Practical Exam-Findings Flashcards

1
Q

What would BMI and Bp show for NAFLD?

A

BMI: ↑ (central adiposity)
Bp: ↑ due to IR, systemic inflammation + obesity

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2
Q

What would external eye exam show in NAFLD?

A

Jaundice
Pallor (if liver disease leads to anemia)

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3
Q

What would a skin exam show in NAFLD (4)?

A
  1. Spider angiomas
  2. Signs of portal hypertension → edema, ascites, caput medusae
  3. Palmar erythema
  4. Jaundice (eyes + skin)
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4
Q

What would liver percussion + palpation show in NAFLD?

A
  1. Hepatomegaly → larger than 12 cm mid-clavicular or 8 cm mid-sternal
  2. Firmness indicating cirrhosis on palpation
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5
Q

What would a spleen percussion + palpation show in NAFLD?

A

Splenomegaly → due to portal HTN associated w/ liver fibrosis

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6
Q

Test for ascites in NAFLD?

A

Ascites due to portal HTN + fluid retention

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7
Q

What would Bp, HR, RR, and WC show in obesity?

A
  1. Bp → HTN
  2. HR → ↑ due to ↑ physiologic demands, potential artherosclerosis
  3. RR → ↑ due to ↑ physiologic demands
  4. WC → ↑
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8
Q

What would a skin exam show in obesity (6)?

A
  1. Acanthuses Nigerians (IR)
  2. Striae (stretch marks)
  3. Acrochordons (skin tags associated w/ IR)
  4. Edema
  5. Xanthoma
  6. Central adiposity
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9
Q

Would would an external eye exam show in obesity?

A

xanthoma

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10
Q

What would a liver percussion + palpation show in obesity?

A

Hepatomegaly (due to NAFLD – comorbidity)

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11
Q

What would a heart auscultation show in obesity?

A

Extra sounds (S3+ S4) due to CV comorbidities

Stenosis + regurgitation due to CV comorbidities

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12
Q

What would a test for ascites show in obesity?

A

Fluid accumulation due to comorbidities

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13
Q

What would a peripheral edema exam show in obesity?

A

Edema due to comorbidities such as CHF, venous insuffiency

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14
Q

What would a BP be in someone with diabetes?

A

elevated - HTN

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15
Q

What would a skin exam show in someone with diabetes (7)?

A
  1. Acanthoses nigricans (IR)
  2. Eruptive xanthomas
  3. Central adiposity/ weight gain
  4. Diabetic dermopathy
  5. Skin tags (IR)

On the feet..
- ulcers
- pre-ulcerative callus/ corn

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16
Q

What would ophthalmoscopic exam show on diabetes (4)?

A

Diabetic retinopathy:
- micro aneurysms: small swellings attached to vessels
-flame hemorrhages
-hard exudates
-neovascularization

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17
Q

What would a peripheral pulses exam show in diabetes?

A

Diminished pulses due to PAD (atherosclerosis) or diabetic neuropathy (poor circulation due to nerve damage that control vessel constriction/ dilation)

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18
Q

What would a sensory exam should is diabetes (Ipswich touch test, soft touch, vibration, pain)

A

Vibration: absence
Ipswich touch test: absence of light touch on 2 or more sites out of 6 = + for diabetic neuropathy
Soft touch, pain: absence

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19
Q

What would a positive external rotation lag test mean?

A

Supraspinatus + infraspinatus tear

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20
Q

What would a positive internal rotation lag test mean?

A

Subscapularis tear

21
Q

What would a positive painful arc test mean?

A

pain btwn 60-120 → supraspinatus impingement OR rotator cuff tendonitis/ tear

22
Q

What would a positive drop-arm test mean?

A

Supraspinatus tear

23
Q

What would Bp, HR, temp + W:H show in hypothyroidism?

A

Bp: Diastolic hypertension
HR: Bradycardia
Temp: slightly lower body temperature
W:H: Weight gain (5lbs)

24
Q

What would a skin exam show in hypothyroidsim (4)?

A
  1. Lateral 1/3 eyebrow thinning
  2. Puffy face/ eyelids
  3. Skin pallor or yellowing (carotenemia)
  4. Dry skin
25
Q

What would a hair + nail exam show in hypothyroidism?

