Solutions!
Do any patient complaints belong in the physical exam? - ANSWER-NO
If a patient states that their abdomen is very painful, does that mean it will be tender
upon exam? - ANSWER-No. subjective info vs objective
Which of these two physical exam findings can a physician appreciate without
auscultating the Pt's lungs? a) No respiratory distress b) No Rales? - ANSWER-No
respiratory distress
What does PERRL stand for? - ANSWER-Pupils equal Round and reactive to light
What does AT/NC stand for? - ANSWER-atraumatic/ normocephalic
What does NAD stand for? - ANSWER-No Acute Distress/Disease
If a Pt has pale conjunctiva what does that indicate? - ANSWER-Anemia
What is scleral icterus? What does it indicate? - ANSWER-yellowing of the eyes.
Indicates liver failure
Name an instrument a physician may use to closely investigate the eyes? - ANSWER-
Slit lamp, woods lamp, opthalmascope (AKA fundiscopic exam)
In which body system would you document "TM erythema and bulging"? - ANSWER-
Ears
What is the medical term for nostril? - ANSWER-Naris (both nostrils is nares)
If a patient has a "runny nose" what would be indicated, epistaxis or rhinorrhea? -
ANSWER-rhinorrhea
what would dry mucous membranes indicate? - ANSWER-dehydration
why is midline bony tenderness "worse" than paraspinal tenderness? - ANSWER-a.
midline tenderness (aka vertebral point tenderness) points towards a spinal fracture and
therefore raises concern for a spinal cord injury.
b. paraspinal tenderness points toward a muscle sprain or strain
If you saw "RRR" in a cardiac exam , what do you think it might mean? (normal finding)
- ANSWER-Regular rate and rhythm
,name the rhythm the physician would hear if the pt was in AFIB? - ANSWER-irregularly
irregular rhythm
If the physician checks the pulse on the right wrist and says "The pulses are fine", what
would you document in the physical exam? - ANSWER-Right radial pulse is 2+
Name two "peritoneal signs" in the abdominal exam? - ANSWER-Guarding, rebound
tenderness, rigidity.
What abdominal sign is indicative of cholecystitis? - ANSWER-Murphy's sign
If the doctor take one finger and presses in a specific spot in the RLQ, what is the name
of the finding they are investigating? - ANSWER-McBurney's point tenderness
Which of these findings is not a peritoneal sign? - ANSWER-Tenderness
What would a Guiac positive stool sample diagnose? - ANSWER-GI bleed
What phrase do you have to document in the GU exam for every female pelvic exam
performed by a male physician? - ANSWER-Female chaperone present
What is bony tenderness a sign of? - ANSWER-bone deformity, fracture, or injury
What is CVA tenderness? - ANSWER-Flank Tenderness (costo-vertebral angle
tenderness).
Tenderness over the kindeys
what is fluctuance a sign of? - ANSWER-abscess
What is the difference between a laceration and abrasion? - ANSWER-a. Laceration is
an incision in the skin that typically needs sutures
b. abrasion. scrape of the skin
What procedure is associated with a laceration and not abrasion? - ANSWER-
Laceration repair, sutures
What does A&Ox3 mean? - ANSWER-Alert and oriented to person place and time
what section of the neurological exam would you document "normal-finger-nose-finger
test" and "normal heel-to-shin test" ? - ANSWER-cerebellar/ coordination
What does DTR stand for? - ANSWER-Deep tendon reflex
Point to the general area of your body that the cranial nerves control? - ANSWER-face
In the neurological exam what does "normal gait" mean? - ANSWER-Walking normally
, In the psychiatric exam what do SI and Hi stand for? - ANSWER-Suicidal ideation and
homicidal ideation
Is the gloscow coma scale (GCS) associated with trauma pt's or medical pt's? -
ANSWER-Trauma
Would you document RUE strength 3/5 under the neurological or extremities section of
the exam? - ANSWER-Neurological
What would you guess TTp means? - ANSWER-tender to palpation
A mother states that her child has been " extremely tired and drowsy recently", based
on mom's words could you document lethargic in the child's physical exam? -
ANSWER-NO!
Spell the medical term for "Hives" allergic reaction rash - ANSWER-Uticaria
What is the medical term for "swollen lymph nodes"? - ANSWER-lymphadenopathy
If you document "There is right pronator drift" in the neurological exam, can you also
document " no focal neurological deficits"? - ANSWER-No, it is a contadiction
If you documented "NAD" in the constitutional section, would you be contradicting
yourself if you wrote "There is mild respiratory distress" in the pulmonary exam? -
ANSWER-YES
When does the physician start the physical exam? - ANSWER-The moment they walk in
the door
T or F: some exam findings may be appreciated form afar by simply observing the
patients external appearance; while other findings require a specific exam technique to
investigate. - ANSWER-True
T or F: The physician tailors their physical exam to each pt based on the HPI, PMHx
and DDx for the visit? - ANSWER-True
what do the objective observations include? - ANSWER-symptoms that can be
measured, seen , heard, touched, felt or smelled.
What are included in objective observation? - ANSWER-vital signs: temp, pulse,
respiration, physical exam findings and the results of diagnostic tests.
what part of the physical exam can be completes in the first 30 seconds? - ANSWER-
General: do they look like they are in pain?
Eyes: Are the sclera yellow?
Pulmonary: are they breathing comfortably?