Practical exam 1: GU, ABG, ACLS

Question 1

When to wear gloves for clinical breast exam?

Answer 1

Only if weeping/excoriated lesions

Question 2

Need a chaperone for clinical breast exam?

Answer 2

Yes

Question 3

What to verbalize for PT position for inspection part of clinical breast exam?

Answer 3

Seated, disrobed at waist

Question 4

What to assess for in inspection of clinical breast exam? (Hint: 4)

Answer 4

1. Skin changes
2. Size/symmetry
3. Countour
4. Nipple characteristics (inverted or not)

Question 5

4 PT maneuvers in inspection of clinical breast exam?

Answer 5

1. Arms at side
2. Arms overhead
3. Hands pressed at hips
4. Lean forward

Question 6

PT position for palpation of clinical breast exam?

Answer 6

Supine, one arm above head, shoulder raised with towel, undrape one breast

Question 7

Pattern and fingers for palpation of clinical breast exam?

Answer 7

Vertical stripe patters with 2, 3, and 4 fingers

Question 8

How to palpate in clinical breast exam?

Answer 8

Small concentric circles

Question 9

What to palpate in clinical breast exam?

Answer 9

Entire breast including periphery, tail of spence (armpit area), and axilla

Question 10

Which 3 lymphnodes to palpate for malignancy in clinical breast exam?

Answer 10

1. Supraclavicular
2. Infraclavicular
3. Axillary regions

Question 11

What to verbalize for findings consistent with malignancy in clinical breast exam? (Hint: 5)

Answer 11

1. Hard
2. irregular shape
3. dimpling of overlying skin
4. nipple retraction
5. non-tender mass

Question 12

Need gloves and chaperone for male GU exam?

Answer 12

Yes

Question 13

Position for inguinal hernia in male GU exam?

Answer 13

Standing

Question 14

Where to place index finger for inguinal hernia?

Answer 14

Near inferior scrotal sack. Move digit up near inguinal canal following spermatic cord up to inguinal ligament. Feel for external ring.

Question 15

What to tell mannequin/patient while checking for bulges in inguinal hernia?

Answer 15

Grunt/cough and valsalva

Question 16

If external ring is large enough what to do in male GU exam?

Answer 16

Palpate near ext ring with valsalva for bulges

Question 17

Position for assessing femoral hernia?

Answer 17

Standing

Question 18

Where to place fingers in femoral hernia assessment?

Answer 18

Anterior thigh/femoral canal region

Question 19

How to assess for femoral hernia?

Answer 19

Tell PT to valsalva (grunt/cough). Assess for pulse, bulging, tenderness, swelling.

Question 20

3 indications for Arterial Blood Gas?

Answer 20

1. General diagnostic, therapeutic purposes
2. Exacerbation of COPD and asthma
3. After hyperventilation/CPR

Question 21

4 CIs for Arterial Blood Gas?

Answer 21

1. Aterial pulse not palpable
2. Negative result of Allen’s Test
3. Superficial landmarks not visible
4. Presence of arterial dz

Question 22

How to do Allen’s Test prior to Arterial Blood Gas?

Answer 22

Make fist, occlude radial and arteries at wrist with thumbs, open hand.

Question 23

What to verbalize for normal Allen’s Test?

Answer 23

“Normal ulnar artery if the hand flushes red in 3-5 seconds after taking pressure off ulnar artery.”

Question 24

What to verbalize for abnormal Allen’s Test?

Answer 24

Flushing delayed or part of hand pale then do not perform radial puncture.

Question 25

Position for penis and scrotum exam?

Answer 25

Standing or supine

Question 26

How to inspect base and prepuce of penis?

Answer 26

Base for excoriation or inflammation Prepuce=ask PT to retract and look for smegma. Check glans penis for ulcers, scars, nodules, and inflammation.

Question 27

How to inspect scrotum?

Answer 27

Lift to view posterior surface. Check for scrotal contous, swelling, lumps, and veins.

Question 28

How to palpate scrotum?

Answer 28

Palpate each testis and epididymis for size, shape, consistency, tenderness, nodule, and swelling (hydrocele)

Question 29

4 things to transilluminate scrotum for?

Answer 29

1. Inguinal hernia 2. Varicocele 3. Testicular tumor 4. Hematoma

Question 30

How to assess cremasteric reflex

Answer 30

Stroke medial thigh briskly inferiorally downwarn fashion with reflex hammer. Testis on that side move upward. DOES NOT HAPPEN WITH TORSION!