A) HISTORY Besides chief complaints, other portion of history is similar to the one you prepare in internal medicine. 1. Description of symptom (SOCRATES): S – Site (Unilateral or Bilateral) O- Onset C – Character R – Radiation (if applicable) A – Aggravating and relieving factors T – Timing and…
Tag: Clinical examination
Clinical Skills and Approaches 
Pathological reflexes – Variations of Babinski
Normally, the pathological reflexes are not evident because they are suppressed by cerebrum at brainstem or spinal cord level by 6 months of age. Importance: Up-going (dorsiflexion) toe can be elicited at various sites and all indicated Upper Motor Neuron (UMN) lesion. Use a blunt-pointed object like fingernail or tip…
Clinical Skills and Approaches 
Hematological Signs – Angular Stomatitis and Atrophic Glossitis
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…
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…
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…
Clinical Skills and Approaches 
Meningeal signs
Meningitis refers to the inflammation of leptomeninges and underlying subarachnoid cerebrospinal fluid (CSF). Meningism or meningismus is a morbid state characterized by a meningitic syndrome (a triad of headache, photophobia and nuchal rigidity) without intracranial inflammation. Some authors, have also used the term “meningism” or “meningismus” to describe the characteristic signs…