This is a collection of all the Checklists in the common.

Everything gathered here, organized, illustrated, to

prepare you for the Active OSCE.
This was done in 2017, anything before this year is included, what is after is not included.
Done by:
Abdulrahman Awil
Eid alAgha
Ahmad alMhammadi
Bassam Yaghmoor

Abdullah AlZahrani - SC
 Index
Disorder’s Name Page
Diarrhea 3
Fever 4
Asthma 5
Chest Pain 6
Lower limb swelling 7
abdominal pain 8
SOB 9
Upper GI bleeding 10
History

Weakness 11
Headache 12
Jaundice 13
thyroid disorder 14
Hemoptysis 15
joint pain 16
Anemia 17
pregnant lady history 18
Diabetes Mellitus 19
Hematemesis and melena 20
chronic cough 21
Infective endocarditis 22
Lower Motor Examination 23
Examination

Local Neck Examination 24

General CVS Examination 25
Cerebellar Examination 26
Cranial Nerves Examination 27
Thyrotoxicosis Examination 28
Right Sided Heart Failure Examination 29
General GIT Examination 30
Local GIT Examination 31
General Respiratory Examination 32
Local Respiratory Examination 33
 History of Diarrhea
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission/ Explain what she will do
4. Onset
5. Duration
6. Frequency
7. Volume
HPI

8. Presence of blood or mucus

9. Offensive smell
10. Floating
11. Previous similar episodes
12. Associated abdominal pain
Associated symptoms

13. Associated fever

14. Weight loss
15. Alternates with constipation
16. Intolerance to certain food
17. Other GI symptoms
18. History of travel
Risk Factors

19. Contract with infected patient

20. History of eating in uncertain place/ exposed food
21. Residency
22. History of medication e.g. antibiotics & laxatives
23. History of thyroid disorders
24. History of irritable bowel syndrome
PMH

25. Previous surgery or radiation to the abdomen

26. History of tumors
27. History of immune diseases e.g. AIDS Or recurrent
infections
28. Thank the patient
 History of Fever
A 25y/o patient presented to the ER with history of fever for 3 months. Ask relevant
question
1. Greeting the patient
ID

2. Introduce yourself to the patient

3. Ask for permission
4. Onset (acute / gradual)
5. Progressive
6. Duration
HPI

7. Pattern (intermittent / relapsing / persistent)

8. Aggravating factors
9. Relieving factors
10. Loss of weight
11. Skin rash / Hair loss
12. Mouth ulcers
Associated symptoms

13. Joint pain

14. Loss of Appetite
15. Nausea
16. Vomiting
17. Jaundice
18. Cough with / without hemoptysis
19. Diarrhea with / without blood or mucus
20. Headache
21. Neck pain / stiffness
22. History of TB
23. History of Rheumatic fever
PMH

24. Allergy
25. Blood transfusion
26. Recent travel
27. Pets or any animal in the house
Social Hx

28. Contact with TB patients/ with patients with similar illness

29. Ingestion of raw milk
30. IV drug abusers
31. Drug ingestion
32. Take family history
33. Thank the patient
 History of Asthma
A 17y/o boy known asthmatic presented to the ER with history of wheezy
chest. Ask relevant question.
1. Greeting the patient
2. Introduce yourself to the patient
ID

3. Ask for permission

4. Occupation
5. Duration.
6. Onset (sudden/gradual).
7. Diurnal variation of the symptoms.
HPI

8. Severity (Affect life style or sleep).

9. Previews similar attacks
10. Hx of eczema or allergic rhinitis
11. Associated Ask all the respiratory symptoms
12. symptoms Shortness of breath
13. Chest tightness
14. Cough
15. Inhaled allergens at home (pets – cockroaches)
16. Exercises. (typically develop 5 to 15 minute after exertion).
17. Tree or grass (seasonal variation)
18. Smoking exposure (at home or outside)
Risk Factors

19. Indoor or outdoor pollutant & irritant: Fumes, wood-burning,

painting, etc.
20. Work place: does the pt have the symptom during but not
during the weekend.
21. Symptoms of rhinitis.
22. GERD.
23. Medication use: NSAID, aspirin, beta-blocker.
24. FHx of atopy (or asthma): allergic rhinitis or atopic dermatitis.
25. Respiratory infections
26. Use of home oxygen
27. Use of Ventolin (frequency or PRN).
Social Hx

