NBCE Part 4 Clinical & Set-Ups Latest 2023 Graded A+

NBCE Part 4 Clinical & Set-Ups Latest 2023 Graded A+ Case History - Identifying Data (name, age, etc.) - Chief Complaint - Present Illness (OPPQRST) - Past History - (SHITM) - Family History - Occupational History - Social History - Review of Systems Vitals - Temperature - Pulse - Respiration - Blood Pressure - Height - Weight Blood Pressure How to do Blood Pressure: 1. Patient seated 2. Arm elevated (doctor braces patient's wrist) 3. Empty air from cuff, wrap tight on patient 4. Palpatory systolic (on the way up until disappears) 5. Place stethoscope in ears 6. Pump 30-40 higher 7. Auscultate to O (recording true systolic/diastolic values) Physical Exam - Skin Exam XXX - Eye Exam - Nose Exam XXX - Ear Exam - Mouth & Throat Exam XXX - Endocrinology Exam XXX - Genital Exam XXX - Lymphatic Exam - Peripheral Exam - Lung Exam - Heart Exam - Abdominal Exam Eye Exam: CN III, IV, VI Cardinal Field of Gaze Eye Exam: CN II & III - Direct (ipsilateral eye) - Indirect ( contralateral eye) Eye Exam: CN II & III Accommodation reflex Accommodation: Converge & Constrict Follow up questions to a + Eye Exam? - headaches? - trouble reading? - last eye exam? - normally wear glasses/contacts? Ear Exam: Weber & Rhinne - Preform WEBER first - Then preform Rhinne on the EAR that CAN HEAR - *Every case has been Meinier's disease* (ask: ringing?, deafness?, dizzyness?) Lymphatic Exam: palpation palpate w/ 3 fingers - *Neck* (EENT questions) - Supraclavicular (ROS) - *Axillary* (breast, chest, and arms questions) 4 walls - Inguinal (legs/STDs) Peripheral Vascular Exam (PVE): upper extremity palpation *3 of them/ Seated* - Unlar - Radial - Subclavian - Carotid - Temporal Peripheral Vascular Exam (PVE): lower extremity palpation *Supine* - Femoral - Popliteal - Posterior Tibial - Dorsal Pedis Peripheral Vascular Exam (PVE): special tests - Capillary Refill - Allen's Test - Claudication Test - Buerger's test - Homan's test Peripheral Vascular Exam (PVE): auscultation *BELL* - @ carotid bifurcation (c4) - bruit -turbulance Heart Exam: palpate & auscultate valve sites *A* - 2nd right intercostal space (parasternal) *P* - 2nd left intercostal space (parasternal)