Clinical Skills Exam |Complete and A+ Graded
What are the 7 steps of hand washing?
Rubbing hands palm to palm to generate lather
Right palm over left dorsum with fingers interlaced and vice versa
Palm to palm with fingers interlaced
Backs of fingers to opposing palms with fingers interlocked
Rotational rubbing of left thumb clasped in right palm and vice versa
Rotational rubbing, backwards & forwards with clasped fingers of right hand in left palm and vice
versa
Rotating the palm of the hand over the wrist joint of the opposite arm in a circular manner.
Repeat
for each side.
What organisms are resistant to alcohol?
Clostridium difficile or other organisms that cause diarrhoea.
When are the five key times to wash your hands?
- Immediately before every episode of direct patient contact or care, including aseptic procedures.
- Immediately after every episode of direct patient contact or care.
- Immediately after any exposure to body fluids
- Immediately after any other activity or contact with a patient's surroundings that could potentially
result in hands becoming contaminated
- Immediately after removal of gloves.
Why might nails club?
Clubbed fingers is a symptom of disease, often of the heart or lungs which cause chronically low blood
levels of oxygen.
Patients are often asked to put the nail beds of similar finge
What are Korotkoff sounds?
Pulsatile blood flow through compressed artery, used to measure BP with sphygmomanometers
pulse sound appears - systolic pressure
pulse sound disappears - diastolic pressure
Where is the JVP?
, Where is the carotid pulse?
What does the JVP represent?
The preload of the head - right arterial pressure as it empties into it.
What does it mean if the JVP is low?
Healthy, hypovolaemic.
What does it mean if the JVP is high?
Heart failure and decompensation.
Where can you hear the apex beat?
5th left intercostal space, mid clavicular line.
Displaced AB due to enlarged heart or lung pathology pushing to side.
Where is the oblique fissure of the lung found?
Third thoracic spine (T3*) to 6th costal cartilage
anteriorly (approx. medial border of scapula with arm above head)
Where is the right horizontal fissure of the lung found?
horizontal line from sternum at 4th costal cart to oblique fissure
What do different lung percussion sounds mean?
Normal
Hyper-resonant e.g. pneumothorax
Dull e.g. lobe collapse, pneumonia
Stony dull e.g. pleural effusion
Radiographs of respiratory conditions
What are you looking for at the neck in an abdominal exam?
Lymphadenopathy (from behind or the side)
Submental, submandibular, preauricular, postauricular, anterior cervical chain, posterior cervical
chain, occipital, supraclavicular, infraclavicular
What is the most important node to look at in an abdomen exam?
→L supraclavicular
Virchow's node Gastric cancer (or other intra-abdominal malignancies)
What are you looking for when examining the chest?
Gynaecomastia - (man boobs) mechanism debated, possibly due to reduced breakdown of oestrogens
What are the 7 steps of hand washing?
Rubbing hands palm to palm to generate lather
Right palm over left dorsum with fingers interlaced and vice versa
Palm to palm with fingers interlaced
Backs of fingers to opposing palms with fingers interlocked
Rotational rubbing of left thumb clasped in right palm and vice versa
Rotational rubbing, backwards & forwards with clasped fingers of right hand in left palm and vice
versa
Rotating the palm of the hand over the wrist joint of the opposite arm in a circular manner.
Repeat
for each side.
What organisms are resistant to alcohol?
Clostridium difficile or other organisms that cause diarrhoea.
When are the five key times to wash your hands?
- Immediately before every episode of direct patient contact or care, including aseptic procedures.
- Immediately after every episode of direct patient contact or care.
- Immediately after any exposure to body fluids
- Immediately after any other activity or contact with a patient's surroundings that could potentially
result in hands becoming contaminated
- Immediately after removal of gloves.
Why might nails club?
Clubbed fingers is a symptom of disease, often of the heart or lungs which cause chronically low blood
levels of oxygen.
Patients are often asked to put the nail beds of similar finge
What are Korotkoff sounds?
Pulsatile blood flow through compressed artery, used to measure BP with sphygmomanometers
pulse sound appears - systolic pressure
pulse sound disappears - diastolic pressure
Where is the JVP?
, Where is the carotid pulse?
What does the JVP represent?
The preload of the head - right arterial pressure as it empties into it.
What does it mean if the JVP is low?
Healthy, hypovolaemic.
What does it mean if the JVP is high?
Heart failure and decompensation.
Where can you hear the apex beat?
5th left intercostal space, mid clavicular line.
Displaced AB due to enlarged heart or lung pathology pushing to side.
Where is the oblique fissure of the lung found?
Third thoracic spine (T3*) to 6th costal cartilage
anteriorly (approx. medial border of scapula with arm above head)
Where is the right horizontal fissure of the lung found?
horizontal line from sternum at 4th costal cart to oblique fissure
What do different lung percussion sounds mean?
Normal
Hyper-resonant e.g. pneumothorax
Dull e.g. lobe collapse, pneumonia
Stony dull e.g. pleural effusion
Radiographs of respiratory conditions
What are you looking for at the neck in an abdominal exam?
Lymphadenopathy (from behind or the side)
Submental, submandibular, preauricular, postauricular, anterior cervical chain, posterior cervical
chain, occipital, supraclavicular, infraclavicular
What is the most important node to look at in an abdomen exam?
→L supraclavicular
Virchow's node Gastric cancer (or other intra-abdominal malignancies)
What are you looking for when examining the chest?
Gynaecomastia - (man boobs) mechanism debated, possibly due to reduced breakdown of oestrogens