28. Use of steroids

29. Affect daily activity
30. Frequency of exacerbation of the attacks and ER visits.
31. ICU admission
32. Thank the patient
 History of Chest Pain
1. Greeting the patient
2. ID
Introduce yourself to the patient
3. Ask for permission
4. Site
5. Onset (sudden / gradual)
6. Character (tightness / crushing / burning / stabbing)
7. Radiation
8. Aggravating (walking/ exercise/ breathing / relation with meals)
HPI

9. Alleviating factors (rest/ nitroglycerin / leaning forward /

Antacids)
10. Duration
11. Does it increase with breathing
12. Severity (life style affection).
13. Dyspnea
Associated symptoms

14. Vomiting & nausea

15. Heartburn
16. Hemoptysis
17. Cough / fever / Sputum
18. Relation to meals (Increase / Decrease with meals)
19. Palpitations
20. Intermittent claudication (calf pain during walking and relieved
by rest)
21. Hx of DM
Risk Factors

22. Hx of hypertension
23. Hx of drugs especially oral contraceptive pills
24. Hx of hyperlipidemia
25. Smoking
26. Recent Hx of trauma
27. Thank the patient
 History of Lower limb edema
55 years old Yamani male came to your clinic complaining of lower limb
swelling complete the history…?
1. Greeting the patient
ID

2. Introduce yourself to the patient

3. Ask for permission
4. Duration
5. Onset
HPI

6. Progression
7. Uni/bilateral
8. Pain
9. DDx: Heart Dyspnea
10. failure ? Orthopnea
11. Paroxysmal nocturnal dyspnea
12. Chest pain
13. DDx: Liver Abdominal pain
14. disease ? Abdominal distention
15. Weight gain
16. Fever
17. Vomiting
18. Pruritis
19. DDx: Change in urine amount
Nephropathy? Change in urine Color
20. Myocardial Infarction
21. Heart failure
22. Renal disease
23. Liver diseases
PMH

24. Allergies
25. Blood transfusion
26. Duration
27. Diabetes
Medication compliance
28.
Mellitus
Complications; Diabetic retinopathy
29. Past surgical history
30. Social Hx
31. Family history
32. Thank the patient
 History of Abdominal pain:
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Onset
Acute or Gradual
Intermittent or continuous
5. Duration
6. Nature
HPI

7. Colicky
8. Constant
9. Radiation
10. Does the pain wake you at night
11. Is it related to meals, defecation, or menstruation
12. Weight increasing or decreasing
13. Loss of appetite
Associated symptoms

14. History of fever

15. Nausea or vomiting
16. Change in bowel habit
17. Any relieving factor
18. Any hematemesis or melena
19. Blood or mucus in stool
20. History of jaundice
21. Any abdominal surgery in the past
22. Any history of drugs like NSAID, steroids or aspirin
PMH

23. History of alcohol ingestion

24. History of diabetes
 History of Shortness of Breath:
1. Greeting the patient

ID
2. Introduce yourself to the patient
3. Ask for permission
4. Onset (acute/progressive)
5. Frequency of attacks
6. Variation throughout the day
7. Aggravating factors
Cold weather 
Dust/fumes/smoke
HPI

Exercise
8. Severity
How far can they walk?
Can they climb stairs?
Can they do daily activities?
Can they walk from room to room?
9. Fever
10. Cough (with sputum? Haemoptysis?)
Associated

11. Wheezing
symptoms

12. Orthopnoea/PND
13. Ankle swelling
14. Chest pain
15. Onset (sudden/progressive)
16. Increases with respiration?
17. Previous hospitalization/ER visit
18. Chronic diseases
19. Treatment history (inhalers/oxygen)
PMH

20. Allergies
21. Blood transfusion (type? When? Why? Where?)
22. Oral contraceptive pills
23. Immobilization/recent surgery
24. Smoking
Social Hx

25. Duration
26. Number of cigarettes per day
27. Alcohol
28. Occupational history
29. Family history
30. Thank the patient
History of Upper Gastrointestinal Bleeding
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Amount
5. Colour
HPI

6. Frequency
7. Previous episodes
8. Repeated vomiting 
9. Abdominal pain
10. Heartburn
11. Dysphagia
Associated symptoms

