Physical Examination Flashcards

A patient presents with a small, round, painless ulcer with indurated edges on the penis. The most appropriate next examination step is:

Answer: Examine the inguinal lymph nodes

A painless indurated penile ulcer (chancre) requires inguinal lymph node examination, which typically shows non-tender lymphadenopathy in primary syphilis.

When assessing ankle clonus, how many beats of sustained clonus is considered pathological?

Answer: 3 or more beats

Sustained clonus (3 or more rhythmic beats) is pathological and indicates an upper motor neuron lesion; 1-2 beats can be normal.

During thyroid examination, which maneuver best confirms that a midline neck swelling is the thyroid gland?

Answer: Asking the patient to swallow

The thyroid gland moves upward on swallowing because it is enclosed in the pretracheal fascia, distinguishing it from other neck masses.

On ophthalmoscopy, arteriovenous (AV) nipping at arteriovenous crossings is most associated with:

Answer: Hypertensive retinopathy

AV nipping occurs when hardened, thickened retinal arteries compress the veins at crossing points, a hallmark of hypertensive retinopathy.

When performing the finger-nose test in a patient with cerebellar disease, the characteristic finding is:

Answer: Intention tremor increasing as finger approaches target

Intention tremor that worsens as the finger approaches the target (dysmetria) is the hallmark of cerebellar dysfunction on the finger-nose test.

Which physical examination finding would suggest cardiac tamponade as part of Beck's triad?

Answer: Hypotension, muffled heart sounds, and raised JVP

Beck's triad of cardiac tamponade consists of hypotension, muffled heart sounds, and raised jugular venous pressure (JVD).

When testing light touch sensation in the dermatome over the lateral aspect of the forearm, which nerve root is being assessed?

Answer: C6

The lateral forearm (including thumb and index finger) is supplied by C6 via the musculocutaneous nerve's lateral cutaneous branch.