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MEDICINE FOR FINALS
DR INDER MAINIE
MAY 2002
CARDIOVASCULAR
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INTRODUCTION
MAY I EXAMINE YOU?
45 DEGREES
INSPECTION (SOB, SCARS, MALAR
FLUSH, ANKLE OEDEMA)
ALWAYS LOOK AROUND THE BED,
INHALERS, OXYGEN, DIET DRINKS ETC
EXAMINATION
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LOOK AT THE HANDS
FINGER CLUBBING
CYANOSIS
SPLINTER HAEMORRAGES
PALE
PULSE
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RATE
RHYTMN
CHARACTER BRACHIAL/CAROTID
VOLUME
COLLAPSING PULSE
CAUSES OF IRREGULAR
IRREGULAR PULSE
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ATRIAL FIBRILLATION, VE’S, ATRIAL
FLUTTER WITH VAR BLOCK, CHB
CAUSES OF AF
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ISCHAMIC HEART DISEASE
RHEUMATIC HEART DISEASE
THYROID
NO CAUSE
CARDIOMYOPATHY
WPW
INFECTION
ASD
COLLAPSING PULSE
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AORTIC REGURG LOOK FOR CORRIGAN’S
SIGN
PDA
PAGETS
PREGNANCY
RUPTURED ANEURYSM OF AORTIC SINUS
FEVER
ANAEMIA
RADIO-FEMORAL DELAY
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COARCTATION OF THE AORTA
ASK WHILE EXAMINING THE PULSE
CAN YOU CHECK FOR THIS
BLOOD PRESSURE
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ALWAYS REMEMBER TO ASK IF YOU
CAN CHECK THE BLOOD PRESSURE
JVP
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INTERNAL JUGULAR
BETWEEN THE TWO HEADS
EQUAL TO PRESSURES IN THE RIGHT
ATRIUM
a WAVE = ATRAL CONTRACTION
v WAVE= ATRIAL FILLING DURING
VENTRICLAR SYSTOLE,TRICUSPID
VALVE IS CLOSED
CAUSES OF A RAISED JVP
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HEART FAILURE –ELEVATION, SUSTAINED
HJR
PE – ELEVATED
PERICARDIAL EFFUSION-ELEVATED,
PROMINENT Y DESCENT
CONSTRICTIVE PERICARDITIS-ELEVATED
KUSSMAULS, PARADOXICAL RISE ON
INSPIRATION
AF NO a WAVES
TRICUSPID STENOSIS- GIANT a WAVES
TRICUSPID REGURG- GIANT v WAVES
COMPLETE HEART BLOCK- CANNON WAVES
APEX BEAT
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LOOK FOR STERNOTOMY SCARS
LOOK FOR THORACOTOMY SCARS
POSITION AND CHARACTER
CHECK FOR HEAVES OR THRILLS
HEART SOUNDS
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PALPATE THE CAROTID
SIMULTANEOUSLY
COMMENT ON I AND II OR
ADDITIONAL
MURMURS
MURMURS
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STENOSIS- APEX LEFT LATERAL USE
THE BELL
REMEMBER CHANGES IN BREATHING
INSPIRATION RIGHT HEART MURMURS
GET LOUDER
EXPIRATION LEFT SIDE MURMURS GET
LOUDER
PANSYSTOLIC MURMUR APEX, AXILLA
EARLY DIASTOLIC AORTIC REGURG 3RD
ICS SIT FORWARD ON EXP
GRADING OF MURMURS
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1.
2.
3.
4.
5.
6.