12. Dyspepsia
13. Appetite loss
14. Weight loss
15. Fever
16. Chest pain
17. Constipation/diarrhoea
18. Cough
19. Haemoptysis
20. Shortness of breath
21. Symptoms of anemia
22. Previous GI bleeding
23. History of liver disease
24. History of bleeding tendency (easy bleeding or bruising)
History of peptic ulcer
PMH

25.
26. Chronic diseases
27. Previous endoscopy/surgery
28. NSAID & medication
29. Alcohol
So Hx

30. Travel history

31. Smoking
32. Family history
33. Thank the patient
 History of Weakness:
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Onset (acute/progressive)
5. Location
Proximal/distal
One side/both sides of the body
Ascending/descending
Symmetric/asymmetric
HPI

6. Course through the day (progresses? Worse at…?)

7. Severity
Difficulty in climbing the stairs?
Difficulty in getting up from the chair?
Difficulty in combing hair?
Increases after exercise?
8. Similar previous episodes
9. Headache
10. Facial drooping
Associated symptoms

11. Difficulty in swallowing

12. Visual disturbance/double vision
13. Eye lid drooping
14. Paraesthesia (tingling sensation)
15. Tremors/seizures
16. Behavioural changes
17. Fever
18. Night sweats
19. Rash/mouth ulcers/joint pain/hair loss
20. Weight loss
21. History of diabetes
22. Thyroid disorders
PMH

23. Drug history (+steroid use)

24. Allergies
25. Blood transfusion (type? When? Why? Where?)
26. Smoking
Hx
So

27. Alcohol
28. Family history
29. Thank the patient
 History of Headache
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Onset
5. Duration
6. Frequency
7. Duration of each attack (Acute/Chronic)
8. Site (frontal/occipital/temporal/generalized) (unilateral/bilateral) 
9. Radiation
HPI

10. Character (dull aching/squeezing/stabbing/throbbing)

11. Progression
12. Severity
13. Aggravating factors (smell/eating/cough/sneeze/exercise/light/other?)
14. Relieving factors (medication/sleep/compression/food/position change)
15. Diurnal variation (worse at morning/evening/night)
16. Fever
17. Neck pain
18. Muscle Tenderness
19. Sweat
Associated symptoms

20. Nausea
21. Vomiting
22. Dizziness
23. Seizures
24. Runny nose
25. Blurred vision/vision loss
26. Photophobia
27. Teeth and jaw and Ear pain
28. Fatigue
29. Loss of consciousness
30. Previous episodes
31. Previous history of head injury
PMH

