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Cardiology
Respirology
Gastroenterology
Endocrinology
Renal
100
Important aspects of the JVP that you should comment on during physical examination
What are: non-palpable, able to occlude, located between the heads of the sternocleidomastoid muscle, decrease with inspiration, decrease with elevation of head of bed and increase with hepatojugular reflux
100
This is the term used to describe right sided heart failure caused by pulmonary issue
What is cor pulmonale
100
This is the area that is commonly described as McBurney's Point
What is 1/3 along the line from the ASIS to the umbilicus
100
These are the clinical symptoms of hyperglycemia
What are: polydipsia, polyphagia, polyuria, weight loss
100
Stones of this size can usually be passed without intervention
What is <5mm
200
This murmur is a systolic ejection murmur that commonly radiates to the clavicles
What is aortic stenosis
200
Demonstrate the special tests that might help you discern whether there is a consolidation in the chest
What are: 1. Whispered pectoriloquy: whispered word will be heard more clearly over area of consolidation 2. Egophony: when patient says "eeee" it sounds like "aaaa" over area of consolidation
200
Ecchymosis found around the umbilicus
What is cullen's sign, which suggests retroperitoneal hemorrhage (eg hemorrhagic peritonitis)
200
Demonstrate the appropriate physical exam for a 54 yr old patient that presents with dry skin, hair thinning, and constipation.
What is the thyroid exam: Inspection: from anterior and lateral Palpation: anterior or posterior approach
200
Name 2 differences between the kidney and spleen on palpation
What are: 1. Inferior movement of the kidney with inspiration 2. Ballotable 3. Spleen has a notch 4. Can feel the upper pole of the kidney, but not the spleen 5. Kidney can be resonant to percussion because of overlying bowel, but not spleen 6. Splenic rub (aka bullshit)
300
This is the differential diagnosis for a wide-complex tachycardia
What are: 1. Ventricular tachycardia 2. Ventricular fibrillation 3. Wolff Parkinson White (WPW) with aberrancy 4. Pacemaker
300
Describe the lung disease seen in this pulmonary function test: FEV1/FVC: < 0.65 FEV1: 82 VC: decreased RV: increased DLCO: decreased
What is obstructive disease- COPD
300
These are the signs/stigmata of chronic liver disease
What are: 1. Hair thinning 2. Temporal wasting 3. Fetor hepaticus 4. Muscle wasting 5. Bruising 6. Dupuytren's contracture 7. Nail changes 8. Palmar erythema 9. Ascites 10. Caput medusa 11. Spider angioma 12. Bulging/herniated umbilicus 13. Testicular atrophy
300
These are the risk factors for osteoporosis?
What is age >65, vertebral fracture, family hx of osteoporosis, systemic glucocorticoid tx >3 months, primary hyperPTH, propensity to fall, early menopause (<45yrs)
300
Name some of the clinical signs that indicate that a patient requires acute dialysis
What is Acidosis Electrolytes (mostly K+) Intoxication (lithium, asa) Overload (that is refractory to diuretics) Uremia (with mental status changes, or pericarditis)
400
Demonstrate (b/c this is clinical skills) and name each of the pulses that we palpate clinically from head to toe
What are: 1. carotid 2. brachial 3. radial 4. ulnar (dont have to do this one) 5. abdominal aorta 6. femoral 7. popliteal 8. posterior tibialis 9. dorsalis pedis
400
What are the clinical exam findings that you would expect with the following CXR?
What are: 1. Chest pain (can be pleuritic chest pain, may radiate to ipsilateral shoulder) 2. SOB (in this case, severe) 3. Hypotension 4. Hypoxia
400
These are the clinical symptoms of ascending cholangitis.
What is fever, RUQ pain, jaundice, hypotension and mental status changes?
400
This is known as the "bronze diabetes"
Hemochromatosis
400
Demonstrate (or speak aloud) the clinical exam for volume overload.
What is....you all know it.
500
The mechanism of warfarin action (what factors are inhibited) and the method we use to clinically test whether the level is therapeutic
What is antagonism of vitamin K dependent factors (factor X, IX, VII, II, protein C, protein S) and monitoring is done by measuring INR (which should be between 2-3 for native valve and 2.5-3.5 for mechanical valve).
500
These are the most common bacteria that cause pneumonia in healthy adults
What are: 1. Strep pneumoniae 2. Moraxella catarrhalis 3. Haemophilis influenza
500
The three common causes of small bowel obstruction.
What is adhesions, hernia and malignancy?
500
Demonstrate the exam for Cushing's Syndrome
VITALS: hypertension Inspection: moon facies, dorsocervical fat pad, supraclavicular fat pad, proximal muscle wasting, thin skin, bruises, straie, central obesity Palpation: include this in your cardiac exam (mostly PMI). abdominal exam Percussion: ? Auscultation: heart, lungs
500
What urine lab test would you send if you were worried that a patient was developing diabetic nephropathy
What is urine microalbumin to creatinine ratio, or 24 hr urine protein