Physical Examination -2017

OCTOBER

1. morton neuroma pt had tingling in foot

2.knee examination(possibly osteoarthritis) DDs asked , had tenderness in medial lat joint line

3.GIT exam- aslo assess dehydration. I think the pt was mild dehydrated. give findins as you go with the exam .
the case was abd pain of a 27yr old man. i did not get any positive finding here. just non specific abd pain. Give
DDs

4. scrotal exam- possibly hernia or hydrocele or seminoma

5. Breast PE

6. Hand examination DD

7. pt with cough and SOb. 7 minute PE. explain diagnosis

8. 2 days ear ache 27yo. hx of previous ear aches. 2 minute hx. do PE on pt and manequin. looks like
cholesteatoma and otitis

9. right calf pain ask for history 2 mins. PE no ABI available. buergers negative. pulseless on fem artery
distribution. ? PVD

10. GCS for young man in coma and do PE on him to find the reason 

11. .Ear (cholesteatoma)

12.Ear plus cranial nerve exam ( facial nerve palsy)

13.tremor ,only upper limb examination (Dx ..BET)

September

1.ear examination

2.haematologi examination

3.Thyroid examination

4. Head injury- eye exam

5. Achilles tendenopathy-archelles tendonitis

Patient complaint of pain in the right ankle. It started after completing the intensive training of hiking.
(4weeks). The pain worse at the first steps from the bed in the morning and get worse during cycling
progressively and at the end of the day. No relevant medical history or taking any drugs.
Task: perform physical examination
Tell dx and ddx

6. blurred vision examination

Patient has involved in MVA. LOC + for 3 mins. P survey is done and all normal. Cervical spine injury
is excluded and collar is already removed. Patient complaint of blurred vision
Task perfom physical examination on head and vision. Report the findings to the examination while u
r examing
Explain the findings. Give reasons to patient

7. Parkinson

. Pt thinks has parkinson. PE. Task to Upper limb neurological exam and other examination you
would consider relevant. Gait normal , no shuffling or broad based, no head nodding ect. tone power
normal, no cogwheel ridgety, nomicrographic, - No signs - but has resting tremor - dx

8.Testicular cancer. 25 patient. with dummy. Task - PE explain to patient dx and dgx Inspection -
need to look at role player - cant see scar swelling redness etc. must wear gloves. swelling can get
above. fixed mass hard and not mobile. Palpated local lymph nodes. had to do a bit of breaking of bad
news. explained that mass hard, irregular, fixed and painless. most likely ca.Referral to specialists -
need further investigations. Do you want me to call someone ?

9.CVS w/ photo of a fundoscopy

CVS with fundoscopy pic. Man with 3 reeding of high BP. Came and did fundo - in stem. tasks: do
cardivascular examination and explain funduscopy to examiner and most likely condition.

CVS exam - including measuring BP with set. Role player BP normal. 110/70. JVP normal, carotid
pulse and bruit. Chest no impulses no deformity, apex beat ..... all normal. Funduscopy can see av
nipping and signs of oedema - correlates with hypertensive retinopathy. explained to examiner.

10.Acute AbD

11. sudden onset loss of vision of a patient with well controlled HBP, DM. perform focus eye
examination. discuss the diagnosis and d/d

12. neonatal examination

13. .lower limb tingling sensation. taking alcohol. lower limb examination

14. Lower limb neurological examination- diabetic neuropathy

15. .Scrotal examination- hydrocele

16. claw hand examination aft fall from tree

17. Hearing difficulty in Young lady. Ex Explain dx

18. breast lump exam

19.pancoast

20.tremor

21.PVD

22.Back examination

AUGUST

1. Breast examination

2. Haematological examination IDA

3. Thyroid – features of hyperthyroidism. T4 increased TSH low jittery patient

4. 17yr boy with bilat knee pain more on R. Tender on patella tendon but anterior drawers positive?

5. Respiratory examination post URTI. Do PEFR (3X was650) Non asthmatic

6. Clavicle # - apply triangular bandage. Xray displaced fracture no pneumothorax.

Management.

