Archive for the ‘Clinical Examination’ Category

Respiratory history

July 17, 2012

CAPTION

  • Cough +/- sputum, purulent, blood
  • Atopy or allergy
  • Pain –site and if pleuritic
  • Timing of breathlessness e.g. nocturnal / acute
  • Infective prodrome or not including gastrointestinal symptoms
  • Other similar episodes
  • Normal state and treatment –usual morbidity / co-morbidity

Contributing factors to disease:

STOP

  • Social –smoking, drugs, alcohol
  • Travel
  • Occupation
  • Pets
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Past medical history essential conditions

June 3, 2012

HAM SPED

In taking a past medical history, specifically ask about :

  • Hypertension
  • Angina
  • Myocardial infraction
  • Stroke
  • PE/DVT
  • Epilepsy
  • Diabetes mellitus

Sexual history essential elements

February 29, 2012

The 5 P‘s

  • Partners – overall and recently
  • Practices e.g. vaginal, anal, oral sex
  • Protection e.g. condoms
  • Pregnancy – desire to become pregnant or prevention (e.g. combined oral contraceptive)
  • Past history of sexually transmitted infections

Lumbar puncture contraindications

December 23, 2011

BRIC

  • Bleeding diathesis (tendency to bleed)
  • Raised intracranial pressure
  • Infection at site of needle insertion
  • Cardiorespiratory compromise

Parkinson’s disease examination

December 11, 2011

TRAMESS

  • Tremor
  • Rigidity
  • Akinesia
  • Micrographic
  • Eye movements (Glabellar tap and impaired upward gaze in supranuclear palsy)
  • Speech slow and monotonous
  • Shuffling gait (stooped posture, reduced arm swing)

Describing an ulcer

December 8, 2011

BBEDDS

  • Basics – site, size, shape
  • Base – colour (red, pink, white, black)
  • Edge:
    • Flat, sloping (venous)
    • Punched-out (arterial/neuropathic); arterial = pain, neuropathic = no pain
    • Undermined (pressure sores)
    • Rolled edge (basal cell carcinoma)
    • Everted edge (squamous cell carcinoma)
  • Depth – measure height (mm)
  • Discharge – serous (clear), blood, purulent
  • Surroundings – skin changes, colour, scars

Lump examination (2)

September 29, 2011

She Cuts The Fish PERfectly!

  • Site, Size, Surface (skin)
  • Colour, Contour (border), Consistency (firm/soft)
  • Temperature, Tenderness, Trans-illuminable
  • Fluctuance (fluid-filled), Fixity
  • Pulsatile (aneurysm)
  • Expansile
  • Reducible (hernia)
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Lump examination

June 20, 2011

Should The Children Ever Find Lumps Readily

  • Size/Site/Shape/Surface/Skin changes/Scars/Symmetry
  • Temperature/Tenderness/Transilluminability
  • Colour/Consistency/Compression
  • Edge/Expansion and pulsation
  • Fluctuation/Fluid thrill/Fixation
  • Lymph nodes
  • Relations to surrounding structures

End-of-bed observations

May 22, 2011

JACCOL

  • Jaundice
  • Anaemia
  • Cyanosis
  • Clubbing
  • Oedema
  • Lymphadenopathy

Pain questions

May 11, 2011

SOCRATES (Greek philosopher)

  • Site – central?
  • Onset – sudden?
  • Character – burning, heavy, crushing, tight?
  • Radiation – e.g. jaw, neck, arms
  • Associations – e.g. sweating, dyspnoea, nausea, vomiting
  • Timing – duration?
  • Exacerbating and alleviating factors – e.g. by glyceryl trinitrate
  • Severity out of 10