51 Questions
Which condition is indicated by cold and sweaty hands?
Anxiety
What can be inferred from a handshake with dry coarse skin?
Hypothyroidism
What condition is associated with leukonychia, characterized by white nails?
Hypoalbuminemia and severe anemia
What does a cold dry hand suggest about the person's health?
Raynaud's phenomenon
Which nail condition involves a spoon shape and is linked with iron deficiency anemia?
Koilonychia
What is the cardinal sign of oedema on examination?
Pitting of the skin
Which types of oedema do not pit on pressure?
Lymphoedema and myxoedema
Which of the following is NOT a site for lymph nodes listed in the text?
Abdomen
Where are submandibular lymph nodes located?
Neck
Which type of lymph nodes are found in the armpits?
Epitrochlear
What is the typical diameter of normal glands in adults?
0.5 cm
Which consistency is associated with normal lymph glands?
Soft
Which type of consistency in glands might indicate a pathological condition?
Firm, hard, or stony
What does tenderness in lymph nodes usually signify?
Infection
What does it generally indicate if lymph nodes are fixed to deeper structures or skin?
Malignancy
Which body parts are specifically examined for anemia?
Conjunctiva of the lower eyelid, oral mucosa, gum, nail bed, and palmer creases
What other conditions can pallor indicate?
Vasoconstriction (shock) or hypopituitarism
What causes cyanosis?
Increased level of deoxygenated haemoglobin above 5 gm/dL
Which of the following is NOT a symptom associated with anemia?
Blue lips
Where might you observe cyanosis in a patient?
Lips or extremities
Where is peripheral cyanosis typically observed?
Hands and feet
What condition primarily causes central cyanosis?
Arterial hypoxemia
Which of the following can be a sign of peripheral cyanosis?
Raynaud's phenomenon
For which type of disease is clubbing of the fingernails a sign?
Lung and heart diseases
Which of the following body parts do not show signs of central cyanosis?
Feet
What can hoarseness of voice indicate?
Hypothyroidism
What might a stale or mousy smell indicate?
Liver failure
Which condition can cause a sweetness of breath (acetone)?
Diabetic ketoacidosis
What condition is indicated by a shuffling gait?
Parkinsonism
What could wrinkled clothing indicate about a patient?
Their personality and state of mind
What substance's increased level causes jaundice?
Bilirubin
Where is jaundice typically examined?
Sclera, oral mucous membrane, and skin
Which of these is NOT a type of jaundice?
Lymphocytic
What is a common sign of anemia?
Pale color of skin or conjunctiva
What causes anemia?
Increased destruction or decreased production of RBCs
Which condition is suggested by a moon face?
Cushing syndrome
Which facial expression suggests hyperthyroidism?
Startled expression
Which aspect is included in the general observation of a patient?
Inspection of the face
JACCOL is a mnemonic used to check for which conditions?
Jaundice, Anemia, Cyanosis, Clubbing, Oedema, Lymph nodes
What clinical feature may indicate depression?
Apathy, Poverty of expression and poor eye contact
Which one of these is NOT a criterion for confirming clubbing?
increasing redness in the nail bed
Which cardiac disease can lead to clubbing?
infective endocarditis
Which type of oedema is relatively common in inactive patients?
postural oedema
Which of the following is a gastrointestinal disease that can lead to clubbing?
celiac disease
What is oedema?
swelling of tissues due to increased interstitial fluid
Which of the following respiratory diseases can lead to clubbing?
bronchiectasis
What symptom is associated with rheumatoid arthritis affecting the joints?
Swelling, pain, hotness, and limitation of movement
Which condition is related to the wasting of the thenar muscle?
Carpal tunnel syndrome
Which examination method is used to check for retrosternal goiter?
Percussion
During the inspection of a thyroid gland for goiter, what is the patient asked to do?
Swallow a sip of water
What is the purpose of auscultation in the examination of the thyroid gland?
To detect any thyroid bruit
Study Notes
Lymph Node Characteristics
- Normal lymph nodes are usually less than 0.5cm in diameter.
- Normal nodes feel soft and rubbery, while pathological nodes can feel firm, hard, or stony.
- Tenderness in lymph nodes is a sign of infection.
- Fixed nodes to deeper structures or skin usually indicate malignancy.
Hands
- Cold and sweaty hands can indicate anxiety.
- Cold dry hands can indicate Raynaud's phenomenon.
- Hot sweaty hands can indicate hyperthyroidism.
- Large sweaty hands can indicate acromegaly.
- Dry coarse skin can indicate hypothyroidism.
Nails
- Koilonychia (spoon shape) can indicate iron deficiency anemia.
- Leukonychia (white nail) can indicate hypoalbuminemia and severe anemia.
- Splinter hemorrhages can indicate trauma and infective endocarditis.
Oedema
- Pitting of the skin is a cardinal sign of oedema.
- Lymphoedema and myxoedema do not pit on pressure.
- Oedema can be seen on the hands and ankles.
Lymph Nodes (Location)
- Neck (submental, submandibular, preauricular, supraclavicular, and deep cervical glands, scalene nodes, posterior auricular and occipital nodes)
- Axilla
- Armpits (epitrochlear)
- Groins
Anemia
- Examined in the conjunctiva of the lower eyelid, oral mucosa, nail bed, and palmar creases.
- Pallor can also be due to vasoconstriction (shock) or endocrine disease (hypopituitarism).
Pallor
- Pale skin can indicate anemia.
Cyanosis
- Blue coloration of lips or extremities due to increased deoxygenated haemoglobin above 5 gm/dL.
- Types: peripheral cyanosis (hands and feet) and central cyanosis (lips and tongue).
Clothing
- Provides information about the patient's personality, state of mind, and social circumstances.
Sounds
- Abnormal sounds can indicate various conditions (e.g., hoarseness of voice: infective laryngitis, hypothyroidism, heavy smoking, and neurological disease).
Odors
- Stale or mousy smell: liver failure (fetor hepaticus).
- Sweetness of breath (acetone): diabetic ketoacidosis.
- Bad odor (halitosis): gingivitis, stomatitis, atrophic rhinitis, and tumors of nasal passages.
Posture and Gait
- Weakness and neurological disease can affect posture and gait (e.g., shuffling gait in parkinsonism, waddling gait: proximal myopathy).
Joint
- Examination for swelling, pain, hotness, and limitation of movement (e.g., rheumatoid arthritis).
Muscle
- Wasting of thenar muscle (e.g., rheumatoid arthritis, debilitating diseases, carpal tunnel syndrome).
Thyroid Gland
- Examination for goiter (enlarged thyroid): inspection, palpation, percussion, and auscultation.
Physical Examination
- General observation of the patient.
- JACCOL (Jaundice, Anemia, Cyanosis, Clubbing of nails, Oedema of ankles, and Lymph nodes).
- Inspection of face and body for evidence of systemic diseases.
- Examination of the thyroid gland.
Identify the normal and abnormal characteristics of lymph nodes, including size, consistency, tenderness, and fixation. Learn how to differentiate between normal and pathological lymph nodes.
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