FAINT
FAINT BUT EASILY DETECTED
POMINENT BUT NOT LOUD
LOUD THRILL
VERY LOUD
LOUD WITHOUT CONTACT
REMEMBER
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LUNG BASES
SACRAL OEDEMA
HEPATOSPLENOMEGALY FAILURE
PERIPHERAL PULSES
MITRAL STENOSIS
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MALAR FLUSH
PULSE- IRREGULR IRREGULAR
RAISED JVP
TAPPING APEX NOT DISPLACED
LEFT PARASTERNAL HEAVE(RIGHT
VENTRICULAR ENLARGEMENT)
LOUD 1ST HS
OPENING SNAP
MITRAL STENOSIS
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CAUSES- RHD
TAPPING APEX BEAT -DUE TO
ACCENTUATED 1ST HS
OPENING SNAP OPENING OF A STENOSED
VALVE – PLIABLE, ABSENT IN DIFFUSELY
CALCIFIED VALVE
LOUD 1ST – VALVES ARE MOBILE
PRESYSTOLIC ACCENTUATION- SINUS
RHYTMN DUE TO THE ATRIAL SYSTOLE
WHICH INCREASES FLOW ACROSS A
STENOTIC VALVE
COMLICATIONS
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LEFT ATRIAL ENLARGEMENT
AF
PULMONARY HTN
TR
RHF
SEVERITY
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NARROWER DISTANCE BETWEEN 2ND
HS AND OS
LONGER THE DIASTOLIC MURMUR
MITRAL REGURG
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PERIPHERAL PULSES- NORMAL JERKY DUE
TO REDUCED SYSTOLIC EJECTION TIME
SECONDARY TO A LARGE VOLUME OF
BLOOD REGURG INTO LEFT ATRIUM
APEX BEAT- DISPLACED
1ST HS SOFT
3RD HS
PSM -> AXILLA LOUDER ON EXP
CAUSES OF MR
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MITRAL VALVE PROLAPSE
RHD
LEFT VENTRICLAR DILATATION
CORONARY DISEASE
ANNULAR CALCIFICATION
ENDOCARDITIS
PAPILLARY MUSCLE RUPTURE
CARDIOMYOPATHY
CONNECTIVE TISSUE DISORDER
TRAUMA
MYXOMATOUS DEGENERATION
CAUSES OF PSM
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MR
TR
VSD
HOCM
AORTIC REGURG
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PULSE- LARGE VOLUME, COLLAPSING
CORRIGAN’S
APEX DISPLACED OUTWARDS,
FORCEFUL
EDM- LSE SIT FORWARD EXPIRATION
Aortic Regurgitation
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WIDE PULSE PRESSURE
FEMORALS- PISTOL SHOTS(TRAUBE’S)
TO AND FRO MURMUR (DUROZIEZ’S)
CORRIGANS – CAROTID PULSATION
QUINCKE’S
UVULA PULSATIONS (MULLER’S)
ARGYLL ROBERTSON PUPIL
MARFANS
ANK SPOND, RA
Causes Of Aortic Regurgitation
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RF
HTN
ATHEROSCLEROSIS
ENDOCARDITIS
SYPHILIS
MARFANS
RA
ANK SPOND
TRAUMA
AORTIC DISSECTION
SEVERITY
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WIDE PULSE PRESSURE
SOFT 2ND HS
3RD HS
AUSTIN FLINT MURMUR
LVF
LONGER + LOUDER
AORTIC STENOSIS
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LOW VOLUME SLOW RISING
APEX- HEAVING, NOT DISPLACED
SOFT 2ND
EJECTION CLICK
S4 MAY BE HEARD
ESM
NARROW PULSE PRESSURE
REVERSE SPLITTING
CAUSES OF AORTIC STENOSIS
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RHEUMATIC
DEGENERATIVE CALCIFICATION OF A
BICUSPID VALVE
OTHER CAUSES OF ESM
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PULM STENOSIS
HOCM
SUPRAVALVULAR STENOSIS
SYMPTOMS
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FATIGUE
ANGINA
DYSPNOEA
SYNCOPE
DEATH
INVESTIGATIONS
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ECG
CXR
ECHO
CATH
EST BE CAREFUL IF SYMPTOMATIC
TRICUSPID REGURGITATION
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CAUSES
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FUNCTIONAL
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PULMONARY HTN
CCF
RHD
ENDOCARDITIS – DRUG ADDICTS
VSD
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PSM AT LSE
LOUD P2 OF PULM HTN
MAY HAVE CCF
LOUDNESS DOES NOT MEAN SEVERE
CAUSES OF VSD
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CONGENITAL
