PCP Examinations

Question 1

What are the sequence of events in the GI exam?

Answer 1

Prepare the patient - undress, explain

Hand Hygiene

General Inspection

Hand Examination - Leuconychia, clubbing, palmar erythema, pallor of palmar creases, Dupuytren’s contracture, asterixis (flapping hands)

Head and neck - jaundice in eyes, conjunctivae pallor

Chest - Spider naevi, gynaecomastia

Inspect Abdomen - Scars, distension, masses, collateral vessels around the umbilicus, distended abdominal wall veins

Palpation of abdomen - tenderness, masses, enlarged organs

Examination of the liver and palpate

Examination of the spleen

Examination of the kidneys

Ascites

Question 2

What is the sequence of event involved in the cardiovascular exam?

Answer 2

Prepare the patient

Hand hygiene

General Inspection

Examine the hands - clubbing, cap refill, pallor of palmar creases, nicotine stains

Take the radial pulse

Take BP

Conjunctiva pallor, tongue (on and under)

JVP

Carotid pulses

Inspect chest

Find apex beat

Auscultate precordium (bell and diaphragm)

Auscultate back for crepitations (just bases)

Peripheral oedema

Pedal pulses - dorsalis pedis and posterior tibial pulses

Question 3

What are the sequence of events involved in the respiratory exam

Answer 3

Prepare the patient

Hand Hygiene

General Inspection

Examine the hands - palmar crease pallor, clubbing

Radial pulse and resp rate

Conjunctiva pallor, tongue (on and under)

Palpate the trachea

Inspect ant and lat chest wall

Feel chest expansion, x2 on the front

Percuss precordium - 4 each side on the front, 2 each side on the side

Auscultate breathing and “99’s” at the same places

Feel for lung expansiono on the back

Precuss back (arms forward)

Auscultate breathing and “99’s” on back

Spirometry