7. Back pain PE >>>> Sciatica

8. Scrotal PE

9. Diabetic Foot exam

10. Respi PE, peak flow meter instruction and interpretation

11. Respiratory examination and perform PEFR.

12. Gynaecomastia

13. Diabetic Peripheral Neuropathy

14. Rash exam

15.Abdominal exam

16.Upper limb exam

17.Ear exam

18.Middle age lady come with tingling in her right hand,worse at night,wake from sleepy amine
relevant examination,tell patient about Dx & causes
cubital fossa syndrome

19. Middle age lady come with tummy pain for 2days,worse last 24 hours back,passage of loose stool
for 2times,no past history of genitourinary & gastrointestinal symptoms
VS -temperature 38'C,other stable
Acute abdomen ,DDx with reasons to patient

20. Lady come with hearing problem in left ear...no relevant past history..healthy
Do relevant examination
Tell possible ddx with reasons to patient

21. Lady come with linear rash on left mid arm

Take history for 2min
Do relevant examination
Tell most possible dx & ddx with reasons

JULY

1. hyperthyroidism

2.cholangitis

3.Carpal tunnel syndrome

4.Ear exam-cholesteatoma
5. You are a HMO at ED. Next patient is 22 yrs old male patient who recently got left sided chest pain suddenly
while playing football. It get worse with deep breathing. Vital signs provided(all normal). Patient is given
oxygen via facemask.
Task:perform relevant respiratory examination(6mins),ask for CXR from examiner,explain CXR finding to
patient,explain most likely diagnosis and other possible causes

6. You are a GP. Next patient is 45 yr old professional lady who complaint of pain in right foot for 4 weeks.
Task:take relevant history,perform physical examination,explain condition with reason to patient

7. You are a HMO. Next patient is 10 days old baby brought in by mother for routine followup as suggested by
community nurse. Baby's weight,height,head circumference given.
Task:take history regarding pregnancy and delivery,perform examination on baby while explaining what you are
examining and why,summarize findings to mother.
(Fundoscopy and paediatric sthethoscope given)

8. You are a HMO. Next patient is 30 yr old lady who has headache and stomache. She passed watery brown
motions 4 time this morning. She vomitted old food once. No significant past medical history. No travel history.
No recent antibiotic. Does not have contact history.
Task:perform physical examination including dehydration assessment and abdomen,explain to the examiner at
every step about your finding,explain most likely condition to patient and differential diagnoses

9. Severe Headach Left temporal region ,with high Bp

Task: Do PE / dx/dd

10: Breast Examination

11: Neurological LL examination came with weakness in LL/Bp high/father had stroke

12. rash PE

13. eye examination with fundoscopic interpretation

14. scrotal examination

15. Diplopia exam

16.Hydrocele

17. . Man with burning feet. Ho long DM with poor control.

Tasks PE and telling finding to the examiner as you proceed n explain Dx ddx to patient with reasons.
Pt lying on bed. Examiner told to examine as on bed. So not checked gait n romberg’s test.
Reduced hairs in feet, dorsum, cold feet, CRT about 3 sec in Lt foot, reduced dorsalis pedis pulse in left
In both sides, Reduced pin prick ( pt said blunt, not sharp ) up to ankle, reduced vibration ? up to both knees, not
sure.

18. middle age lady upper abd pain and nausea, fever for few hours.
Perform PE, explain PDx n DDx to the patient.
Positive findings T 38.9? PR 110, BP no postural drop, RR 20 …
Tenderness and localized guarding in RHC, Murphy’s S positive, others said to be normal.

19. planter fascitis pe

20.lower abd pain with 7wk amenorrhoea pe

21.ear pe (cholestetoma)

22.unconscious pe (neck stiffness +)

23. Morton's neuroma-42 yr old professional with right foot pain- history, examination, give diagnosis and
explain to patient( no investigations or management)
24. CVS examination in a pt with murmur diagnosed 2 yrs back. Presents for examinarion for changes in
insurance policy-focus on cvs, exclude abdominal and leg examination. Examine, give running commentary and
tell patient what you think. (No investigations or treatment)

25. Bell's palsy-patient noticed change in his face when having breakfast. No change when he went to bed last
night. Able to swallow. Don't take history. Examination of relevant cranial nerves and dd( no mgmt). You vl be
given pictures when u give instructions for examination. There is a mannequin for examination when needed

