Clincal Skills
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152 questions
| 🇬🇧 | 🇬🇧 |
| Chronic vein insufficiency and ulceration | What is this? |
| 1. Inspection 2. Auscultation/palpation 3. Palpation/auscultation | Physical examination |
| Size and symmetry Color Radial and brachial pulse Epitrochlear lymph nodes | What to inspect in the arms? |
| Aortic width Pulsatile mass | What to inspect in the abdomen? |
| Size and symmetry Skin color Pulse of femoral, popliteal, dorsalis pedis and tibial Inguinal lymph nodes (horizontal and vertical) Peripheral edema | What to inspect in the legs? |
| In systole Aorta, renal, iliac and femoral arteries | Where and when is it normal to hear bruits in the abdomen? |
| Not more than 3 cm | What is the normal width of the aorta? |
| The 6 P's pain pallor poikilothermia paresthesia pulse paralysis | What are the signs of acute limb ischemia? |
| Atheromatosis an accumulation and swelling in artery walls made up of macrophages, or debris, and contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue | What is the main cause of peripheral arterial disease (PAD)? |
| Sudden back, flank or abdominal pain (rapidly growing or ruptured aneurysm) pulsatile abdominal mass increased aorta width (over 3 cm) | Red flags for abdominal aorta aneurysm (AAA) |
| Pylorus of stomach Fundus of gallbladder Neck of pancreas Left kidney hilum and superior pole of right kidney Origin of SMA | What organs are found in the transpyloric plane? |
| Left kidney | Which kidney is higher? |
| Increased serum creatine (decreased GFR) Decreased urine output | Symptoms of acute kidney failure |
| Decreased GFR for over 3 months | Symptoms of chronic kidney failure |
| 1. Inspection 2. Auscultation 3. Percussion 4. Palpation (superficial, deep) Assess the tender areas (or areas in pain) last | The order of physical examination |
| Bruits of aorta and renal arteries Bowel sounds (4-12/min) | What sounds are expected to be heard in the auscultation of the abdomen |
| 1. Leukocytes 2. Nitrite 3. Urobilinogen 4. Protein 5. pH 6. Blood 7. Specific gravity 8. Ketones; 9. bilirubin; 10. Glucose | What 10 things does the urine dipstick measure? |
| T12-L3 | Level of kidneys |
| Surgical removal of one or both testicles | Orchidectomy |
| Epididymitis | If you find a mass in the testes that are separate and hard, what is this suggestive of? |
| Epididymal cyst | If you find a mass in the testes that are separate and soft, what is this suggestive of? |
| Hydrocele | If mass is found in testical sac, and it transilluminates, what is this suggestive of? |
| Stroke (pinch) inner thigh This causes the cremaster muscle to to contract -> ipsilateral testicle goes up toward inguinal canal | How to assess the cremaster reflex? |
| Nitric oxide Cyclic guanosine monophosphate | What chemicals causes local vasodilation resulting in an erection of the penis? |
| Penis: primarily to deep inguinal and external inguinal nodes Scrotum: into superficial inguinal lymph nodes Testes: paraaortic lymph nodes | Lymph drainage of the male reproductive system |
| When loops of bowel force their way through the inguinal canal Above inguinal ligament | What is an inguinal hernia? |
| They have higher rates of depression, suicide, anxiety, drug use, sexual victimization and risk of infection with HIV and other STIs | Why is it important to identify LGBT patients? |
| Gonorrhea | A man complains of yellow penile discharge, what is this indicative of? |
| Multiple sex partners Same sex partners Illicit drug use Prior history of STI | What factors increases risk of an HIV infection in men? |
| For the detection of chancres (painless genital ulcer commonly formed during the primary stage of syphilis) and carcinomas | Why, during inspection, is it neccessary to to retract the prepuce? |
| 12.5% (1:8) 80% occur after the age of 50 | What is a woman's lifetime risk of having invasive breast cancer? |
| Medial: midline chest wall Lateral: mid-axillary line Superior: 2nd anterior rib Inferior: 6th anterior rib | Border of breast |
| Fibrous connective tissue that provides structural support , connected to both skin and underlying fascia | Cooper's Ligament |
| At the terminal ductal lobular unit | Where does most breast cancer develop? |
| Thickened skin with enlarged pores. Caused by: 1. Edema of the skin produced by lymphatic blockage 2. Cancer | Peau d'orange |
| 40 y/o | Beginning at what age does the American Cancer Society recommend annual mammogram screening in females of average risk for breast cancer? |
| Most common: breast Most deadly: lung (then breast) | What is the most common cancer in females? What is the deadliest cancer in females? |
| Arms over head, hands pressed agains hips (contracts pectoralis) and leaning forward | What position should a patient be in, in order to assess for breast dimpling? |
| Support pelvic organs aid in sexual function (orgasm) Urinary and fecal continence Stabilize connecting joints | What does the pelvic floor do? |
| S3-5 The perineal membrane and the urogenital diaphragm are innervated by the pudendal nerve | How is the pelvic diaphragm innervated |
| Age at onset of menses | Menarche |
| Bleeding between menses, includes infrequent, excessive, prolonged or postmenopausal bleeding | Abnormal uterine bleeding |
| Less than 21 days interval between menses | Polymenorrhea |
| Abnormally light or infrequent menstruation | Oligomenorrhea |
| Bleeding from vagina after sexual intercourse suggests cervical polyps or cancer (in older females: atrophic vaginitis) | Postcoital bleeding |
| Causes include endometrial cancer, hormone replacement therapy and uterine/cervical polyps | Postmenopausal bleeding |
| Gravida: total number of pregnancies Para: outcome of pregnancies F (full term), P (premature), A (abortion), L (living child) | Gravida-Para system |
| A threatened abortion or dysfunctional uterine bleeding related to lack of ovulation (p.572) | Amenorrhea followed by heavy bleeding, is suggestive of what? |
| In menustrating women: ectopic pregnancies, ovarian torsion and appendicitis | What could be the cause of acute pelvic pain? |
| Sexual abuse | What is chronic pelvic pain a red flag for? |
| Persistent infection with high-risk HPV subtypes (16 and 18: cause 70% of cervical cancers) Failure to undergo screening (50% of diagnosed women) Multiple sexual partners | Cervical cancer risk factor |
| Abdominal distention Abdominal bloating Urinary frequency | Symptoms of ovarian cancer |
| Family histroy BRCA1 and 2 mutation Obesity Nulliparity Postmenopausal hormonal replacement therapy | Risk factors of ovarian cancer |
| Age <26 multiple partners prior history of STIs | Risk factors for chlamydia |
| Fertility awareness/periodic abstinence, withdrawal, lactation | Natural methods of contraception |