32. Previous history of frontal sinusitis

33. Medications
34. Vaccination
35. Travelling
36. Family history
37. Social history
38. Thank the patient
 History of Jaundice:
1. Onset (Acute / Progressive)
2. Pain: (Colicky / Dull aching / Constant)
3. Pain in Relation to meals
4. Pain Location
Epigastric
right hypochondrial
5. Pain Radiation
back
shoulder
6. Fever / chills
7. Loss of weight /appetite
8. Change in color of urine
9. Change in color of stool
10. Pruritus
11. Malaise /myalgia
12. Abdominal distension
13. Confusion
14. Edema
15. Alcohol
16. Drugs
17. Prior biliary surgery
18. Blood transfusion
19. Travel
20. Family history of liver disease
21. History of inherited diseases
22. previous history of jaundice
23. mouth ulcers, rashes, joint pains, hair loss
24. Thank the patient
 History of Thyroid Disorder:
1. Onset
2. Weight
increase weight with decrease appetite
decrease weight with increase appetite
3. heat and cold intolerance
4. lethargy
5. bowel habits
Diarrhea
Constipation
6. poor memory /mental slowness
7. arthralgia
8. puffiness around the face
9. change in voice
10. changes in the skin- dry and thick
11. loss of hair
12. irritability
13. increase sweating
14. palpitations
15. tremors
16. swelling of the neck
17. protrusion of the eyes
 History of Hemoptysis
55 years old Yamani male came to your clinic complaining of lower
limb swelling complete the history…?
1. Greeting the patient
2. Introduce yourself to the patient
3. Ask for permission
4. Duration
5. Amount
6. Cough
7. Fever
8. Loss of appetite
9. Nocturnal sweating
10. Chest pain
11. Shortness of breath
12. Bleeding tendency
13. Joint pain
14. Lower limb edema
15. Rashes
16. Smoker
17. Contact with TB patient
18. Drug history (warfarin, aspirin)
19. Thank the patient
 History of Joint pain
1. Age of onset
2. Location
3. Duration
4. Nature: (persisting / intermittent / flitting)
5. Character: sharp or aching
6. Radiation
7. Relieving or aggravating factors
8. Does it affect the mobility
9. Stiffness:
10. Morning or evening
11. Duration of stiffness
12. Severity of stiffness
13. Joint swelling:
14. Location
15. Number of joints
16. Persistent, intermittent, progressive
17. Loss of weight
18. Fever
19. Changes in the skin (vasculitis or psoriasis)
20. Loss of hair
21. Changes in the nails
22. Eye pain or irritation, dry mouth
23. Change in bowel habit
24. Urethral discharge
25. Loss of sensation in any part of the body
26. History of mouth ulcers
27. History of recurrent abortions
28. Any similar family history
29. Thank the patient
 History of Anemia:
1. Onset
Acute
Gradual
Life Long
2. Diet (vegetarian, poor diet)
3. Epigastric pain / heart burn
4. Hematemesis
5. Color of stool
6. Melena
7. Hematochezia
8. Nausea and vomiting
9. Loss of appetite and weight
10. History of bleeding:
Nose
Mouth
Piles
11. Drugs (NSAIDS, aspirin)
12. Menstrual history; menorrhagia
13. Alcohol ingestion
14. Diffuse pain and chest pain; sickle cell anemia
15. Family history of anemia
16. Repeated blood transfusion
17. Jaundice; hemolysis, chronic liver disease
18. Fever, mouth ulcers, joint pains, loss of hair
19. Lethargy
20. Palpitations
21. Drowsiness
22. Headaches
23. Dizziness
24. Syncope
25. Stocking; glove paresthesia
26. History of renal failure
 History of Pregnant lady
1. Greeting the patient
2. Introduce her/himself
3. Explain what you will do
4. Nationality
5. Marital status / Duration of Marriage
6. Job
7. LMP / sure, normal, use of OCP
8. EDD & GA (ask student to move to next question)
9. Any current complaint
10. History of current pregnancy (when diagnosed, symptoms of
pregnancy, fetal movement, medical advice, medication)
11. Past obstetric history (details of each pregnancy)
12. Past medical history
13. Past surgical history
14. Allergy to drugs and food
15. History of blood transfusion
16. Review of symptoms (ask student to move to next question)
17. Social history (partner history, life style, environment)
18. Family history (medical disease, congenital anomalies,
consanguinity, twins)
19. Thank the patient in the end
 History of DM
Take history from A 53y/o patient regarding his disease, complication and
compliance on medication
1. Greeting the patient
2. Introduce yourself to the patient
3. Ask for permission
4. Polyuria.
5. polydipsia and polyphagia.
6. Nocturia, number of times he wakes to pass urine.
7. Hypoglycemic Attacks
8. Sweating
9. Palpitation
10. Fatigue
11. Lethargy
12. Loss of consciousness
13. Weight loss
14. Type of treatment: insulin or OHA
15. Compliance to treatment and diet.
16. Compliance to follow up.
17. Compliance to Diet
18. Regular glucose monitoring.
19. Cardiovascular Complication
(Chest pain, SOB/intermittent claudication/foot ulcers/hx of
transient ischemic attack/stroke/MI/angina)
20. Autonomic Neuropathy Complication
(Postural hypotension/impotence/sweating/diarrhea)
21. Neurovascular Complication
(Numbness / paresthesia)
22. Retinopathy Complication
(Visual disturbance/ laser surgery)
23. Nephropathy Complication
(frothy urine / hematuria)
24. Previous admission to control the blood sugar or hypoglycemic attacks
or ketoacidosis.
25. Previous admission for control of diabetes or other complications
26. History of dyslipidemia.
27. History of smoking.
28. Family history of diabetes.
29. Thank the patient
 History of Hematemesis and Melena
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Amount
5. Color
HPI

6. Frequency
7. Melena—large amount, how many times
8. Severity (life style affection).
9. Dizziness / syncope
Associated symptoms

10. Repeated Vomiting & nausea

11. Heartburn
12. Palpitations / sweating (signs of anemia)
13. Weight loss (malignancy)
14. Loss of appetite
15. Dysphagia
16. Non-steroidal anti-inflammatory drugs
17. Alcohol
18. Smoking
Risk Factors