26. Breast examination in a 27 yr old. H/o breast ca in Mom at the age of 54. Examine on plastic model. Give
diagnosis with management

27. . 40 + year old man, moderate alcohol drinker one bottle of wine a night, GGT high. Perform examination
on patient , giving running commentary to examiner , explain your assessment of liver status to patient

28. 17 year old boy complaining of knee pain , doing a lot of exercise, pain on climbing stairs..etc long
stem.Task Perform examination , explain diagnosis to patient

29. Knee joint examination ? Osgood

30. Claw hand deformity-hand exam

31. abdominal exam-RUQ pain.give dds

JUNE

1. Scrotal exam ( notice swelling in left side)

I saw herpes lesion on penis
Hard mass on left testes, think testicular tumor

2. haemato examination
Already gave inguinal lymph node enlargement. Don't need to do inguinal LN check again
Perform other examination, and explain finding to pts.

3. Focussed Abdominal exam + DRE in Mannequin

Bleeding PR , could feel haemorrhoids

4. Lower limb examination

Alcoholic neuropathy
B12 , folic acid was normal
GTT – deranged
Megaloblastic anaemia +

5. . Lady in ED , nausea + once vomiting

buzzing in left ear , Vertigo
deafness conductive / sensoryneural ???
Eye problems as well ( eye movement picture was shown in Ipad)
Other cranial nerves are normal.
( I Forgot to ask the task – I think It is PE station + DDs )

6. PE- 57 yrs old lady have noticed lump in rt breast. Task- perform PE (on mannequin) tell dx and dds to pt,
next inv to pt (findings- fard fixed lump in upper & outer quadrant)

7. Lady have severe lower abdominal pain, constipation with distension. Task- perform physical exam, PEFE
and tell dds to pt

8. Young man with features of Asthma. Task - perform relevant exam, demonestrate pt how to do peak flow,
interpret the peak flow record and tell pt the interpretation
9. Examination of a 10 weeks pregnant lady with micocytic hypochromic anaemia . There was a ldy lying on the
bed , i asked for vitals , examianer said – check it yourself – I took pulse and RR ( did waste my time ) .
Couldn’t finish the exam.

10. Examination of thyroid for a hyperthyroid patient

11. Amaurosis Fugax – had to do fundoscopy – Examiner gave me a picture ( A big one ) , explain the changes
to examiner , it was a very clear obvious picture of silver wiring , AV nipping, no soft or hard exudates . No
pappiloedema
It was long stem with loss of vision , for eye examination .

12. serotonin Pe

13. Pancoast exam

14. ear examination

15.rash on the hand examination

16. head injury blurred vision physical examination with fundoscopy

17 Scrotum (with manikin) hydrocele was present

Tasks - gain consent, do pe, explain dx, further invx (all with patient)

18.Ankle (typical case of archilles tendonitis)

Tasks - do pe, explain dx and ddx

19.Hand (tingling sensation in palm)

Tasks - do pe, explain dx and ddx
(No idea what the case was, positive findings were sens: loss on little finger, phalen's test+(which i missed)
T,M,P,Rx all normal
.
20. Ear pain 3rd episode . Manniquni provided for ear exam and tuning for k provided

21. . Sinusitis pe and history

22. Ear examination for ear pain with conduction hearing loss on one side

MAY

1. Lady have severe lower abdominal pain, constipation with distension. Task- perform physical exam, PEFE
and tell dds to pt

2. Young man with features of Asthma. Task - perform relevant exam, demonestrate pt how to do peak flow,
interpret the peak flow record and tell pt the interpretation

3. breast exam
27 year old , right breast lump, on OCP , maternal history of CA breast,
Task : perform PE on dummy. Give Dx Ddx. No further history or inv:

4. 47 yr old man, on anti-hypertensives and oral hypoglycaemic drugs. Long standing history of diabetes which
is poorly controlled. Complained of double vision.
Task :
PE Dx and DDx with reasons. ( needed to actually perform ophthalmoscopy and result was given with a photo )

5. 27 yr old woman with single episode of post-coital bleeding. No dyspareunia. On OCPs. The menstrual
history unremarkable. PAP smear 3 mths ago and normal.
TASK:
Pelvic examination
Most likely diagnosis with reasons
6. Secondary PPH. 10 day Puerperium work up. Currently Breast-feeding baby. Fever +
Task :
Relevant PE ( Pelvic examination : endometritis Fs)
History
Dx and D.Dx with reasons

