Irene Gold Part 4: The Physical Exam (Purple Pages)
1. Initial: LMNOPQRST PAA PAA Practice going through a
Red Flags: Fatigue, weight change, appetite change, full history.
thirst changes, fevers/chills/sweats, px that doesn't
change with position, px waking you up at night.
Bruising easily.
Past health history: Surgery, hospitalizations, infec-
tions or immunizations, trauma, or allergies.
Family history: Ask about family members who are
close blood-relations. Easy way to ask: "Does anyone
in the family have heart disease, stroke, cancer, dia-
betes, arthritis".
Social: Smoking, sleep habits, sexual activity, drugs,
drinking, diet, and exercise. Occupation, hobbies, etc.
ROS: Integumentary, HEENT, Respiratory, cardiovas-
cular, gastrointestinal, Genitourinary, OB GYN or male
repro, neuromusculoskeletal, Endocrine/hematologi-
cal, neurological/psychological.
2. Guillain Barre (especially if she is an artist). A women complains of
rubbery legs. What should
we think of?
3. dissecting aneurysm If someone describes
tearing pain we should
immediately think of...
4. If over epigastric its likely an ulcer. If anywhere else If you ask where the pain
with a known bursa... its bursitis. is and they point with their
finger to single area it is
likely...>
5.
, Irene Gold Part 4: The Physical Exam (Purple Pages)
Temp: 98.6 (Can fluctuate 96,4 in morning to 99.1 in Normal values for temp,
evening). pulse, respiratory rate,
Pulse: 60-100 and BP.
Respiratory Rate: Irene Gold says 14-18. We learned in
school 12-20. Below 12 and above 25 is abnormal.
Blood Pressure: 120/80
6. 99 degrees At what temperature do
we tell most people they
have a temperature?
7. Normal: 120/80 Give the values for BP for
Elevated: Systolic 120-129 and diastolic <80. normal, elevated, hyper-
Stage 1: Systolic 130-139 or diastolic 80-89. tension stages I and II,
Stage 2: Systolic 140+ or diastolic 90+. and hypertensive crisis.
Crisis: Systolic >180 and/or diastolic >120.
8. Increase it What will grave's disease
do to pulse rate?
9. Low If intracranial pressure is
high, pulse rate will be...
10. Systemic lupus erythematosus Butterfly rash
11. Psoriasis Silvery scales
12. Herpes Zoster Vesicles which follow a
thoracic dermatome and
is sensitive to clothing.
13. Impetigo Pustules
14. Lymes disease Bulls eye
, Irene Gold Part 4: The Physical Exam (Purple Pages)
15. Kaposi Sarcoma Red or purple patches of
abnormal tissue
16. 1. Temporal artery Feel these pulses in your-
2. Facial artery self or a partner:
3. Carotid artery
4. Brachial artery
5. radial artery
6. Femoral artery
7. Popliteal artery
8. Posterior tibial artery
9. Dorsal pedis artery
17. Dekleyn's: Patient supine with head extended off Two tests for verte-
table. Dr instructs patient to hyperextend and rotate brobasilar artery insuffi-
head. Hold for 15-45 seconds. Dr may provide minimal ciency are...
support. Repeat on opposite side.
Vertebrobasilar Artery Functional Maneuver: Patient
seated. Auscultate head using bell and palpate sub-
clavian and carotid arteries. If no bruits, pt rotates and
hyper-extends the head to each side. Test positive if
18. Iron deficient anemia Spoon nail
19. Hypoxia or bronchogenic carcinoma clubbing
20. myasthenia gravis bilateral ptosis
21. Horners syndrome (loss of cervical sympathetics, pto- Unilaterael ptosis
sis, miosis, and anhydrosis) or CNIII lesion.
22. early stages of ankylosing spondylitis Iritis/uevitis
1. Initial: LMNOPQRST PAA PAA Practice going through a
Red Flags: Fatigue, weight change, appetite change, full history.
thirst changes, fevers/chills/sweats, px that doesn't
change with position, px waking you up at night.
Bruising easily.
Past health history: Surgery, hospitalizations, infec-
tions or immunizations, trauma, or allergies.
Family history: Ask about family members who are
close blood-relations. Easy way to ask: "Does anyone
in the family have heart disease, stroke, cancer, dia-
betes, arthritis".
Social: Smoking, sleep habits, sexual activity, drugs,
drinking, diet, and exercise. Occupation, hobbies, etc.
ROS: Integumentary, HEENT, Respiratory, cardiovas-
cular, gastrointestinal, Genitourinary, OB GYN or male
repro, neuromusculoskeletal, Endocrine/hematologi-
cal, neurological/psychological.
2. Guillain Barre (especially if she is an artist). A women complains of
rubbery legs. What should
we think of?
3. dissecting aneurysm If someone describes
tearing pain we should
immediately think of...
4. If over epigastric its likely an ulcer. If anywhere else If you ask where the pain
with a known bursa... its bursitis. is and they point with their
finger to single area it is
likely...>
5.
, Irene Gold Part 4: The Physical Exam (Purple Pages)
Temp: 98.6 (Can fluctuate 96,4 in morning to 99.1 in Normal values for temp,
evening). pulse, respiratory rate,
Pulse: 60-100 and BP.
Respiratory Rate: Irene Gold says 14-18. We learned in
school 12-20. Below 12 and above 25 is abnormal.
Blood Pressure: 120/80
6. 99 degrees At what temperature do
we tell most people they
have a temperature?
7. Normal: 120/80 Give the values for BP for
Elevated: Systolic 120-129 and diastolic <80. normal, elevated, hyper-
Stage 1: Systolic 130-139 or diastolic 80-89. tension stages I and II,
Stage 2: Systolic 140+ or diastolic 90+. and hypertensive crisis.
Crisis: Systolic >180 and/or diastolic >120.
8. Increase it What will grave's disease
do to pulse rate?
9. Low If intracranial pressure is
high, pulse rate will be...
10. Systemic lupus erythematosus Butterfly rash
11. Psoriasis Silvery scales
12. Herpes Zoster Vesicles which follow a
thoracic dermatome and
is sensitive to clothing.
13. Impetigo Pustules
14. Lymes disease Bulls eye
, Irene Gold Part 4: The Physical Exam (Purple Pages)
15. Kaposi Sarcoma Red or purple patches of
abnormal tissue
16. 1. Temporal artery Feel these pulses in your-
2. Facial artery self or a partner:
3. Carotid artery
4. Brachial artery
5. radial artery
6. Femoral artery
7. Popliteal artery
8. Posterior tibial artery
9. Dorsal pedis artery
17. Dekleyn's: Patient supine with head extended off Two tests for verte-
table. Dr instructs patient to hyperextend and rotate brobasilar artery insuffi-
head. Hold for 15-45 seconds. Dr may provide minimal ciency are...
support. Repeat on opposite side.
Vertebrobasilar Artery Functional Maneuver: Patient
seated. Auscultate head using bell and palpate sub-
clavian and carotid arteries. If no bruits, pt rotates and
hyper-extends the head to each side. Test positive if
18. Iron deficient anemia Spoon nail
19. Hypoxia or bronchogenic carcinoma clubbing
20. myasthenia gravis bilateral ptosis
21. Horners syndrome (loss of cervical sympathetics, pto- Unilaterael ptosis
sis, miosis, and anhydrosis) or CNIII lesion.
22. early stages of ankylosing spondylitis Iritis/uevitis
