Physical assessment

  1. 55 yo woman w/heart failure, presents to ER, shortness of breath, ran out of meds 1 week ago. You would expect to see her:
    sitting up
  2. 62 yo w/ COPD, shortness of breath. Lips, mucosa, lips are discolored referred to as:
    central cyanosis
  3. 72 yo confused, gain wt, appetite decreased.  Swollen in general.  dx: hypothyroidism.  On examination of skin you expect it to be:
  4. 28 yo female for 6 week post partum check up.  Fatigue, palpitations, hair loss, denies depression.  No prior medical problems.  first period since giving birth last week.  Pregnancy test is neg.  Most likely dx:
  5. 22yo coughing for 6 weeks.  Non productive, worse first thing in am.  Denies fever, chills, sweat.  Has clear rhinorrhea, itchy watery eyes. dx: allergic rhinoconjunctivitis.  On physical examination of nose, expect to find:
    Pale to bluish, boggy mucosa
  6. 57 yo decreased vision in R eye.  Fundoscopic exam reveals cataract.  What did you see to make this diagnosis?
    ABSENCE of red reflex
  7. 3yo w/ fever, loss of appetite, emesis for 2 days.  Relieved w/ antipyretics.  dx: otitis media.  What is most likely finding of otoscopic exam?
    erythematous, bulging tympanic membrane
  8. 26 yo F w/ hair loss.  Incr wt and diarrhea.  dx: Hyperthyroidism (Graves).  On examination of hair, you would expect to find:
    fine hair
  9. When you look at tympanic membrane with otoscope, what normal landmark is present?
  10. 38 yo w/ headache for years, increasing recently. bp 170/100. dipstick is positive for proteinuria only. Fingerstick glucose is 100mg/dl.  dx: uncontrolled HTN.  What fundoscopic exam would support this?
    arteriovenous (AV) nicking
  11. 42yo F, SOB, temp:103F, coughing green sputum. Chest radiograph reveals consolidation of left lower lobe.  dx: lobular pneumonia. tactile fremitus would be:
  12. In healthy adult, expected distance of descent of diaphragm would be:
    5 to 6 cm
  13. When you percuss left lower thorax you expect sound to be:
  14. When you auscultate pt with COPD, you expect to hear:
    delayed expiratory phase
  15. When you perform test for egophony you expect to hear:
  16. In patient with lumbar pneumonia you expect to expect breath sounds on auscultation to reveal
    increased resonance
  17. 80yo woman presents w/ palpitations, SOB.  Electrocardiogram reveals irregularly irregular rhythm w/o discrete P waves.  dx: a-fib.  Most likely physical finding upon auscultation is:
    irregularly irregular rhythm
  18. What could you ask pt to do to accentuate findings of mitral valve prolapse?
    Valsalva maneuver
  19. 61 yo w/ SOB, examine JVP and heart auscultation.  dx: R sided heart failure.  JVP measurement would most likely be:
    6cm above sternal angle
  20. 22yo, pain in chest, anxious.  Worse with physical exertion ie climbing stairs.  No smoking, alcohol, drugs, excessive caffeine. dx: mitral valve prolapse.  What did you hear to make this dx?
    midsystolic click
  21. 75 yo for routine check up.  hx of class III CHF.  Taking meds as prescribed.  On examination of cardiovasc sys what would you expect to find?
    PMI in 5th interspace, anterior axillary line
  22. 60yo swelling in R arm.  Recent mastectormy for R sided ductal carcinoma in situ.  What is most likely dx?
  23. 62yo w/ rash on lower legs for months. No fever or chills. Smoker. Skin is hyperpigmented with bluish red.  Shallow ulcer on R medial calf. dorsalis pedis are 2+, normal hair distribution.  Most likely dx:
    venous insufficiency
  24. 55yo swelling in feet, bilateral, non smoker, no surgeries. Works 2 8-hour shifts daily, 6 days weekly. BP 110/60, cardio exam is normal, legs have 2+ pitting. No rashes, thickening, ulcerations.  dx?
    orthostatic edema
  25. 25 yo prior drug abuser, presents to ER w/ 5 day nausea, emesis, RUQ pain.  Skin looks ill and is yellow. Temp 102.5 ht rt of 112bpm.  dx: hepatitis.  What to expect on abdominal exam? 
    Liver edge is tender, 4-5 fingerbreaths below RCM
  26. Which is not a peritoneal sign?
    voluntary guarding
  27. 40 yo abdominal pain, worse after eating spicy of fatty food.  OTCs don't help.  You suspect cholecystitis.  What sign on examination increases your suspicion
    Murphy's sign
  28. 25 yo w/ flank pain, dysuria, nausea, fever.  Urine pregnancy test is negative.  Urine dipstick is pos for leukocyte esterase.  What is most likely physical sign?
    CVA tenderness
  29. 15yo hx 1day nausea, anorexia.  Right lower quadrant localized pain, upon palpation.  What is name of this sign?
    Rovsing's Sign
  30. 18yo football player heard a pop on the field in his knee.  On physical exam, swollen.  Significant forward excursion when Lachman test performed.  More movement with R tibia when drawn forward compared to left.  dx?
    ACL tear
  31. 55yo with pain in wrists for months. Recently daily pain.  OTCs seem to help. No fever, chills, rashes. Hard dorso lateral nodule on Distal Inter Phalangeal joint of middle finger.  MCP joints are normal.  dx?
  32. 27yo numbness pain in fingers in both hands.  Not relieved by OTCs.  family history positive for HTN and cerebrovascular disease.  bp 110/170.  thenar eminence is atrophic.  What test to confirm carpal tunnel syndrom?
    anterior drawer test
  33. You want to decide is pt's coma is metabolic or structural cause.  You examine pt's pupillary response to light. If a pt were in a coma due to opiate over dose, what reaction would you expect to see?
    Pupils equally responsive to light, pinpoint
  34. Which is considered a higher cognitive function?
    calculating ability
  35. 22yo fever 103F, headache, neck pain.  Photophobia and neck stiffness.  Flex pt's hip and knee, then straighten knee to elicit meningeal irritation.  This sign is:
    Kernig's sign
  36. 70 yo f/u after stroke.  Slurred and indistinct words.  dx:
  37. 25 yo in urgent care for paralysis in face.  Upper respiratory infection prior of symptoms.  Drooping face, unable to close eye. dx:
    Bell's palsy
  38. fever 105F. Headache, respiratory patterns are irregular, Cheyne-Stokes breathing.  Pupils are unequally reactive to light. dx: coma.  Cause:
    brain abscess
  39. Mental status change: pt's eyes open, responds to you, but confused, speaks slowly.  This status is called:
Card Set
Physical assessment
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