RUPTURE AFTER MI
50% MAY CLOSE SPONTANEOUSLY
COMPLICATIONS ARE
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CCF
AORTIC REGURG
SBE
PULM HTN
INFECTIVE ENDOCARDITIS
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ANAEMIA
CLUBBING
SPLINTER HAEMORRAGES- EMBOLISM
OSLER NODES- INFLAMMATION OF EMBOLI
JANEWAY LESIONS
PETECHIAE
ROTH SPOTS
SPLENOMEGALY
HAEMATURIA
DENTAL
FBP- NORMOCYTIC NORMOCHROMIC
ESR
BLOOD CULTURES
COMLICATIONS OF SBE
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CARDIAC FAILURE
RENAL PAIN
CEREBRAL ANEURYSMS
MYCOTIC ANEURYSMS
VALVE ABSCESS
HOCM
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PULSE JERKY
DOUBLE APICAL- LEFT VENTRICULAR
HEAVE WITH PROM PRESYSTOLIC
PULSE
PSM- SOFTER ON SQUATTING
4TH HS
FAMILY HISTORY
RESPIRATORY
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INTRO
SITTING POSITION
SPUTUM CUP
BREATHLESS
WASTING
ASYMMETRICAL BREATHING
COUNT RESP
HANDS
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CLUBBING
CYANOSIS
TAR
BOUNDING PULSE
ASTERIXIS
TONGUE – CYANOSIS
EYES- PALLOR, HORNERS
EXAMINATION
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LOOK FOR NECK VEINS
CERVICAL LYMPH
TRACHEA DEVIATION tug
PALPATE
MOVEMENTS OF BOTH SIDES
VOCAL FREMITUS
PERCUSSION
AUSCULTATION
PLEURAL EFFUSION
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LOOK FOR DECREASED MOVEMENT
TRACHEAL DEVIATION
ASPIRATION MARKS
STONY DULL
DECREASED VOCAL RESONANCE
FIND THE UPPER LEVEL
BRONCIAL BREATHING
SIGNS OF RA, TAR, LYMPH NODES,
RADIATION BURNS, MASTECTOMY
CAUSES OF DULLNESS
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PLEURAL EFFUSION
PLEURAL THICKENING
CONSOLODATION
COLLAPSE
RAISED HEMIDIAPHRAGM
INVESTIGATIONS
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CXR
TAP
SEND FOR PROTEIN, LDH, GLUCOSE,
BACTERIOLOGY, CYTOLOGY
PH IF EMPYEMA
AMYLASE IN NG, PANCREATITIS,
OESOPHAGEAL RUPTURE
RHEUMATOID FACTOR
TRANSUDATE
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NEPHROTIC SYNDROME
CARDIAC FAILURE
LIVER FAILURE
HYPOTHYROID
CONSTRICTIVE PERICARDITIS
MEIGS
EXUDATE
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CA
SECONDARIES
PNEUMONIA
PE
TB
RA
SLE
LYMPHOMA
MESOTHELIOMA
PROGNOSIS
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POOR IN NG PEURAL FLUID
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LOW GLUCOSE
LOW pH
HAEMORRAGIC FLUID
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PE
NG
TB
REMEMBER OCCUPATION
EG SHIP BUILDING
BRONCHIECTASIS
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LOOK FOR SPUTUM CUP
FINGER CLUBBING
BILATERAL COARSE CREPS
LATE INSP CREPS
BRONCHIECTASIS
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DEF - CHRONIC NECROTIZING
INFECTION OF THE BRONCHI AND
BRONCHIOLES LEADING TO
ABNORMAL, PERMANENT DILATATION
OF THE AIRWAYS
CAUSES
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PNEUMONIA
MEASLES
PERTUSSIS
TB
MECHANICAL OBSTRUCTION
ASPERGILLOSIS
KARTAGENERS
CYSTIC FIBROSIS
IDIOPATHIC
INVESTIGATION
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FBP
SPUTUM
CXR
CT
COMPLICATIONS
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PNEUMONIA
PLEURAL EFFUSION
PNEUMOTHORAX
SINUSITIS
HAEMOPTYSIS
BRAIN ABSCESS
AMYLOIDOSIS
TREATMENT
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POSTURAL DRAINAGE
ANTIBIOTICS
NEBS
SURGERY
CONSOLIDATION
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SPUTUM
TACHYNOEA
REDUCED MOVEMENT ON AFFECTED SIDE
TRACHEAL CENTRAL
DECREASED PERCUSSION
BRONHIAL BREATHING
CREPS
CAUSES
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PNEUMONIA
