Cyanosis can be seen in most examination cases. It is a grave mistake to miss such a finding. The advice below will help you answer questions. There are 2 types of cyanosis Peripheral cyanosis and central cyanosis Causes of peripheral cyanosis Exposure to cold Raynaud’s phenomenon Congestive cardiac failure Hyperviscosity syndrome Shock Causes of central […]

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Clubbing This is the swelling go the terminal part of fingers and toes It happens due to hypertrophy of the soft tissue in nail bed causing an increase in the anterior-posterior and transverse diameter of the nail Measurement It is measured by measuring the angle between the nail and nail bed  – Its called the […]

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It is auscultating the patients chest in different fields hen the child speaks Method Ask the patient to repeat words like ‘Ninety Nine’ continuously in the same tone and voice depth No auscultate the lung in different area like upper lobe, middle lobe and lower lobe. Auscultate the same areas simultaneously, i.e once on the […]

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Differentiating different respiratory sounds can be asked in clinical exams Wheeze is the high pitch musical sound heard Characters Mostly heard in expiratory phase of respiration Indicates small airway obstruction Conditions Asthma Bronchitis Tropical eosinophilia Stridor This is a harsh hoarse sound which is low pitched Features Better heard in Inspiratory phase Indicates large airways […]

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Dyspnoea Uncomfortable awareness of breathing Tachypnoea Rapid breathing Seen in anxiety, fever, heart failure, acidosis Hyperventilation Increased depth of ventilation Seen in anxiety, Metabolic acidosis, infections Bradypnea Slow breathing rate Orthopnoea Breathless on lying down Seen in heart failure, asthma, pleural effusion Cheyne Stokes respiration Periods of rapid breathing and periods of pause Each phase […]

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The tracheal position also indicates the apex beat position. The normal position of trachea is slight deviation towards the right Methods to examine tracheal position. Method 1 Stand in front of the patient. Make sure the patient is sitting or standing and never lying down Gently palpate the cricoid cartilage with your finger and run […]

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There are various types of cough, based on the type one can suspect the underlying conditions. These can be discussed in exams as well Dry cough Acute pleurisy Croup Wet cough Bronchiectasis Lung abscess Lobar pneumonia Brassy cough Laryngeal carcinoma Spluttering cough Tracheoesophageal fistula Barking cough Epiglottitis Foul smelling cough Bronchiectasis Lung abscess

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Tympanic note Pneumothorax Emphysematous bulla Subpleural lung cyst Left sided hiatus hernia Hyperresonant note Emphysema Lung cysts Impaired (Diminished) note Thick pleura Lung fibrosis Lung collapse Lung tumors Consolidation of lung Early pleural effusion Dull note Consolidation Pleural effusion Empyema

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Unilateral restriction Pleural effusion Chest trauma Pleurisy Pneumothorax Collapse of lung Fibrosis to lung Thickened pleura Lung consolidation Bilateral restriction Emphysema Interstitial fibrosis Weak respiratory muscles Ankylosing spondylitis

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Look around the room to see if any accessories/ instruments like crutches/ wheelchairs/ glasses/ inhalers/ Sputum sample Once the child is seated, ask if you could expose the upper body. For lower body, you may need to ask permission from the examiner also General examination Level of consciousness- Alert/ Oriented/ cooperative Decubitus (position in bed) […]

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