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Internal Medicine | Medicine (MD/DO) School Study Aid
History & Physical Exam Skills
25 Picmonics to Learn | 54 mins
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Leukocyte Differential
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
2 mins
Casts in Urine (Differential Diagnosis)
- Characteristics
- RBC Casts
- Glomerular Disease
- WBC Casts
- Acute Interstitial Nephritis
- Acute Pyelonephritis
- Fatty Casts
- Maltese Cross Sign
- Nephrotic Syndrome
- Granular Muddy Brown Casts
- Acute Tubular Necrosis (ATN)
- Waxy Casts
- End Stage Renal Disease (ESRD) (Chronic Renal Failure)
- Hyaline Casts
- Non-Specific
2 mins
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Disseminated Intravascular Coagulation (DIC)
- Pathophysiology
- Bleeding State
- Activation of Clotting Factors
- Deficiency of Clotting Factors
- Causes
- Sepsis
- Trauma
- Obstetric Complications
- Acute Pancreatitis
- Malignancy
- Nephrotic Syndrome
- Transfusion
2 mins
Motor Neuron Signs UMN and LMN
- Upper Motor Neuron (Increases)
- Increased DTRs
- Positive Babinski
- Spastic Paralysis
- Clasp-Knife Reaction
- Lower Motor Neuron (Decreases)
- Decreased DTRs
- Negative Babinski
- Flaccid Paralysis
- Muscle Atrophy
- Fasciculations
2 mins
Glasgow Coma Scale
- LOC Assessment
- Score of 3 to 15
- 8 or Less = Coma
- Eye Opening
- Verbal Response
- Motor Response
1 min
Lung Sounds - Wheezes
- Location
- Throughout Lung
- Description
- High Pitched
- Sounds Like
- Musical
- Cause
- Air Moving through Narrowed Airways
38 secs
Lung Sounds - Crackles
- Location
- Lower Lobes
- Description
- Fine/Coarse
- Sounds Like
- Fine: Twisting Hair through Fingers
- Coarse: Velcro
- Cause
- Collapsed Small Airways and Alveoli "Popping Open"
1 min
Lung Sounds - Rhonchi
- Location
- Trachea and Bronchi
- Description
- Low Pitched Rumbling
- Sounds Like
- Gurgling
- Cause
- Narrowed Airway
- Secretions or Bronchospasm
49 secs
Lung Sounds - Pleural Friction Rub
- Location
- Anterior Lateral Lung
- Description
- Dry, Rubbing, or Squeaking
- Sounds Like
- Rubbing a Balloon with Finger
- Cause
- Inflamed Pleura
50 secs
Neurovascular Assessment 6 P's
- Pain
- Paresthesia
- Pulse
- Pallor
- Pressure
- Paralysis
1 min
Skull, Scalp and Hair Assessment
- Skull
- Inspect Size, Shape and Contour
- Inspect and Palpate Areas for Tenderness or Lesions
- Scalp
- Inspect for Tenderness, Lesions or Rashes
- Inspect for Dandruff
- Inspect for Lice or Nits
- Hair
- Inspect Quality and General Appearance of Hair
- Observe Hair Distribution
2 mins
Cognitive Abilities Assessment
- Mental Status Examination (MSE)
- Collecting/Organizing Objective Information
- Cognitive assessment tests
- Mini-Mental State Examination (MMSE)
- Montreal Cognitive Assessment Test (MoCA)
- Mini-Cog
2 mins
Head, Face and Neck Assessment
- Head
- Inspect Size and Shape of Skull
- Palpate Temporal Artery
- Face
- Observe Facial Expression
- Inspect Facial Structures and Symmetry
- Neck
- Look for Symmetry
- Check Range of Motion
- Inspect Lymph Nodes and Thyroid Gland
- Confirm Trachea is Midline
2 mins
Eye Assessment
- Inspect External Structures
- Eye and Eyebrow Symmetry
- Eyeball Alignment
- Inspect Eyeball Structures
- Examine Cornea and Lens for Cloudiness
- Iris and Pupil Shape and Size
- Pupillary Light Reflex and Accommodation
- P.E.R.R.L.A
2 mins
Nose Assessment
- External Nose
- Inspect for Deformity or Asymmetry
- Inspect for Inflammation and Skin Lesions
- Nasal Cavity
- Check for Nasal Obstruction
- Inspect Nasal Mucosa
- Note Discharge, Bleeding or Foreign Body
- Sinus Area
- Palpate the Sinus Areas
2 mins
Throat and Mouth Assessment
- MOUTH
- Inspect for Color, Asymmetry and Swelling
- Inspect Lips, Teeth, Gums and Oral Mucosa
- Assess Tongue
- THROAT
- Examine Pharynx with Tongue Depressor
2 mins
Reflexes Assessment
- Grading
- Hyperactive
- Hypoactive
- Deep Tendon Reflexes (DTRs)
- Biceps
- Triceps
- Brachioradialis
- Patellar (Quadriceps)
- Achilles Tendon
- Cutaneous (Superficial) Reflexes
- Plantar Reflex (Babinski Sign)
3 mins
Nail Assessment
- Observe the Nails
- View Index Finger at its Profile
- Look at Consistency
- Observe Color
- Check Capillary Refill
2 mins
Ear Assessment
- EXTERNAL EAR
- Inspect Position and Symmetry
- Inspect for Lesions, Drainage, Nodules or Redness
- Inspect Opening of Ear Canal
- OTOSCOPIC EXAMINATION
- Insert Speculum
- Position Scope
- View Structures
- Light Reflect
- HEARING ACUITY TESTS
- Whisper Test
- Weber’s Test
- Rinne Test
4 mins
Skin Assessment
- Inspect the skin
- Observe for Abnormal Skin Pigmentation
- Inspect for Cyanosis
- Observe Skin for Pallor
- Observe for Jaundice
- Inspect for Erythema
- Palpate the Skin
- Check the Temperature
- Observe the Skin for Moisture
- Inspect for Diaphoresis or Dehydration
- Check skin for edema
- Imprint Thumb Firmly for 3 to 4 Seconds
- Look for lesions
- Note the Characteristics
- Palpate Lesion
4 mins
Cerebellar Assessment
- Coordination
- Observe Rapid Alternating Movements (RAM)
- Touch Thumb to Each Finger
- Finger-Nose-Finger Test
- Heel-to-Shin Test
- Observe Gait
2 mins
ROM Assessment
- Types of ROM
- Active ROM (AROM)
- Active Assisted ROM (AAROM)
- Passive ROM (PROM)
- Upper Extremity
- Neck Flexion, Extension and Rotation
- Shoulder Flexion, Extension and Rotation
- Elbow Flexion and Extension
- Fingers and Wrist Flexion and Extension
- Lower Extremity
- Hip and Knee Flexion
- Hip Abduction and Rotation
- Ankle Rotation
- Toe Flexion and Extension
- Lumbar Rotation and Spine Inspection
4 mins
Gastrointestinal System Assessment
- Mouth
- Inspect Mouth, Jaw, Teeth, Gums and Oral Mucosa
- Inspect Tongue
- Palpate Areas for Tenderness/Lesions
- ABDOMEN
- Inspect Abdominal Quadrants
- Auscultate
- Percuss
- Palpate
- Light Palpation
- Deep Palpation
- Check for Rebound Tenderness and Ascites
- Rectum and Anus
- Inspect Perianal Area
- Palpate Rectum with Gloved Index Finger
6 mins
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