PD practical 1 scenarios
Terms
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- A young male w/ a sore throat and yellowing of the skin DDX
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-mono
-Hep A,C
-Strep pharyngitis
-HIV - A young male w/ a sore throat and yellowing of the skin PE
-
-general appearance
-vitals: BP, pulse, resp, temp, height, weight
-HEENT (don't forget sinuses)
-Neck (lymph nodes)
-skin
-abdomen
-quick heart + lung? - 25 y/o female in ER c/o L calf pain x 2 days - DDX:
-
-DVT
-muscle strain
-tumor
-arterial embolus
-cellulitis - 25 y/o female in ER c/o L calf pain x 2 days
-
-general appearance
-vitals
-peripheral vascular of LE
(inspect, palpate inguinal nodes, pulses, temp, edema, stand, homan's)
-heart
-lung - 20 y/o female c/o abd. pain, fever, nausea PE:
-
-General appearance
-vitals
-abdominal (mention rectal/vag first!)
-special tests: cutaneous hyperesthesia, rebound, rovsing's, reffered rebound, obturator, iliopsoas
-heart
-lung - 59 y/o male c/o L sided CP PE:
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-general appearance
-vitals
-heart (including carotid arteries and JVP)
-lung (possibly bronchophony, egophony, whispered pectoriloquy)
-skin...? - 36 y/o male c/o R knee pain PE:
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-general appearance
-vitals
-hip (including thomas test)
-knee (including, balloon, balottment, bulge, mcmurrays, lachman, drawers, collaterals)
-ankle
-skin (don't forget to mention groin) - 27 y/o male w/ lower back pain radiating to thigh
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-general appearance
-vitals
-neuro on legs: muscle strength, motor, sensory (light touch, sharp/dull, vibration, position,don't forget to say medial aspect of buttock), reflexes (don't forget babinski, clonus)
-cervical spine
-thoracic/lumbar spine
-hip MS
-knee MS
-ankle MS
-limb length
-test for herniated disc
-thomas test
-scoliosis test - headache
-
-gen appearance, vitals
-entire neuro
-head + neck, tmj
-fundo
-brudzinski + kernig
-skin - cough
-
-gen appearance, vitals
-HEENT
-lung
-heart
-calf - joint pain
-
-gen appearance, vitals
-skin
-gait for hip and down
-palpate, ROM's
-pulses distal to pain
-strength, sensory, reflexes distal to pain
-limb length - chronic fatigue
-
-gen appearance, vitals
-mention rectal and vaginal
-skin, nails
-eyes incl. fundo
-lips + tongue
-heart
-spleen
-neuro: romberg, babinsky, vibration - hypothyroidism
-
-gen appearance, vitals
-skin
-hair
-eyes
-voice
-tongue
-thyroid
-hearing
-heart
-lungs
-joints for effusion
-DTR's
-extremities for pitting edema - mononucleosis
-
-gen appearance, vitals
-skin
-sclera
-mouth/pharynx
-neck
-abdomen
-selected neuro - bell's palsy? - heart failure
-
-gen appearance, vitals
-heart
-JVD and HJR
-lungs
-abdomen
-feet and ankles for edema - dizziness/lightheadedness/presyncope/vertigo
-
-gen appearance, vitals + orthostasis
-whole neuro
-skin
-heart + carotid bruits
-HEENT
-rectal - hyperthyroidism
-
-gen appearance, vitals
-skin/nails
-head/eyes
-neck
-heart
-hands (tremor)
-legs (edema)
-DTR's - abdominal pain
-
-gen appearance, vitals
-first mention rectal and vaginal
-whole abdominal
-special tests: abd fist percussion, CVA fist percussion, iliopsoas, obturator, rebound, rovsings, referred rebound, murphy's, cutaneous hyperesthesia, ventral hernia, abd mass, fluid wave, shifting dullness
-heart
-lung