CMS100 Practical Exams: Physical and Dermatology Exam Techniques

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Questions and Answers

What is the recommended positioning in relation to the patient during a physical exam for optimal charting?

  • Right side (correct)
  • Left side
  • Front side
  • Back side

During a dermatology exam, which areas should be carefully examined around the face?

  • Eyebrows and eyes (correct)
  • Ears and neck
  • Chin and shoulders
  • Hair and scalp

In a dermatology exam, why is it important to pull the lower lids down to observe the conjunctival rim?

  • To examine pallor in mucous membranes (correct)
  • To evaluate skin texture
  • To check for jaundice
  • To assess pupil dilation

What part of the patient should be exposed and examined when performing a dermatology exam on the arms?

<p>Dorsal and ventral surfaces of both arms (C)</p> Signup and view all the answers

In a dermatology exam, why is it important to examine the areas between the fingers in the webs?

<p>To evaluate skin folds for rashes (C)</p> Signup and view all the answers

What areas should be observed and evaluated when examining nails during a dermatology exam?

<p>Fingers and hands (B)</p> Signup and view all the answers

What type of skin lesion is defined as a nodule filled with an expressible liquid or semisolid material?

<p>Cyst (C)</p> Signup and view all the answers

Which type of skin lesion is characterized by a palpable, elevated, circumscribed, superficial, fluid-filled blister up to 1 cm in size?

<p>Bulla (D)</p> Signup and view all the answers

What type of skin lesion is typically deeper and firmer than a papule?

<p>Nodule (D)</p> Signup and view all the answers

Which skin lesion is an elevated, firm, circumscribed, palpable area larger than 0.5 cm?

<p>Nodule (B)</p> Signup and view all the answers

What skin condition involves a visible and palpable thickening of the epidermis with roughening of the skin due to chronic rubbing?

<p>Lichenification (A)</p> Signup and view all the answers

Which type of skin lesion is a transient, elevated, irregularly shaped area of localized skin edema?

<p>Wheal (B)</p> Signup and view all the answers

What is NOT a descriptor used in the ABCD(E) method to screen for melanoma?

<p>Symmetrical shape (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of tinea versicolor?

<p>Raised, red and scaly patches (D)</p> Signup and view all the answers

Which skin condition presents with annular lesions on the forearm with circular, red (erythematous) raised borders that are crusty?

<p>Ringworm (tinea corporis) (B)</p> Signup and view all the answers

What distinguishes urticaria (hives) from tinea corporis (ringworm)?

<p>Red raised wheals with regular borders (C)</p> Signup and view all the answers

Which descriptor would be most relevant for distinguishing plaque psoriasis from tinea corporis?

<p>Thick silvery/white dry scale (C)</p> Signup and view all the answers

In the ABCD(E) method for melanoma screening, what does the 'E' stand for?

<p>Evolution/change (C)</p> Signup and view all the answers

What does a change of tympany to dullness upon deep inspiration suggest?

<p>Splenomegaly (C)</p> Signup and view all the answers

During inspiration, what happens to the spleen if it is enlarged?

<p>It moves inferiorly (C)</p> Signup and view all the answers

Which condition can cause a positive Castell's sign?

<p>Splenomegaly (D)</p> Signup and view all the answers

What does a tympanitic percussion sound suggest during inspiration if the spleen is not enlarged?

<p>Tympany (D)</p> Signup and view all the answers

Which direction does the spleen enlarge in when a positive Castell's sign is observed?

<p>Anterior, inferior, and medial (A)</p> Signup and view all the answers

Which of the following is NOT a cause of splenomegaly?

<p>Lung cancer (B)</p> Signup and view all the answers

How is the top of neck veins typically indicated?

<p>By the disappearance of the external jugular veins (D)</p> Signup and view all the answers

Why is measuring the vertical distance between the top of the vein and sternal angle important?

<p>To assess pressure in the right atrium (A)</p> Signup and view all the answers

What does an elevated JVP (jugular venous pressure) indicate?

<p>Heart or lung disease (B)</p> Signup and view all the answers

How can pathologies affecting diastolic pressure on the right side of the heart impact central venous pressure?

<p>Increase central venous pressure (B)</p> Signup and view all the answers

What is the correct way to convert the radial artery pulse rate to beats per minute?

