A

Away

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20
Q

What does a silent chest suggest

A

Pneumothorax

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21
Q

What does tactile vocal fremitus test

A

Whispers are transmitted more loudly across consolidation

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22
Q

Why do you ask the patient to cough and then listen again

A

Crackles from secretions change but crackles from fibrosis dont

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23
Q

Are the lymph nodes tender in malignany or infection

A

Infection

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24
Q

What are you assessing the sputum pot fro

A

Volume, consistency, colour, odour, any haemoptysis

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25
Q

DF: What are you inspecting gait for

A

Symmetry, balance, abnormalities, turning

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26
Q

DF: What are you inspecting the shoes for

A

Size, pattern of wear, abnormalitis

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27
Q

DF: What are you inspecting the skin of the feet for

A 
Trophic changes
Rubor at pressure points
Skin ulceration
Diabetic dermopath
Cellulitis or gangrene
Cracked, cut or dry web spaces
Dystrophic, ingrown toe nails
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28
Q

What trophic changes might you see on a diabetic foot

A

Hairlessness, pallor, decreased sweating, dry skin, pigment changes, atrophy blanche, pallor, cyanosis or erythema

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29
Q

DF: What deformities are you inspecting for

A

Intrinsic muscle wasting
Pes planus
Pes cavus
Charcot deformity

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30
Q

What is pes planus

A

Flat foot

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31
Q

What is pes cavus

A

High arch

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32
Q

What is charcot foot

A

Neuropathy
hot painful erythema
Minor trauma history
Intense inflammatory response

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33
Q

What is the first sense to be lost in diabetic foot

A

Vibration

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34
Q

How to treat charcot foot

A

XRay
Mobilise
Change pot weekly as neuropathy increases ulcer risk

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35
Q

Cardio: What are you doing a general inspection for

A 
GTN spray, walking aids
Patinet
-colour
-breathing
-comfort
-position
-build
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36
Q

Cardio: What are you examining the hands for

A 
Tar staining
Temperature
Sweating
Pallor of palmar creases
Peripheral cyanosis
Clubbing 
Koilonychia
Oslers nodes and janeaway lesions
Tendon xanthomas
Diabetic finger pricks
Splinter haemorrhages
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37
Q

Cardio: what causes sweating

A

Increased sympathetic drive

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38
Q

Cardio: what causes pallor of palmar creases

A

Anaemia

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39
Q

Cardio: What causes clubbing

A

IE
Cyanotic heart disease
Atrial myxoma

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40
Q

Cardio: What causes koilonychia

A

Iron deficiency

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41
Q

How to differentiate oslers nodes and janeaway lesions

A

Janeaway lesions are on the palms and soles

Oslers nodes are on the tips and are painful

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42
Q

What are causes of collapsing pulse

A

Aortic regurgitation
Fever, pregnancy
Patent ductus arteriosus
Thryoid disease

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43
Q

What is radio-radial delay suggestive of

A

Coarctation of the aorta

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44
Q

Cardiac: What are you looking in the eyes for

A

Subjunctival pallor
Corneal arcus
Xanthelasmata

45
Q

Cardiac: What are you looking at the face and mouth for

A 
Malar flush
Central cyanosis
High arched palate
Dental caries
Angular stomatitis
46
Q

What is subjunctival pallor suggestive of

47
Q

What is corneal arcus and xanthelasmata suggestive of

A

Hyperlipidaemia

48
Q

What is malar flush suggestive of

A

Mitral stenosis

49
Q

What is a high arched palate suggestive of

50
Q

Cardiac: What do dental caries increase your risk of

A

Infective endocarditis

51
Q

What is angular stomatitis suggestive of

52
Q

What is a narrow pulse pressure suggestive of

A

Aortic stenosis

53
Q

What is a wide pulse pressure suggestive of

A

Aortic regurgitation

54
Q

Causes of high JVP

A

Fluid overload
RV failure
Tricuspid regurgitation

55
Q

Cardiac: What are you inspecting the precardium for

A

Sternotomy scar
Severe pectus excavatum
Severe kyphoscoliosis
Visible cardiac pulsation

56
Q

What is a sternotomy scar suggestive of

A

CABG/ Valve repair

57
Q

What is severe pectus excavatum

58
Q

What is severe kyphoscoliosis

A

Curved spine

59
Q

Systolic murmurs are louder when

A

On held expiration

60
Q

How does aortic sclerosis differ from aortic stenosis

A

Same murmur but not at carotids

61
Q

What should you do if coarctation of the aorta is suspected

A

Listen to left of the spine and the 3rd intercostal space

62
Q

Cardiac: What does hepatomegaly suggest

A

Tricuspid regurgitation

63
Q

When do you get radiofemoral delay

A

Coarctation of the aorta

64
Q

GI: What is your general inspection looking for

A 
Colour
Perspiration
Build
Discomfort
Breathing
Conscious level
Distension
Needle marks
Body habitus
65
Q