A

THin brittle nails
Thinning hair/ alopecia

26
Q

What would a thyroid exam show in hypothyroidism (4)?

A

Goitre, bogginess, nodules, tenderness

27
Q

What would DTRs show in hypothyroidism?

A

Delayed DTRs (grade 1)

28
Q

What would Bp,HR, RR + temp show in non-organic fatigue?

A

Bp: mild hypotension
HR: tachycardia
RR: tachypnea
Temp: low grade fever or lower than baseline

looking to rule out infection as a cause of fatigue

29
Q

What would an oropharyngeal exam show in non-organic fatigue?

A

Non-exudative pharyngitis
- erythematous posterior pharynx
- grade tonsils to see if swollen

Looking to rule out infection as a cause of fatigue

30
Q

Cervical + Axillary Lymph node exam for non-organic fatigue?

A

Lymphadenopathy
Tender lymph nodes

looking to rule out infection as a cause of fatigue

31
Q

What would an oropharyngeal exam show in insomnia? (rule out 3 conditions)

A

Use either tonsil grading to see if tonsils enlarged
- grade 3 + 4 have higher risk of obstruction thus insomnia

Or mallampati score class 3 + 4 have higher risk of OSA

Also assess posterior pharynx:
- erythema → evidence of post nasal drip
- ulceration, enamel erosion, cobble stoning → evidence of GERD

32
Q

Nose (external/ internal) + sinus exam for insomnia?

A

External:
- asses for deviated septum → any asymmetry
Internal:
- swollen turbinates → rhinitis, allergies, obstruction,
-mucous - can lead to post nasal drip
-polyps, redness of mucous → sinusitis
Sinus:
- if tender → increase suspicion of post nasal drip

33
Q

Neck circumference in insomnia?

A

≤ 40cm increases risk of OSA

34
Q

Lung auscultation in insomnia?

A

If HF → Fluid/ crackles

35
Q

Heart auscultation in insomnia?

A

if HF → Extra heart sounds (S3), regurgitation

36
Q

Abdominal palpation exam in insomnia?

A

if IBS → palpation may be sensitive/ tender to touch

if GERD → epigastric pain on palpation

37
Q

What would BP show in PAD?

A

hypertension

38
Q

What would a skin exam show for PAD? (5)

A
  1. Cold cool skin
  2. Presence of foot ulcers, ulcers between toes (kissing ulcers)
  3. Discolouration (gangrene)
  4. Rubor
  5. Distal hair loss + hair loss on toes
39
Q

What would hair + nail exam show for PAD?

A

Hair: hair loss on toes + distal ankles
Nails: Dystrophic nail changes → discolouration, hypertrophic nails, splinter hemorrhages

40
Q

What would a peripheral pulses exam for in PAD?

A

All will be diminished (carotid, radial, femoral, posterior tibial, dorsalis pedis)

41
Q

What would auscultation of bruits show in PAD?

A

if bruits detected → Stenosis/ atherosclerosis (PAD)

42
Q

What would a sensory exam (soft touch, vibration, pain, show in PAD?

A

may be absent due to PAD w/ neuropathy
(PAD reduces blood flow can damage nerves)

43
Q

What would BP, HR + RR show in anemia?

A

BP: Hypotension
HR: Tachycardia
RR: Tachypnea

44
Q

What would a skin exam show in anemia?

A

Pallor: face, skin, palmar, palmar creases (IDA), pallor on tongue
- icterus (hemolytic)
- petechia (aplastic anemia, IDA)
- purpura (aplastic anemia)
- bruising

45
Q

What would a hair + nail exam show in anemia?

A

Hair: course, dry hair + evidence of hair loss
Nails: Koiloncyhia (spooning), brittle nails, nail bed pallor (IDA)

46
Q

What would a nutritional status exam show in anemia?

A

-Pallor conjunctiva + rim (anterior)
- pallor on nail beds
- pallor on palms
- pallor on oral mucosa + tongue (IDA)

47
Q

What would BP, Temp, HR + RR show in an UTI?

A

BP: hypotension (if shock)
Temp: fever
HR: Tachycardia
RR: tachypnea

48
Q

Abdominal palpation for UTI?

A

Pain/ tenderness may be felt in lower quad on bladder