PCOA STUDY GUIDE 2025/2026 QUESTIONS WITH
ANSWERS RATED A+
✔✔Waist/Hip circumference:
-Increased risk for CV/metabolic disease (men, women)
-Waist/Hip Ratio - ✔✔Increased risk:
-Men >40 inches
-Women >35 inches
Equation: waist/hip (inches)
- <0.85 for men = low risk
-<0.7 for women = low risk
->1 associated with increased risk
✔✔Physical Exam: HEENT - ✔✔Head:
-Inspect/palpate skull, hair, scalp, face
-Normal = NCAT
Eye:
-Normal = PERRLA (pupils equal, round, reactive to light + accomodation)
-Normal = EOMI (extraocular movements intact)
Ear:
-Inspect tympanic membrane + external canal
-Normal = external auditory canals + hearing grossly intact
-Inpsect for deformities, lumps or lesions
Nose:
-Examine for obstruction + color, symmetry + lesions
Throat:
-Inspect mouth for sores, bleeds, tooth/gum inflammation, or swelling
-Normal = pink + clear, wet
-Odor: fruity (DKA), fishy (CKD), foul (resp. tract infection)
✔✔Physical Exam:
-Neck
-Skin
-Breasts
-Heart - ✔✔Neck:
-Inspect/palpate for unusual lumps, masses, scars
-Lymph nodes only palpable when enlarged
-JVD
Skin:
-Poor skin turgor and cool/clammy may signal dehydration
, -Erythema, swelling, or warmth may signal edema (assess edema by pressing 2 fingers
into skin + noting how long indent remains)
Breasts:
-Inspect for symmetry, contour and apperance of skin
-Palpate for nodules, indurations, tender/warm areas
Heart:
-Auscultate for sounds (Diaphragm for S1/S2 -- normal valve closure)
-S3 = volume overload (heart failure)
-S4 = HTN
-Murmurs = anemia, hyperthyroidism, irregular valve, congenital
-snaps/clicks = Valve irregularities
-Gallops = exaggerated diastolic sound
✔✔Physical Exam:
-Lungs
-ABD
-EXT
-GU/Rectum
-Neuro - ✔✔Lungs:
-Normal = CTAB (clear to auscultation bilaterally)
-Dull = fluids
-Ronchi + rales = wheezing, crackles, stridor (indicative of COPD, HF, asthma, etc)
-RUL = Right upper lobe
-LLL = Lower left lobe
ABD:
-Distended = bloating or free fluid in cavity (ascites)
-Normal bowel sounds = NABS
-Hypoactive = constipation
-Hyperactive = diarrhea
EXT:
-Clubbing (COPD)
-Koilonychias (spooning of nails) = iron deficiency anemia
-Onycholysis (separation of nail from bed) = trauma, malnutrition, hyperthyroid
-Enlarged/distorted joints = osteoarthritis
GU/Rectum:
-Inspect for lumps, inflammation, ulcerations, etc
-Prostate, palpate for size, consistency and tenderness
Neuro:
-Mini Mental State Exam (MMSE)
-Normal = AAO x3 or x4 (alert, aware, oriented to person, place, time, +/- event)
ANSWERS RATED A+
✔✔Waist/Hip circumference:
-Increased risk for CV/metabolic disease (men, women)
-Waist/Hip Ratio - ✔✔Increased risk:
-Men >40 inches
-Women >35 inches
Equation: waist/hip (inches)
- <0.85 for men = low risk
-<0.7 for women = low risk
->1 associated with increased risk
✔✔Physical Exam: HEENT - ✔✔Head:
-Inspect/palpate skull, hair, scalp, face
-Normal = NCAT
Eye:
-Normal = PERRLA (pupils equal, round, reactive to light + accomodation)
-Normal = EOMI (extraocular movements intact)
Ear:
-Inspect tympanic membrane + external canal
-Normal = external auditory canals + hearing grossly intact
-Inpsect for deformities, lumps or lesions
Nose:
-Examine for obstruction + color, symmetry + lesions
Throat:
-Inspect mouth for sores, bleeds, tooth/gum inflammation, or swelling
-Normal = pink + clear, wet
-Odor: fruity (DKA), fishy (CKD), foul (resp. tract infection)
✔✔Physical Exam:
-Neck
-Skin
-Breasts
-Heart - ✔✔Neck:
-Inspect/palpate for unusual lumps, masses, scars
-Lymph nodes only palpable when enlarged
-JVD
Skin:
-Poor skin turgor and cool/clammy may signal dehydration
, -Erythema, swelling, or warmth may signal edema (assess edema by pressing 2 fingers
into skin + noting how long indent remains)
Breasts:
-Inspect for symmetry, contour and apperance of skin
-Palpate for nodules, indurations, tender/warm areas
Heart:
-Auscultate for sounds (Diaphragm for S1/S2 -- normal valve closure)
-S3 = volume overload (heart failure)
-S4 = HTN
-Murmurs = anemia, hyperthyroidism, irregular valve, congenital
-snaps/clicks = Valve irregularities
-Gallops = exaggerated diastolic sound
✔✔Physical Exam:
-Lungs
-ABD
-EXT
-GU/Rectum
-Neuro - ✔✔Lungs:
-Normal = CTAB (clear to auscultation bilaterally)
-Dull = fluids
-Ronchi + rales = wheezing, crackles, stridor (indicative of COPD, HF, asthma, etc)
-RUL = Right upper lobe
-LLL = Lower left lobe
ABD:
-Distended = bloating or free fluid in cavity (ascites)
-Normal bowel sounds = NABS
-Hypoactive = constipation
-Hyperactive = diarrhea
EXT:
-Clubbing (COPD)
-Koilonychias (spooning of nails) = iron deficiency anemia
-Onycholysis (separation of nail from bed) = trauma, malnutrition, hyperthyroid
-Enlarged/distorted joints = osteoarthritis
GU/Rectum:
-Inspect for lumps, inflammation, ulcerations, etc
-Prostate, palpate for size, consistency and tenderness
Neuro:
-Mini Mental State Exam (MMSE)
-Normal = AAO x3 or x4 (alert, aware, oriented to person, place, time, +/- event)