7. breast exam fibro adenoma

8.eye exam hypertensive retinopathy

9. . Comma young man

10. Clavicle fractured

11. Neck injuries

12. Rash at the posterior calf ( PE)rash is non blanchable !!

Possible Dx

13. ear examination ( cholesteoma )

14. Ankle pain, archilles tendonitis

15.CLD - chronic alcoholic, GGT increase in stem, i cannot find any abnormality, some said there is huge liver
Task: Perform, explain liver status

16.Acute Abdomen - Dx and DDx

(lower abd peritonitis, urine preg test not done)

17.Scaphoid fracture
middle age lady fall on skateboard 2 days ago, Visited GP and reassured as sprain. now pain not relieved
Task: explain XRay, Perform , Dx and Inv, pe typical karen

18. Pid PE abdominal exam severe tenderness in lower abdomen and bilateral adnexal tenderness.

19. Young lady presented with rash. Had viral a week ago. Task: perform PE n relevant PE, tell likely diagnosis
n DDx, cause of condition

20. Young female with pain in one ear for 1 week. Hearing problem on left side. Task: perform PE , give
commentary, tell Dx n DDX

21. Pt fall on right shoulder now having pain. Task: perform PE, give commentary, tell Dx n DDx

22. Scrotal examination(which examiner confuse me i think didnt do well)

23. Eye examination (silver wiring and nipping)

i did everything from acuity and i ask about the distance she didnt tell me wether it is 6 meter she said u can tell
if u think it is ?? So i just did it and i said assuming it is like that, then movement then reflex then field lastly
fundoscopy i ask to turn the light off she smiled said we cannt and she told me no worries i just wanna see ur
way i just examin on side she gave me positive finding and she was smiling when finally i said i would like to
do upper and lower neuro , she said no worries already everything is so good

24. Hand exam post thyroid

Hand examination post thyroidectomy i did everything but nothing postive as pt had tingling and numbness
sensation ,then i saw sphegno. I just ask to do it for and trousseaus sign and she gave me positive finding so i
said it is due to hypoCa. And give other ddx like carpal tunnel or cubital tunnel or due to other arthritis problem
but unlikely.
 long scenario i just remember painful hand with tingling and numbness and pt had thyroidectomy couple of
weeks or days i think wss mentioned she is taking thyroxine and she had 2 occasions of hand problem
previously something like that.
Do pe and explain likely reason and other causes.

Hand examination i thibk she had scar at wrist and i said there was some muscle waisting but nor sure i just
comment wt i was able to see and feel , troussueos sign come positive so not sure if she pretend that or was real

APRIL

1. 6/8 years old Tom came with his mother with right knee pain , refuse to walk for 1-2 days.he was very active
playful boy, got a history of injury 1 week before at school,his granny got arthritis, Task:
history, p/e, diagnosis n differentials, management In p/e: right knee was ok,
restriction of movement of right hip,

2. Middle aged man Damien came with all feature of hypothyroidism. He gained weight, felt cold, had
constipation. His Mother had autoimmune disease. Task: perform physical examination , probable
diagnosis . ( patient got cold n Sweaty hand. Rest of the things were normal. Don't
forget jerks. Patient kept himself exposing to get his jerks examined . Biceps triceps ankle knee jerks were
good. Examiner came closer to check during ankle jerks.).

3. Acute abdomen. Middle aged woman( forgot the age. One candidate remember she was old enough) came
with tummy pain. Task: examination. Possible causes . ( there was generalised pain all over abdomen,
maximum intensity to left side, epigastruc point, mc burney , Murphy all were tender, though there was no
distension or no rigidity girding. I asked per vaginal( though not sure it was relevant / not, examiner told me
bilateral Adnexal tenderness present. Cough impulse tender but no herniation. )

4. An old man came with shakes. Shakes aggravated in stress n problem in manual tasking. Worried about
perkinson as he had someone in his family with perkinson. Task: examination of upper limb for tremor,
n additional examination. Possible cause.

5. 42yr old lady co wilt pain in the left lower abdomen..

