Practical Exam-Findings Flashcards
What would BMI and Bp show for NAFLD?
BMI: ↑ (central adiposity)
Bp: ↑ due to IR, systemic inflammation + obesity
What would external eye exam show in NAFLD?
Jaundice
Pallor (if liver disease leads to anemia)
What would a skin exam show in NAFLD (4)?
- Spider angiomas
- Signs of portal hypertension → edema, ascites, caput medusae
- Palmar erythema
- Jaundice (eyes + skin)
What would liver percussion + palpation show in NAFLD?
- Hepatomegaly → larger than 12 cm mid-clavicular or 8 cm mid-sternal
- Firmness indicating cirrhosis on palpation
What would a spleen percussion + palpation show in NAFLD?
Splenomegaly → due to portal HTN associated w/ liver fibrosis
Test for ascites in NAFLD?
Ascites due to portal HTN + fluid retention
What would Bp, HR, RR, and WC show in obesity?
- Bp → HTN
- HR → ↑ due to ↑ physiologic demands, potential artherosclerosis
- RR → ↑ due to ↑ physiologic demands
- WC → ↑
What would a skin exam show in obesity (6)?
- Acanthuses Nigerians (IR)
- Striae (stretch marks)
- Acrochordons (skin tags associated w/ IR)
- Edema
- Xanthoma
- Central adiposity
Would would an external eye exam show in obesity?
xanthoma
What would a liver percussion + palpation show in obesity?
Hepatomegaly (due to NAFLD – comorbidity)
What would a heart auscultation show in obesity?
Extra sounds (S3+ S4) due to CV comorbidities
Stenosis + regurgitation due to CV comorbidities
What would a test for ascites show in obesity?
Fluid accumulation due to comorbidities
What would a peripheral edema exam show in obesity?
Edema due to comorbidities such as CHF, venous insuffiency
What would a BP be in someone with diabetes?
elevated - HTN
What would a skin exam show in someone with diabetes (7)?
- Acanthoses nigricans (IR)
- Eruptive xanthomas
- Central adiposity/ weight gain
- Diabetic dermopathy
- Skin tags (IR)
On the feet..
- ulcers
- pre-ulcerative callus/ corn
What would ophthalmoscopic exam show on diabetes (4)?
Diabetic retinopathy:
- micro aneurysms: small swellings attached to vessels
-flame hemorrhages
-hard exudates
-neovascularization
What would a peripheral pulses exam show in diabetes?
Diminished pulses due to PAD (atherosclerosis) or diabetic neuropathy (poor circulation due to nerve damage that control vessel constriction/ dilation)
What would a sensory exam should is diabetes (Ipswich touch test, soft touch, vibration, pain)
Vibration: absence
Ipswich touch test: absence of light touch on 2 or more sites out of 6 = + for diabetic neuropathy
Soft touch, pain: absence
What would a positive external rotation lag test mean?
Supraspinatus + infraspinatus tear