Practical

Question 1

Socrates stand for

Answer 1

Symptoms 
Allergies 
Medication 
Past medical 
Last in and out 
Events leading up to

Question 2

Socrates

Answer 2

Site 
Onset 
Characteristics 
Radiation 
Associated symptoms 
Timing 
Severity

Question 3

Inspect abdo

Answer 3

Scars
Spider naevi more than 5
Caput Medusa - cirrhosis
Asymmetry 6Fs - fat, flatus, fluids, faeces, fetus, functional

Cullen - umbilicus
Grey turners - flanks

Question 4

Auscultate abdo

Answer 4

4 quadrants

Question 5

Palpate abdo

Answer 5

Left hypochondriac
Epigastric
Right hypochondriac

Left lumbar
Umbilical
Right lumbar

Left iliac
Suprapubic
Right iliac

Question 6

Signs to look for abdo

Answer 6

Rebound tenderness - peritonitis

Murphys sign - right subcostal, breath in - cholecystitis

Rovsing press left iliac will feel in right - appendicitis
Mcburney - right side - appendicitis
Psoas - lie on side pull right leg back
Obturator- bend 90 then twist out

Question 7

Percussion abdo

Answer 7

Looking for ascites
Tympani will move

If two persons can do wave one

Question 8

Hands abdo

Answer 8

Pallor
Leukonychia - liver disease
Kolionychia -crohn

Palmar erythema - red heel - kidney
Dupuytrens contracture - alcohol
Clubbing - ibs

Skin turgor
Asterixis
Needle track marks

Question 9

Eyes abdo

Answer 9

Conjunctiva pallor - anaemia
Jaundice - liver, gallstones

Corneal arcus- high cholesterol
Xanethelasma - high cholesterol

Kayser fleischer rings - Wilson’s disease

Question 10

Mouth - abdo

Answer 10

Angular chelitus - gi malignancy
Dry mouth - hydration

Glositis
Oral candidiasis - immunosuppressive
Aphthous ulceration - b12

Question 11

Neck - abdo

Answer 11

Virchows nodes

Question 12

Hands - CVS

Answer 12

Clubbing- heart disease 
Peripheral cyanosis 
Tar staining - smoker 
Splinter haemorrhages - infective endocarditis 
Jane way lesions - micro abcess 
Osler nodes - inflammatory complex

Question 13

Eyes - CVS

Answer 13

Conjunctive pallor - anaemia
Corneal arcus - high cholesterol
Xanthelasma - high cholesterol

Question 14

Mouth - CVS

Answer 14

Central cyanosis

Angular cheilitus
Glositis

Question 15

Face - CVS

Answer 15

Malar flush

Question 16

Neck - CVS

Answer 16

JVD
Raised - fluid overload
Kusmauls sign - tamponade, c. Pericarditis
Canon waves - complete heart block

Lymph nodes feel if swollen

Question 17

Abdo - cvs

Answer 17

Pulsating masses

Ascites

Question 18

Leg - CVS

Answer 18

Oedema

Question 19

Chest inspection - CVS

Answer 19

Shape -
Pectus excavatum
Pectus carinatum
Barrel chest

Scars / pacemakers / patches

Question 20

Chest - palpate on- CVS

Answer 20

Feel for deformity/ tenderness / crepitus

Feel for apex beat - 5th IC

Thrill - palpable murmur
Heave - abnormally large beating of heart

Question 21

Chest auscultation- CVS

Answer 21

All paramedic take medicine

Aortic - stenosis - regurgitate
Pulmonary - stenosis - regurgitate
Tricuspid - regurgitate- stenosis
Mitral - regurgitate- stenosis

Listening for murmurs indicating stenosis or regurgitation

Base of lungs - crackles

Question 22

Resp - hands

Answer 22

Clubbing - CF, lung cancer 
Peripheral cyanosis 
Tar staining 
Joint swelling / deformity 
Asterixis 
Fine tremor

Question 23

Resp - eyes assessment

Answer 23

Conjunctive pallor - anaemia

Ptosis/miosis - horners

Question 24

Resp - mouth

Answer 24

Angular cheilitus/ glositis - iron def
Central cyanosis
Oral candida - steroid use

Question 25

Leg - resp

Answer 25

Oedema - heart failure | Calf pain - dvt

Question 26

Chest inspection resp

Answer 26

Scars Chest wall deformities Pectus excavatum/ pectus carinatum/ barrel Breathing pattern

Question 27

Chest palpate on resp

Answer 27

Apex beat Chest expansion - symmetry, bilateral reduction, unilateral reduction Tenderness

Question 28

Chest percussion resp

Answer 28

Dullness | Hyper resonance

Question 29

Chest auscultation

Answer 29

``` J shape Stridor Wheeze Crackles Pleural rub ```

Question 30

First cranial nerve

Answer 30

Olfactory | Sense of smell

Question 31

Second cranial nerve

Answer 31

Optic Read something far away Corner test

Question 32

3rd /4th/6th

Answer 32

Oculomotor, trochlear, Abducens Abducen responsible for 4/6 Oculomotor superior oblique Trochlear lateral rectus Swinging light test H test Look for double vision and nystagmus

Question 33

5th cranial nerve

Answer 33

Trigeminal Sensations in face Ophthalmic, mandibular, maxillary Clench jaw

Question 34

7th cranial nerve

Answer 34

Facial Do different facial expressions

Question 35

8th cranial nerve And test ?

Answer 35

Vestibulocochlear Do cochlear part Sound each ear

Question 36

9th and 10th cranial nerve

Answer 36

Glossopharyngeal and vagus Uvula central Soft palate equal Swallow something

Question 37

11th cranial nerve

Answer 37

Accessory Shrug against pressure Turn head against pressure

Question 38

12th cranial nerve

Answer 38

Hypoglossal Tongue into 4 corners Tongue into cheek

Question 39

Cerebellum tests | 7

Answer 39

``` Gait Ram Coordination Pronator drift Romberg Arm strength Dermatomes ```