I did as usual and give
Dx-diverticulitis

AMC's feedback- abdominal pain - pass

6. Lady with blurred vision

Had hypertension well controlled
Currently on ARB.
tasks- ho,pe (silver wiring in fundoscopic but,normal va and vf), explain

AMC's feedback- visual disturbance- pass

7. Thyroid PE

AMC's feedback-health review- pass

8. PE- benign essential tremor

AMC's feedback-shaky hands-pass

9. chedt pain, pr bleeding

Examination
Examined the abdomen and did a pr on a mannequin, wear gloves, put lignocain and tell the pat,. Inspect and
put ur finger
Dx i said i am not sure could be ca causing bleeding

FB pass
10. ear examination
Dx wax
Mx drops to dewax and review after 3days

Fb hearing problem: pass

11. A middle age man who is having chest pain on activity, heart racing, pain radiating to arms and shoulder and
had episodes of bright blood in stool....
Task: 1. Talk to him and gain consent for examination
2. Do abdominal examination
3 do DRE
4. Explain the most likely diagnosis with patient( maybe mesentric ischemia but I missed it)

12. A young man with unilateral hearing loss....

Task: do relevant examination and tel him the cause and what you are doing( on otoscopy of dummy there was
cholesteatoma

13. A young man who was taking anabolic steroid presented with bilateral breast enlargement
Task: 1. Do Examination
2. Tel the patient the cause

14. Abd pain

Either it is a medical/surgical case or it is a physical examination case
PE – Handbook p202 or Tally o’connor
Medical case: read Chapter 35: Abdominal pain, John Murtagh 5th ed. p308-28

15. Diabetic foot

Either it is a medical case or it is a physical examination case.
Medical: foot pain DDx: Diabetic foot ulcer, PVD, DVT, cellulitis, varicose veins, injury, etc.

16. Scrotal examination

As previous recalls.
DDx: varicocele, haematocele, hydrocele, swelling of epididymis, testicular tumour, inguinal scrotal hernia
(John Murtagh 5th ed. p1059, Tally o’connor)

17. . Tremors with risperidone (PE)

- Tremour examination: DDx: Parkinson disease, hyperthyroidism, cerebellar disorder, chronic alcoholism,
benign essential tremor

18. Woman 57 yr or so come with stress incontinence symptoms. Task Pelvic exam, explain diagnosis. With
reasons. Cough test urine leaking.

19. Fall on hand 1 month, Initially X-ray normal, pain going on, come for check up. Task examination hand,
explain X rays, further investigations. Got scaphoid findings.

20. 37 yr man, send from blood bank as he come to donate, BP 170/ 100. Task examination of CVS. Then
explain patient his condition as well as explain him given fundoscopy findings. ( need to do BP as well, need to
change BP cuff size as it is Paedi cuff, fundoscopy show silver wiring for sure)

21. ED, A middle age woman with tummy pain since last night. Pain in the epigastrium and chronic alcoholic
and she smoked one to two cigarettes for years. Otherwise normal.
Tasks- Perform relevant examination with running commentary to examiner
- Explain Dx and DDx with reasons to patient
Positive findings- Patient was irritable with pain, and not cooperative at all. Tenderness the whole abdomen and
more prominent on epigastrium, No rigidity and guarding. I turned to the examiner and told that I would like to
skip to test organomegaly and percussion to test free fluid coz my patient is in deep pain. The examiner said it
was OK. But it did percussion to access liver dullness obliteration present or not. Bowel sound was absent on
Auscultation. Murphy sign was positive but I didn’t do other special tests. PR and VE were normal. I forgot to
mention ECG and other bedside tests.
Dx – Acute abdomen probably acute pancreatitis.
22. GP, 72 year old man with headache for 3 months, Jaw pain while chewing for 2 months and weight loss for
2-3 kg in a few months
Tasks- Perform relevant examination focusing on head and neck
- Explain Dx and DDx with reasons to patient
Patient was a very cooperative Aussie chap. The only positive finding was the patient scream out loud when I
feel his left temporal area. No dilated vessel was observed. When I examined the eye and ENT, the examiner
assessed me how to assemble and use fundoscope and otoscope but no need to examine the patient. (some
candidates needed to do those) Both were normal. Visual acuity, visual field and LAMP were normal. I saw
tongue depressor but I had no idea where to examine. (thought it was for tenderness over teeth)
Dx- Temporal arteritis