<p>Multiply by 4 (B)</p> Signup and view all the answers

What does a pulse amplitude of '0' indicate?

<p>Absent/not palpable (A)</p> Signup and view all the answers

What characterizes a regularly irregular pulse pattern?

<p>Variation is predictable (D)</p> Signup and view all the answers

Which age group is sinus arrhythmia common in?

<p>Adolescents (B)</p> Signup and view all the answers

What defines an irregularly irregular pulse?

<p>No pattern to the irregularity (B)</p> Signup and view all the answers

What is the characteristic of a pulse with an amplitude of '3'?

<p>Full, bounding (A)</p> Signup and view all the answers

When assessing skin turgor, what does it indicate if tenting lasts longer than 3 seconds?

<p>Dehydration (D)</p> Signup and view all the answers

What is the characteristic of a macule skin lesion?

<p>Flat, nonpalpable area of color change (C)</p> Signup and view all the answers

How can skin lesions be described based on their characteristics?

<p>Firm, raised, red, or tan areas (D)</p> Signup and view all the answers

What type of skin lesion is characterized by an elevated, fluid-filled blister up to 1 cm in size?

<p>Vesicle (B)</p> Signup and view all the answers

During a dermatology exam, what does assessing skin texture involve?

<p>Palpating for roughness or smoothness (C)</p> Signup and view all the answers

What are the possible locations where skin turgor can be assessed?

<p>Dorsum of the hand and clavicle region (D)</p> Signup and view all the answers

What is the first area to assess during a dermatology exam according to the provided text?

<p>Skin on the scalp (B)</p> Signup and view all the answers

Why should the patient stand and raise their gown up to mid-thigh during a physical exam?

<p>To observe the dorsal and ventral surfaces of both arms (B)</p> Signup and view all the answers

What should you do as part of an assessment of pallor in mucous membranes during a dermatology exam?

<p>Observe the conjunctival rim by pulling lower lids down (A)</p> Signup and view all the answers

What should be examined carefully during a dermatology exam on the arms?

<p>Dorsal and ventral surfaces of both arms (A)</p> Signup and view all the answers

Why is it important to note the skin around the proximal and lateral nail folds during a dermatology exam?

<p>To observe the nails - shape, contour, and texture (B)</p> Signup and view all the answers

What part of an assessment should include exploring areas from frontal region to occiput during a dermatology exam?

<p>Areas around and behind the ears (D)</p> Signup and view all the answers

What instructions should be given to the patient to facilitate thyroid palpation?

<p>Flex the neck slightly forward and tilt the head to the right (B)</p> Signup and view all the answers

What is a red flag when palpating lymph nodes?

<p>Hard and fixed lymph node (B)</p> Signup and view all the answers

What is the position of the SCM muscle during deep cervical lymph node palpation?

<p>Relaxed (D)</p> Signup and view all the answers

What technique is recommended for focusing on during spleen examination?

<p>Percussion Castell's Sign (A)</p> Signup and view all the answers

What could diffused lymphadenopathy potentially suggest?

<p>HIV infection (A)</p> Signup and view all the answers

What characteristic differentiates normal Shotty Nodes from concerning lymph nodes?

<p>Hard texture (C)</p> Signup and view all the answers

When examining cervical lymph nodes, which group is located at the base of the skull?

<p>Occipital (A)</p> Signup and view all the answers

What is the purpose of the deep palpation technique described in the text?

<p>To detect masses and organomegaly (A)</p> Signup and view all the answers

Why is liver percussion performed at both midclavicular and midsternal lines?

<p>To identify the liver's upper and lower borders (B)</p> Signup and view all the answers

What is the significance of increased tenderness during liver palpation?

<p>Indicates inflammation or congestion (A)</p> Signup and view all the answers

What is the primary purpose of the fluid wave test described in the text?

<p>To detect shifting dullness (D)</p> Signup and view all the answers

Why is McBurney's Point essential in clinical examination?

<p>To diagnose appendicitis (C)</p> Signup and view all the answers

What does the thyroid palpation technique aim to evaluate?

<p>Thyroid gland mobility (C)</p> Signup and view all the answers

Why should you draw a line between umbilicus and ASIS when locating McBurney's Point?

<p>To identify area of maximal tenderness in appendicitis (A)</p> Signup and view all the answers

What would an absence of movement upon thyroid palpation during swallowing suggest?