GI causes of clubbing

A

Hepatic cirrhosis
UC
Crohns
Coeliac

66
Q

GI: What are you looking at the hands for

A 
Colour
Temperature
CLubbing
Leukonychia
Koilonychia
Spider naevia
Dupuytrens contracture
Asterixis
67
Q

GI: What does hand pallor suggest

68
Q

GI: What does palmar erythema suggest

A

Increased oestrogen from liver disease

69
Q

GI: What does leukonychia suggest

A

Hypoalbuminaemia

70
Q

GI causes of hypoalbuminaemia

A

Nephrotic syndrome, liver failure, protein malabsorption

71
Q

GI: What is koilonychia

A

Spoon shaped nails

72
Q

GI: What causes koilonychia

A

Chronic iron deficiency

73
Q

GI: What causes dupuytrens contracture

A

Family history or alcohol excess

74
Q

GI: What causes asterixis

A

Renal failure, CO2 retention uraemia

75
Q

GI: What are you inspecting the arms for

A

Bruising
Petechia
Exacerations
Track marks

76
Q

GI: What are you inspecting the axillae for

A

Lymphadenopathy
Hair loss
Acanthosis nigricans

77
Q

What causes acanthosis nigricans

A

GI adenocarcinoma

Obesity

78
Q

GI: What are you examining the eyes for

A 
Jaundice
Anaemia
Xanthelasmata
Corneal arcus
Kaiser Fleischer rings
79
Q

What causes keiser fleischer rings

A

Wilsons disease, copper

80
Q

GI: What are you inspecting the face for and what causes this

A

Telangectasia (threadlike veins)- hereditary haemorrhagic telangectasia

81
Q

GI: What are you inspecting the mouth for

A 
Telangectasia
Pigmentation
Angular stomatitis
Glossitis
Dehydration
Halitosis and dental carries
Ulcers
82
Q

Causes of angular stomatitis

A

B6, B12, Folate or iron deficiency

83
Q

Causes of glossitis

A

B12, Folate or iron deficiency

84
Q

GI: causes of hair loss

A

Malnutrition
Iron deficiency
Pseudofeminisation

85
Q

GI: causes of mouth ulcers

A

B12 deficiency, Iron deficiency,

Crohns and Coeliac

86
Q

GI: What are you inspecting the chest for

A

Spider naevi
Gynaecomastia
Hair loss

87
Q

GI causes of gynaecomastia

A

Liver failure causing increased oestrogen

88
Q

GI: What are you feeling the lymph nodes for

A

Virchows node
Trossiers sign
Intraabdominal malignancy

89
Q

Causes of abdominal distension

A 
Fluid (ascites)
Faeces (constipation)
Flatus (subacute obstruction)
Foetus (pregnancy)
Fat (obesity)
90
Q

GI: what are you inspecting the abdomen for

A

Scars
Shape and symmetry
Diaphragmatic breathing
Swellings and masses

91
Q

What is cullens sign

A

Periumbilical bruising, pancreatitis

92
Q

What is grey turners sign

A

Flank bruising, pancreatitis

93
Q

What to do once you find an abdominal mass

A

Ask the patient to lift their head up

94
Q

What is murphys test

A

Pain on inspiration- chloecystitis

95
Q

What is rosvigs test

A

Press down LLQ and then suddenly release= pain. - appendicits

96
Q

What is rebound tenderness a sign of

A

Peritonitis

97
Q

Tinkling bowel sounds a sign of

98
Q

Hypothyroidism examination findings

A

Low temperature
Dry skin
Brittle nails
Loss of outer 1/3 eyebrow

99
Q

Hyperthryoidism examination findings

A 
High temperature
Sweating
Palmar erythema
Onycholysis
Fine tremor
Proximal muscle wasting
Tachycardia
AF
100
Q

Graves examination findings

A

Thyroid acropachy
Exopthalmos
Bruit

101
Q

How to test supraspinatus

A

First 15 degrees of abduction

102
Q

How to test deltoid

A

Up to 90 degrees of abduction

103
Q

How to test trapezius and serrratus anterior

A

Beyond 90 degrees of abduction

104
Q

How to test infraspinatus and teres minor

A

Resisted active external rotation

105
Q

How to test subscapularis

A

Lift off test

106
Q

How to test for acromioclavicular joint pathology

A

Scarf test

107
Q

Rinnes louder at mastoid

A

Conductive hearing loss

108
Q

Rinnes same at both

A

Sensorineural hearing loss

109
Q

Webers different results depending on side

A 
Neural= louder on good side
Conductive= louder on bad side

2b (28 decks)

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