MARCH

1. Right lower abdominal pain Exam ? ectopic ( She looks really pale. I start examination with vital sign
the examiner very nice I said I need watch. he said pulse normal I start the Bp then he give me all the vital
signs. I quickly check the face then Jvp , then abdomen and ask patient where is the pain? pointed to me I
did full examination then i said the patient has week pt positive. I want to do vaginal examination I need
the patient consent and I need cheparone for examination then the examiner give me all the examination
cervical excitation positive retroverted, bulky uterus no fluid in pouch. I said I need USD. Pending. I turn
to the patient and said most probably you have a condition we called it an ectopic pregnancy I already
informed the obstetrician. we need USD to confirm it. it's a pregnancy but not in the womb it's outside. Tx
will be decided by specialist. you will be in safe hand. forgot to do appendicitis exam.

2. Post MVA, exam regard to blurred vision.

Ok trauma case beautiful young girl she had MVA and complained from blurry vision. Tasks- to check the
vision I asked if the patient has any pain. look she sit comfortably, no sob, no change in conscious then I
inspect the head, eye, nose, ear, neck then I explain to her what I need to do. today I start with VA, Pupil,
VF, color vision – all normal. then I hold the ophthalmoscope I asked to dim the light the examiner said we
can't do that then I said I will adjust the light and start the examination. the examiner said okay
examination done. and the finding there. he gave me beautiful picture of fundoscopy and said read it to
me I said here is the nerve, arteries, vein and fovea all are normal there is no bleeding, no cupping then I
said I need to do eye movement the examiner didn't said anything it was normal too. he said talk to your
patient I said look I am happy all the eye examination went normal but because you have problem in your
vision I inform the specialist who will come and check you again and might be do further Invx such as ct
scan.

3. . Scortal examination

Scrotal examination.Acute pain in 22 yrs old .Penile discharge ,Erythema ,tenderness,Prehns sign
positive.Case epidydmitis.Tell the pt diagnosis---credit to Huma nadeem

Non-tender lump on right side of testis for 3 months • Scrotal Exam on dummy + actor next to dummy •
Right varicocele- snail like • Left side- larger testis • DDx & reasons----another one

4. Amuroxis fugax . relevant PE only

5. LMN facial palsy+ otoscopy in a manikin

6. Middle aged lady present with tummy pain, loose motion and vomiting a few times containing food
materials. Stool was dark brown no blood. No recent travel H.
Task :Assess dehydration status of the patient,tell examiner about your findings.
Perform abdominal exam, Mention pdx, ddx to patient.

(positive findings : skin turgor sluggish, cap refill normal, BP normal, no sunken eyes, no dry tongue,
patient feeling thirsty a bit. Abdominal examination deep tenderness present on whole abdomen, no signs
of perforation, hepatosplenomegaly absent, PR and VE Examination normal, bowel sound normal, even
did fluid thrill also negative) Mention Gastroenteritis,Typhoid, non specific viral diarrhoea :p,
7. 25 year lady present with repeated ear infection, unilateral deafness Task:Perform Examination
(present findings to examiner) , mention dx explain with reasons
(examiner ask to wear gloves at the start of Examination, unilateral conductive deafness, external ear
normal, ENT clear, tuning fork 256 & 512 provided, Weber laterlization, Rinne bone>Air, Otthoscope on
dummy, but have to tell patient while doing on dummy, pulled ear and use respective orthoscope used,
tympanic membrane not visible, filled with wax like materials, mention cholesteatoma and wax

8. 30yr old male with foot painTask: hx, Perform pe with running commentary to patient, Dx and ddx Pain
in top of foot over second and third toe. Worsens as day progresses. Didn't say whether it was relieved
after taking the shoe off. Has joined walking club lately. Test for Morton's neuroma positive

9. 55 yr with uncontrolled diabetes. Hbaic 11% . C/o burning pain in legs. Task: perform sensory
neurological examination with commentary to patient Most likely dx and ddx
L4-S1 cotton and pinprick lostSole monofilament lostVibration at tibia, Joint position lost 11. 27 yr old
female with maculopapular non blanching non pruritic rash in the lower legs. Viral URTI last week. Task :
perform pe with running commentary to examiner Tell likely dx and ddx to patient