<p>Not an enlarged thyroid gland (B)</p> Signup and view all the answers

How is thyroid palpation different from McBurney's Point location?

<p>Assessing neck region for goitre (B)</p> Signup and view all the answers

What does skin turgor assess, according to the text?

<p>The skin's ability to change shape and return to normal (C)</p> Signup and view all the answers

What could prolonged tenting of the skin during skin turgor assessment indicate?

<p>Dehydration or decreased skin turgor (C)</p> Signup and view all the answers

How are macules defined in terms of skin lesions?

<p>Flat, nonpalpable circumscribed areas up to 1 cm (D)</p> Signup and view all the answers

What does the assessment of skin texture involve during a dermatology exam?

<p>Palpating the skin for roughness or smoothness (C)</p> Signup and view all the answers

In elderly people with hypernatremia, what was significantly associated with this condition according to the study mentioned?

<p>Abnormal subclavicular and thigh skin turgor (A)</p> Signup and view all the answers

How can skin lesions be described based on their characteristics, as mentioned in the text?

<p>Flat, nonpalpable circumscribed areas up to 1 cm (A)</p> Signup and view all the answers

A pulse amplitude of '2' is described in the text as:

<p>Easy to palpate (normal) (C)</p> Signup and view all the answers

Which statement best describes sinus arrhythmia based on the text?

<p>It is common in children, adolescents, and young adults (C)</p> Signup and view all the answers

What type of pulse rhythm is characterized by a pattern of 3 regular beats followed by one missed beat?

<p>Regularly irregular pulse (A)</p> Signup and view all the answers

In which age group is irregularly irregular pulse most commonly observed?

<p>Elderly population (C)</p> Signup and view all the answers

Which type of pulse rhythm has an even tempo with equal intervals between pulsations?

<p>Regularly irregular pulse (A)</p> Signup and view all the answers

Where is Erb's Point located on the chest?

<p>3rd intercostal space on left sternal border (D)</p> Signup and view all the answers

When might you hear the third heart sound?

<p>In early diastole (D)</p> Signup and view all the answers

Which heart sound may be considered normal in children or athletic young adults under 40 years of age?

<p>Third heart sound (D)</p> Signup and view all the answers

What characterizes the fourth heart sound?

<p>Occurs in late diastole (A)</p> Signup and view all the answers

In which cardiac conditions might you hear the fourth heart sound?

<p>Constrictive pericarditis (B)</p> Signup and view all the answers

How is the presence of a third heart sound different from a fourth heart sound?

<p>Association with ventricular stiffness (C)</p> Signup and view all the answers

What is the correct procedure to measure blood pressure according to the text?

<p>Place deflated cuff on patient’s arm, hold the arm at the level of patient’s heart, palpate the radial artery, inflate cuff slowly, and deflate it at a specific rate. (D)</p> Signup and view all the answers

Why should the patient pump their fist 10 times before measuring blood pressure as mentioned in the text?

<p>To stimulate blood flow in the arm. (D)</p> Signup and view all the answers

What is the significance of inflating the blood pressure cuff to a pressure 20-30 mm Hg higher than the value eliminating radial pulse?

<p>To allow for a more accurate measurement of systolic blood pressure. (A)</p> Signup and view all the answers

When assessing cyanosis in individuals of different skin colors, what differences are noted as per the text?

<p>Differences in peripheral and central cyanosis appearance as well as skin color. (A)</p> Signup and view all the answers

What should be done to ensure an accurate assessment of jaundice according to the text?

<p>Examining the eyes for yellow sclera. (D)</p> Signup and view all the answers

What is one key instruction given for locating McBurney's Point?

<p>Connecting ASIS with xiphoid process before palpation. (D)</p> Signup and view all the answers

Which of the following is a common breathing abnormality associated with metabolic acidosis?

<p>Kussmaul (A)</p> Signup and view all the answers

Which type of lung sound is typically heard in pneumonia?

<p>Crackles (B)</p> Signup and view all the answers

Which reflex is assessed by tapping the patellar tendon with a reflex hammer?

<p>Patellar reflex (C)</p> Signup and view all the answers

What is the primary purpose of performing the Romberg test?

<p>Evaluate proprioception and balance (A)</p> Signup and view all the answers

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