19. Previous endoscopy

20. Hx of bleeding tendency
21. Hx of peptic ulcer
22. Hx of chronic liver disease {cirrhosis, jaundice, hepatitis}
(bleeding from esophageal varices)
23. Hx of blood transfusion
24. Thank the patient
 History of chronic cough
1. Greeting the patient
2. ID Introduce yourself to the patient
3. Ask for permission
4. Onset (acute/progressive)
5. Duration
6. Diurnal variation (day/night)
7. Dry / Productive
8. HPI Sputum (Colour/Amount/Haemoptysis)
9. Aggravating factors (allergy/cold weather)
10. Alleviating factors
11. Severity (exercise tolerance/daily activity)
12. Previous episodes
13. Fever (Degree/Duration/Relieving/Diurnal Variation)
14. Night sweating
15. Chest pain
16. Nasal discharge
17. Wheezes
18. Associated Sore throat
19. Symptoms Shortness of breath / Orthopnea / PND
20. Fatigue
21. Intermittent Claudication
22. Convulsions
23. Chills, Rigors
24. GI Symptoms (Vomiting/Rash/loss of weight/Anorexia/Regurge)
25. Previous hospitalization/ER visit
26. Chronic diseases
Treatment history (inhalers/steroids)
PMH

27.
28. Allergies
29. Hx of bronchial Asthma
30. Immobilization/recent surgery
31. Smoking (Duration/Number of Cigarettes)
Social

32. Alcohol
Hx

33. Occupational history (IMP)

34. Hx of contact with TB
35. Family history (same problem, chronic disease, cancers)
36. Thank the patient
 History of Infective Endocarditis
This 38 y/o patient, has been diagnosed with sub-acute bacterial endocarditis
1. Greeting the patient
2. Introduce yourself to the patient
3. Ask for permission
4. Fever
5. Fever Course: intermittent, relapsing, continuous
6. Fever Duration
7. Dyspnoea
8. Orthopnoea
9. PND
10. Palpitation
11. Abdominal pain (Due to splenic infarcts, Hepatic Congestion)
12. Loss of weight
13. Loss of appetite
14. Limbs Weakness/paralysis (cerebral embolism)
15. Painful distal extremities
16. Hx of drug addiction & injections
17. Hx of bad oral hygiene & dental carries
18. Thank the patient
 Lower Motor Examination
Introduced herself to the patient
Introduction &

Explained what she/he wants to do to the patient

Inspection

Approaches patient from right side to examine

Exposes the area to be examined properly, but ensures patients privacy
Looked for wasting
Looked for deformity
Looked for abnormal movements (fasciculation)
Ankles
the tone
Examine

Knees

Hip-flexion
Examine the

Hip-extension
power

Knee-flexion
Knee-extension
Ankle-dorsiflexion + Eversion
Ankle-planter flexion + Inversion
Knee reflex (to test L3-L4)
Examine the
reflexes

Ankle reflex (to test S1 -S2)

Planter reflex (Babinski) (to test L5 – S1 – S2)
Clonus
Thanked the patient in the end

Not part of the Exam, but useful Information

In LL inspection look for Symmetry, Scars, Abnormal Posture, Gait
In LL coordination: Heel to shin, Toe to Finger, tapping foot
 Local Neck Examination
Greeting
Introduced herself to the patient
Introduction

Wash your hands

Approaches patient from right side to examine
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
Sitting the patient 90 degrees
Scars
Discoloration
Inspection from the
front and side of

Swelling
Dilated veins
patient

Ask the patient to drink

Asked the patient to swallow
Ask the patient to protrude his tongue
Skin redness over the gland
Pomberton’s sign
Cervical lymph nodes
Palpation from

Size, shape, Consistency, tenderness and mobility

behind

Thrill over the gland

Compare each side
Carotid artery
Trachea position
Percussion over the upper part of the manubrium sterni
Auscultation for bruit
Overall Organization
Thank & Cover the patient in the end
 General CVS Examination
Greeting
Introduced herself to the patient
Introduction

Wash your hands

Approaches patient from right side to examine
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
Sitting the patient 45 degrees
Appearance
General
Exam

Body built
Color
Distress
Pulse
Rate
Rhythm
Vitals

Volume
Character
Radio-femoral delay
Radio-radial delay
Blood Pressure (skip)
Clubbing
Hand/Arms

