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</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</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</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</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</p> Signup and view all the answers

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

    <p>Nodule</p> Signup and view all the answers

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

    <p>Nodule</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</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</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</p> Signup and view all the answers

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

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

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

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

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

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

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

    <p>Splenomegaly</p> Signup and view all the answers

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

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

    Which condition can cause a positive Castell's sign?

    <p>Splenomegaly</p> Signup and view all the answers

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

    <p>Tympany</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</p> Signup and view all the answers

    Which of the following is NOT a cause of splenomegaly?

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

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

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

    What does a pulse amplitude of '0' indicate?

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

    What characterizes a regularly irregular pulse pattern?

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

    Which age group is sinus arrhythmia common in?

    <p>Adolescents</p> Signup and view all the answers

    What defines an irregularly irregular pulse?

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

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

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

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

    <p>Dehydration</p> Signup and view all the answers

    What is the characteristic of a macule skin lesion?

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

    How can skin lesions be described based on their characteristics?

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

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

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

    What is a red flag when palpating lymph nodes?

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

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

    <p>Relaxed</p> Signup and view all the answers

    What technique is recommended for focusing on during spleen examination?

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

    What could diffused lymphadenopathy potentially suggest?

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

    What characteristic differentiates normal Shotty Nodes from concerning lymph nodes?

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

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

    <p>Occipital</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</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</p> Signup and view all the answers

    What is the significance of increased tenderness during liver palpation?

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

    Why is McBurney's Point essential in clinical examination?

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

    What does the thyroid palpation technique aim to evaluate?

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

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

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

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

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

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

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

    Where is Erb's Point located on the chest?

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

    When might you hear the third heart sound?

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

    What characterizes the fourth heart sound?

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

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

    <p>Constrictive pericarditis</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</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.</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.</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.</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.</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.</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.</p> Signup and view all the answers

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

    <p>Kussmaul</p> Signup and view all the answers

    Which type of lung sound is typically heard in pneumonia?

    <p>Crackles</p> Signup and view all the answers

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

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

    What is the primary purpose of performing the Romberg test?

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

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