10. 55 yr old came after FNAC of right neck lump. Chronic smoker for a long time. Has noticed some
weakness of right hand Task: perform focused upper limb neuroPerform focused examination to find the
cause of the massExplain dx to pt C8T1 power reduced, Respi exam normal I said I want to check vision,
examiner gave me pic of Horner's

11. vaginal bleeding not pregnant stable relationship, perform relevant PE (when you come to pelvic
exam examiner gives you findings of fibroid.. )

12. young teen with bilateral knee pain..perfom PE ( Osgood Schlatter’s, pain in tibial tubercles bilat )
OSD. Positive findings: bilateral tenderness on palpation of tibial tuberosity r>l; bilateral crepitations on
passive ROM.

13. - gynecomastia pt using anabolic steriods perform relevant examination

reg case of gynecomastia with anabolic steroid use. Apart from Vitals, abdominal ( central obeisty, striae,
moon face and upper back hump) and breast exam( unilateral/bilateral, tenderess or no,masses,
discharge and FH of Ca) .
Other dds of gynaecomastia: CLD, Drugs s/a anabolic steroids, Digoxin, Cimetidine, etc, Klinefelter
syndrome, testicular tumours
what additional points shall we stress in exam of this pt

14. fall from tree. do upper limb neuro exam and further relevant exam.

15.ear examination

16.Acute abdomen

17. Footdrop lower limb examination.

( Common peroneal Nerve palsy, )

18.Lt side abdominal pain examination

19. Tibia fibula fracture examination

open fracture tibia fibula
post Mva patient .. X-ray given .. patient has bandage on and you are not supposed to remove it ..vital
signs bit deranged but yet stable ..

Task
examine the patient and explain X-ray and tell diagnosis and management .

Positive findings
on inspection= bandage blood stained , patient teary
can only wiggle toes , sensations and circulation normal.
20.Female with 7 wk pregnancy rt side abdominal pain examination
female patient with pain in right iliac fossa for one week ,now got worse ,, her pregnancy test is vaguely
positive and 7 weeks amenorrhea.

Task
1)physical examination
2)tel most likely diagnosis

positive findings
tenderness right iliac fossa
uterus enlarged and retroverted , adnexa tender ..(CERVICAL EXCITATION /CMT IS NEGATIVE)

21.TIA examination with lower limb examination and relavent ex.

Tia/stroke physical examination

patient with weakness in right lower leg,upper limb neurological examination and gait normal and
cranial nerves are normal .patient has high blood pressure160/90

Task

physical examination of lower limb and examination of relevant system

Positive findings

tone increased on right side , power decreased on right side , reflexes normal, sensations and
coordination nornal ,, normal examination of heart and no carotid bruit , no Afib.

22. non organic abdominal pain ..

Task
History
physical examination
diagnosis and management

positive findings
periumblical pain ,
stressor: grandma colostomy tube
Ex all normal .

23. acute abdomen physical examination

pt having pain in left iliac fossa ..
Task
physical examination
diagnosis and d/ds

positive findings
1)tenderness right iliac fossa and rebound tenderness .temp=38

24. Parkinsons disease exam

25. Carpel tunnel syndrome ,PE,and Dx

A factory worker is coming 50 something,with complaint of tingling in hand,so on findings he gives you
decreased sensation on median nerve,prayer sign and reverse prayer sign's positive,no issue with
movements of thumb,

26.CLd inch tape and torch given

An alcoholic is here,he said that he will quit alcohol last time but hasn't been able to i guess,drinks 8-10
SD daily,do CLD examination and explain what you have found to the patient in the last.during
examination,findings to the examiner.

27.Breast exam right upper outer q mass

same case,but i don't know why the examiner didn't seem happy with my examination.mother had hx of
CA. :-(

28.Ear exam ? Wax ?cholesteatoma

so need to know how to use otoscope.deafness on left ear.

29. PE.
Peripheral Neuropathy.
Hb A1C and B12 normal.
Positive Alcohol plus macrocytosis in history.
Task. PE
Diagnosis. Roomberg plus all sensations lost over both feet.
Said Alcohol Neuropathy.