Pallor
Osler & Jane way nodes
Splinter hemorrhage
Cyanosis
Tendon xanthomata
Pallor
Face/ Eye

Jaundice
Sub-conjunctival hemorrhage
Xanthelasma
Mitrla facies
Positioning
JVP

Measurements
Hepato-jagular reflux
Mouth Cyanosis
Chest / Dilated veins
Abdomen Ascites (skip)
Sacral Edema
Lower Limb Edema
Thank & Cover the patient in the end
Wash hands
 Cerebellar Examination
Greeting
Introduction

Introduced herself to the patient

Wash your hands
Approaches patient from right side to examine
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
Test the speech
& Eye &
Speech

Trunk

Horizontal nystagmus
Vertical nystagmus
Truncal ataxia (ask the patient to fold arms and sit up)
Flexion – extension
Both Elbows
Pronation – supination
Tone
Upper limb

Flexion – extension
Both Wrists
Ulnar – radial deviation
Arm drift
Finger-nose test, and note any intension tremor
Rapid alternating movements
Rebound test
Tone Knee “both” Flexion – extension

Ankle “both” Dorsiflexion – planter flexion

Lower limb

Toe-finger, and note any intension tremor

Heel-shin test
Heel tapping
Knee Jerk (test for pendular knee jerk), “both”
Ask the patient to stand up
Balance
Gate &

Ask the patient to walk

Ask the patient to walk heel to toe
Romberg’s test
Overall organization
Thank & cover the patient
 Cranial Nerves Examination
Greeting
Introduced herself to the patient
Wash your hands
Introduction Approaches patient from right side to examine
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
I Ask the patient about any problem in smelling and mention that he will test each
nostril alone with familiar smells with eyes closed
II Light reflex (Swinging)
Visual Acuity (Snell Chart)
Mentions
Visual Field (Confrontation test)
Ophthalmoscope (Fundal Examination)
III, IV, VI Skip Pupils Examination since an overlap with the II
Eye Movement in H or Square Then Center
V Skip corneal reflex for humanity sake (Just mention it) (Afferent)
Motor: Palpating temporal and masseter muscles while the patient is clenched
Sensory: Sensation forehead, cheeks, Jaw.
Jaw Reflex
VII Inspect nasolabial folds and any asymmetry, Drooling of saliva.
Raise both eye brows
Close both eyes tightly so that you cannot open them
Puff out booth cheeks
Whistle
Taste sensation on Anterior 2/3 of the tongue (Mention)
VIII Rinne’s test
Weber’s test
IX, X Gag reflex
Say AAAA
XI raise both shoulders and apply resistance from behind trapezius muscle
turn the head both sides and apply resistance on sternomastoid muscle
XII Inspect fasciculation in the tongue in the floor of the mouth
Protrude the tongue and look for an asymmetry a deviation
Overall organization
Thank & cover the patient
 Thyrotoxicosis Examination
Greeting
Introduction

Introduced herself to the patient

Wash your hands
Approaches patient from right side to examine
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
Clubbing
onychosis
palmar erythema
warm and sweaty Palms
Hands tremors
muscle wasting
General Examination

Pulse (tachycardia, high pressure, water hammer pulse)

The students should demonstrate the (hyper-reflexia, ill sustained
clonus) using hammer
The students should let the patient talk to figure out if there is hoarseness
Any dermatological changing including alopecia
exophthalmos
Lid Lag, Lid retraction
Eye proptosis
chemosis
Ophthalmoplegia
gynecomastia in male
Chest
Pemberten's sign
Lower limb peritibial myxedema
Overall organization
Thank & cover the patient
 Right side HF Examination
Greeting
Introduced herself to the patient
Wash your hands
Approaches patient from right side to examine
Introduction
Take Permission
Explained what she/he wants to do to the patient
Proper Exposure
Sitting the patient 45 degrees
peripheral cyanosis
Cold, moist skin
Rate
Hands Rhythm
Pulse
Volume
Character
Clubbing
JVP (Perform Hepato-Jagular-reflux)
Neck

Palpable apex beat

parasternal heave
Chest
Auscultation of S3 and S4
basal crepitation
hepatomegaly
splenomegaly

