Clinical History-Taking & Examination Flashcards

Which examination finding is most specific for meningism?

Answer: Kernig's sign

Kernig's sign (inability to extend the knee when the hip is flexed to 90°) is a specific sign of meningeal irritation, seen in meningitis and subarachnoid haemorrhage.

When performing a focused musculoskeletal examination of the knee, which test specifically assesses the anterior cruciate ligament?

Answer: Lachman test

The Lachman test assesses anterior cruciate ligament (ACL) integrity by applying an anterior force to the tibia with the knee at 20–30° flexion. It is more sensitive than the anterior drawer test.

A patient presents with a tremor. Which feature best distinguishes an essential tremor from a Parkinsonian tremor?

Answer: Essential tremor occurs with action; Parkinsonian tremor is a resting tremor

Essential tremor is an action/postural tremor that worsens with movement, whereas Parkinsonian tremor is a resting tremor (pill-rolling) that improves with voluntary movement.

When eliciting the history of presenting illness, what does the 'ICE' framework stand for?

Answer: Ideas, Concerns, Expectations

ICE stands for Ideas (what the patient thinks is wrong), Concerns (what worries them most), and Expectations (what they hope the consultation will achieve). It ensures patient-centred history-taking.

On fundoscopy, which finding is most characteristic of hypertensive retinopathy grade III?

Answer: Flame haemorrhages and cotton wool spots

Grade III hypertensive retinopathy includes flame-shaped haemorrhages and cotton wool spots (soft exudates), reflecting retinal ischaemia. Grade IV adds papilloedema.

A patient presents with ptosis, miosis, and anhidrosis on the right side of the face. Which syndrome does this describe?

Answer: Horner syndrome

Horner syndrome results from disruption of the sympathetic pathway and presents with ipsilateral ptosis, miosis (pupil constriction), and anhidrosis (loss of sweating) on the affected side.