30. Haematological exam.

Young female going for nasal surgery. Had history of low platelets before.
Tasks.
PE. Only pallor was positive.
Explain condition.
I said will do further investigations to rule out the cause.

31. Planter fasciitis PE

Plantar fascitis
A man complains of foot pain for past 3 months, worst in morning when he steps out from bed
Tasks
A)PE
B) Dx
On PE pain on heel and walking, tenderness on heel positive and Windlass positive

32. Endometritis PE
A young lady comes to the GP with heavy bleeding, she is 10 days post partum and had a normal NVD. Task
was to perform PE and give dx

I started with hemodynamically stability , asked few hx qs regarding bleeding and any discharge, calf pain .I did
GA , Vitals , quick chest examiner said normal and on PA examiner said uterus palpable 2 cm above the
symphysis pubis and tender on superficial palpation , Didnt do deep palpation. I asked to do PV. He said that
everything was normal except uterus was tender

33. Breast lump examination

A lady has come with complaint of feeling a lump in the right breast. Her mother had breast cancer.
Task
A) PE
B) Further management
There was a manequin but while doing PE i was saying that ideally i would like to inspect the breasts with hands
on hips , by side and behind the head. So the real patient was doign whatever I asked
FEBRUARY

1. Cyclist, lady, 30yo, pain worse in morning, pain worse cycling (long stem) • Foot exam (6 minutes)-
Ruptured Achilles tendon- plantar fasciitis, • Patient freaked out when doing special • Nothing on
inspection • No tender spots on ankle • DDx with reason

2. 60 yo, wants to know if patient has Parkinson’s, you’re GP intern • Parkinson’s Exam with commentary
to Examiner • Positive Findings o Hypomimia o Bradykinesia o Stuporous person • Gait normal • No
micrographia • Counsel • Neurology opinion • CN + full neurology exam

3. Scrotal exam

4.Thyroid exam

5.Headache in the stem asking for head examination ( not sure what it was)

6.Unsteady gait ( neuro examination) all the cerebellar signs were positive

7. Atopic rash- Child with rash all over the body and itching.
Take history
PE
Management

8. Cubital Tunnel Synd exam

Lady having funny sensation on fingers Lt hand.
Do PE
Explain diag and D/Ds

9. Ear exam
Lady with pain at Left ear.
Take history
perform physical examination (Did whisper, Rinny and Weber tests on role player, the rest on a
mannequin, describe the otoscopic findings that is present on the mannequin)
Management.

10. Hand exam

Boy had fall from skateboard. Did x ray yesterday and another gp said sprain and send him home. Today
came back coz of pain.
Perform physical examination (+ve signs for scaphoid fracture)
Diagnosis
Another imp investigation.

11. 30yrs old in third trimester presents with headache so all tests done,Showed protein urea.Task is to
do physical examination and management

12. Examination of breast lump with DD and investigations.

13.Glosgow coma scale on a girl found unresponsive in her department.Tell 4 reasons for her state.

14.hand pain examination.commentary to examiner and likely diagnosis

15. patient with neck and shoulder pain,History,PE, DDs and investigations.

16. breast examination on manikin. I could feel fibroadenoma. Others could do as well, but some couldn't.

17. hand examination. Real patient. I could appreciate sausage shaped fingers and butterfly rash over face,
others just said it's nodules due to RA. Tell differentials. I told about all.

18. neck pain,cervical spondylosis PE

19. Breast exam, 57 yo lady, lump on Rt breast. Worried as mother Dx as CA Breast in her 60s’.
Perform PE, likely DDx, further Invx.

20.Acute abdomen, middle age man, sudden severe pain in upper abdomen, alcoholic.
Perform PE, likely DDx with reason.

21.young man with nasal congestion

Hx, Perform PE, likely Dx, Mx. ( ? sounds like common cold from Hx, not too sure )
1 fb comment - maxillary sinusitis

22.Clavicular # ( handbook case ) ( sling on table )

Explain XR & its implication to the pt. Perform relevant PE. Initial Mx with material given

23.Diabetic foot exam. DM 10 yrs, has both calf pain and some other /s.
Perform PE, likely Dxs.