Abdomen Shifting dullness

Ascites
Thrill
Back Sacral Edema

Lower Limb Edema

 General GIT Examination
Greeting
Introduced herself to the patient
Wash your hands
Approaches patient from right side to examine
Introduction Take Permission
Explained what she/he wants to do to the patient
Proper Exposure (from nipples to Midthigh, or for patient privacy, to symphysis pubis)
Lying the patient in supine position
Appearance
body
General
Color
Inspection Decubitus
Environment
Leukonychia
Clubbing
Palmer erythema
Bruising
Hands/Arm Petechia
Scratch marks
Asterixis
Dupyrtrine contraction
Muscle wasting (Back of the hand)
Jaundice
Pallor
Face/Eye Kayser-fischer ring
/Neck Arcus sinalis
xanthomata
Fetor hepaticas
Gynecomastia
Abnormal hair distribution
chest Spider nivae
Pectoral muscle weakness
Hepatosplenomegaly
Ascites
Abdomen Signs of portal HTN (Caput Medusa)
Testicular atrophy
Edema
Legs Muscle wasting
Bruising
Cover and thank the patient
 Local GIT Examination
Greeting
Introduced herself to the patient
Wash your hands
Approaches patient from right side to examine
Introduction Take Permission
Explained what she/he wants to do to the patient
Proper Exposure (from nipples to Midthigh, or for patient privacy, to symphysis pubis)
Lying the patient in supine position
Abdominal distention
Movements with respiration
Skin lesion or pigmentation
Hair distribution
Umbilicus
Inspection Scars
Visible peristalsis
Abnormal pulsation
Hernial orifices
Striae
Prominence veins
Ask about site of pain
Look on the face of the patients
Superficial palpation Adequate technique
Guarding
Rigidity
Tenderness
Mass
Palpation Deep palpation Adequate technique
Mass
Tenderness
Liver
Spleen
Gallbladder (murphy's sign)
Kidney (Bimanual)
Proper technique
Liver span
Percussion Spleen
Shifting dullness
Fluid thrill
Bowel sound
Auscultation Renal Bruits
Mention PR Exam
Cover and thank the patient
 General Respiratory Examination
Greeting
Introduced herself to the patient
Wash your hands
Approaches patient from right side to examine
Introduction Take Permission
Explained what she/he wants to do to the patient
Proper Exposure (Undressed, Chest to waist)
sitting the patient in 90 Degrees
Appearance
body
General Color
Inspection Decubitus
Environment
Using accessory muscles
Clubbing
Cyanosis
Nicotinic Stain
Hands Wasting and weakness
Wrist Tenderness
Pulse
Flapping tremor
Pallor
Face Septal deviation & Polyps
Central Cyanosis
JVP
Neck Trachea (position & tug)
Inspection Shape of the chest and the spine
Scars
Local Symmetry

Examination Prominent veins

Palpate Cervical lymph nodes
Chest Expansion
Vocal fremitus
Apex Beat (Anterior Only)
Ideally from
Percussion Supraclavicular
Back and Back
Front Axilla
But most IMP Tidal percussion
is the BACK Auscultation breath sounds
added sounds
Vocal resonance
Edema
Lower limb Dorsalis pulse
Cover and thank the patient
 Local Respiratory Examination
Greeting
Introduced herself to the patient
Wash your hands
Approaches patient from right side to examine
Introduction Take Permission
Explained what she/he wants to do to the patient
Proper Exposure (Undressed, Chest to waist)
sitting the patient in 90 Degrees
Symmetrical movement of the chest
Inspection Deformity
Scars and skin lesion or pigmentation
Ask about Pain or Tenderness
Chest expansion Proper technique
Mention the findings
Tactile fremitus (10 2 apical
Palpation sites) 2 sides
6 central
Zigzagging
Mention the findings
Apex Beat Mention the Location
Ask the patient to move the elbow forward
Percuss over 10 sites 2 apical
2 sides
6 central
Percussion zigzagging
Mention the findings
Proper Technique of percussion “press the hand firmly, other hand percusses
only b moving the wrist, NOT THE FORARM”
Auscultate 2 apical
2 sides
6 central
Zigzagging
Mention the findings Bilateral
Equal Air entry
Auscultation Vesicular breathing
No added sounds
Vocal resonance 2 apical
2 sides
6 central
Zigzagging
Mention the findings “Muffled”
Overall organization
Cover and thank the patient