What are the four principles of the Physical Exam? - Answers Inspection, Palpation, Percussion,
Auscultation
Who said "Teach the eye to see, the finger to feel, and the ear to hear" - Answers Sir William
Osler
What is the typical order for the PE. What are two exceptions? - Answers Inspection first,
auscultation last. Carotid and Abdomen should be auscultated first
When should inspection start? - Answers with first contact with patient and during history taking
How do you percuss (R hand) - Answers allow R hand to swing freely at wrist, use tip of R
middle finger as hammer and target the DIP of the left middle finger which is firmly resting on
the patient. no other fingers should be touching pt
how many taps are used for percussion? - Answers 2-3 sharp taps
what is key to a thorough and accurate PE? - Answers developing a systematic sequence of
examination
How do you approach the pt during the PE? - Answers from the right side. head to toe.
universal precautions - Answers treat all human blood and certain fluids as if they are known to
be infected with BBP. appropriate use of gloves, masks, eye protection and gowns, proper and
safe disposal of sharps
Standard Precautions - Answers recommended for the care of all pts regardless of disease
status. includes hand washing, and PPE when handling bodily fluids
Airborne-infectious agents precautions - Answers -respiratory masks, isolated negative pressure
pt rooms
-Ex. TB, varicella
-spread through small droplets in the air
Droplet precautions - Answers -surgical masks and gloves
-Ex. Respiratory Viruses
-spread through large droplets
Contact precautions - Answers -gown and gloves, committed medical equipment
-Ex. C. diff
, -Spread by skin to skin or via surfaces
what is the most common cancer in the world? - Answers basal cell carcinoma
what percentage of patients have skin disease? - Answers 52%
what percentage of PCP visits involve skin? - Answers 25%
What are the cellular components of the skin? - Answers Keratinocytes & melanocytes
(epidermis), fibroblasts (dermis)
What are the components of the cutaneous exam? - Answers HPI
PMH
Social
Family
Meds
PE
primary lesions - Answers first to appear and due to disease or abnormal state
macule - Answers Primary lesion
flat lesion <1cm
patch - Answers Primary lesion
flat lesion >1cm
papule - Answers Primary lesion
raised lesion <1cm
plaque - Answers Primary lesion
raised lesion >1cm
nodule - Answers Primary lesion
deep (dermal or subq) raised lesion >1cm
vesicle - Answers Primary lesion
fluid filled lesion <1cm
bulla - Answers Primary lesion