ANGULAR STOMATITIS/CHEILITIS Definition: Maculopapular and vesicular lesions grouped on the skin at the corners (or ‘angles’) of the mouth and the mucocutaneous junction. It is made worse by licking the lips. Causes: 1. Oral candidiasis 2. Poorly fitting dentures 3. Bacterial infection 4. Less common Nutritional deficiencies (especially riboflavin, iron and pyridoxine) Iron…
Author: Epomedicine
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Strawberry Gallbladder (Cholesterolosis)
Synonyms: Strawberry gallbladder is also known as hyperplastic cholecystoses. Hyperplastic cholecystoses are a spectrum of non-neoplastic proliferative disorders caused by deposition of cholesterol-laden macrophages within the wall of the gall bladder. The cholecystose range from abnormalities of the gallbladder wall (adenomyomatosis and strawberry gall bladder) to gallbladder polyps extending into…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Cutaneous manifestation in thyroid disorders
Skin – Systemic Disease Connection “When a man has on the skin of his body a swelling or an eruption… and the disease appears to be deeper than the skin it is a leprous disease.” – Leviticus 13: 2-3 In ancient times changes in skin were taken to indicate the…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Hemoptysis – Examination and Evaluation
Synonym: Haemoptysis Definition of Hemoptysis Simple definition: Expectoration of blood or bloody sputum Hemoptysis is defined as the expectoration of blood from the respiratory tract, a spectrum that varies from blood-streaking of sputum to coughing up large amounts of pure blood. True hemoptysis is expectoration of blood from the lower respiratory tree, below…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Respiratory Examination – Relevant Anatomy and Physiology
1. Division of Airway: Extrathoracic (Upper) airway: Nose to Upper trachea Intrathoracic (Lower) airway: Lower trachea to Alveoli and lungs Note: Vocal fold is also regarded as the demarcating line between upper and lower respiratory tract 2. Angle of Louis: Junction of body of sternum to manubrium (2nd costal cartilage…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Respiratory Examination – Noisy Breathing
GRUNTING Definition: A short, explosive, moaning or crying sound heard on expiration (Child and neonates) Cause: Any cause of respiratory distress Mechanism: In attempt to increase FRC which helps to keep narrowed or collapsing airways open, creating a longer time for alveolar gas exchange STERTOR Definition: Non-musical, low pitched, snoring…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Respiratory Examination – Dyspnea
Definition: Breathlessness inappropriate to the level of physical exertion or even occurring at rest (subjective and not a sign) Mechanisms: Chemoreceptors: Peripheral: Carotid and aortic bodies (to pO2, pCO2 and H+) Central: Medulla (to pCO2, not pO2, change in pH of CSF) a. Increased work of breathing: Airflow obstruction: Bronchial…
Clinical Skills and Approaches 
Examination of Hands
History: Hand dominance and occupation? Injury? Pain? Paresthesia? Impaired function? Swelling? Position: Place the patient’s hands on pillow Look: SEATS a. Shape or Deformity: – Wrist: Radial deviation: RA Ulnar deviation and flexion deformity: Spastic hemiplegia (CP) Wrist drop (also finger drop): Radial nerve injury Prominent dorsal ulnar and radial…