CARCINOMA
PE
FIBROSING ALVEOLITIS
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TACHYNOEA
CLUBBING
CENTRAL CYANOSIS
BILATERAL BASAL FINE END INSP
CREPS
DO NOT DISAPPEAR ON COUGHING
SIGNS
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HANDS - RA, SYSTEMIC SCLEROSIS
FACE - RASH OF SLE
MOUTH - DRY OF SJOGRENS
PULMONARY HTN - a WAVE IN JVP,
LEFT PARASTERNAL HEAVE AND P2
LOOK FOR CAUSES - DRUGS EG
AMIODARONE
PROGNOSIS
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50% SURVIVAL AFTER 5 YEARS
INCREASE RISK OF CA
ABDOMEN
EXAMINATION
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LYING FLAT
DO NOT EXPOSE GENITALIA
COMFORTABLE
LOOK AROUND THE BED
HANDS
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CLUBBING
LEUCONYCIA
PALMAR ERYTHEMA
DUPUTRYENS
HEPATIC FLAP
PIGMENTATION
SCRATCH MARKS
EXAMINATION
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NODES
TONGUE
EYES - JAUNDICE, XANTHELASMA
ANAEMIA
SPIDER NAEVIA
ACANTHOSIS NIGRICANS
GYNAECOMASTIA
EXAMINATION OF ABDOMEN
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MOVEMENTS
MASS
VEINS
PERISTALSIS
HERNIA
ASK IF THERE IS ANY PAIN
PALPATION
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KNEEL DOWN
ALWAYS LOOK AT THE PATIENT
SUPERFICIAL THEN DEEP
ALL QUADRANTS
PALPATE
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MASS - CHARACTERISTICS
LIVER - PERCUSSION
SPLEEN
KIDNEYS
LYMPH NODES
HERNIAL ORFICES
TESTICULAR ATROPHY
PERCUSSION
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SHIFTING DULLNESS
AUSCULTATE
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LIVER BRUIT
BOWEL SOUNDS
RENAL BRUIT
LEG OEDEMA
PR
HEPATOMEGALY
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SIZE
TENDERNESS- CHF OR ACUTE
HEPATITIS
SURFACE - SMOOTH OR IRREGULAR
PERCUSS
AUSULTATE- ALCOHOLIC HEPATITIS
OR CA FOR BRUIT
CAUSES
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CHF
CIRRHOSIS
SECONDARIES
INFECTIVE HEPATITIS
MYELOPROLIFERATIVE DISORDERS
SARCOID
HAEMACHROMATOSIS
PBC
AMYLOID
TUMOURS
CAUSES OF HEPATIC
ENCEPHALOPATHY
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INFECTION
DIURETICS, ELECTROLYTE IMBALANCE
DIARROHEA AND VOMITING
SEDATIVES
GI BLEED
ABDOMINAL PARACENTESIS
SURGERY
CAUSE OF ASCITES
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LIVER FAILURE + PORTAL HTN
SECONDARY HYPERALDOSTERONISM
DECREASED METABOLISM OF
ALDOSTERONE BY LIVER
DECREASED METABOLISM OF ADH
LOW ALBUMIN
LYMPHATIC OBSTRUCTION
HAEMACHROMATOSIS
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MALE
PIGMENTED
PALMAR ERYTHEMA AND SPIDER ANAEMIA
JAUNDICE
ASCITES
HEPATOMEGALY
LOSS OF SEXUAL HAIR
TESTICULAR ATROPHY
JOINT PAIN- PSEUDOGOUT
CARDIOMYOPATHY
DIABETES
INVESTIGATIONS
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AUTOSOMAL RECESSIVE
MOSTLY HLA-A3
CHROMOSOME 6
TRANSFERRIN INCREASED
SERUM FERRITIN RAISED
GENE TESTING
LIVER BIOPSY
TREATMENT
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VENESECTION
RISK
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X200 RISK OF HEP CA
PBC
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MIDDLE-AGED WOMEN
CLUBBING
PIGMENTED
XANTHELASMA
ICTERUS
SCRATCH
HEPATOSPLENOMEGALY
PBC
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XANTHOMATA- JOINTS
- SKIN FOLDS
- AREA OF TRAUMA
LOOK FOR OTHER AUTOIMMUNE DISEASES
PROXIMAL MUSCLE WEAKNESS –
OSTEOMALACIA
PERIPHERAL NEUROPHATHY
AMA – M2
OBSTRUCTIVE PICTURE
LIVER TRANSPLANTATION
LOOK FOR
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AUTOIMMUNE CONDITIONS
PROXIMAL MUSCLE WEAKNESS DUE TO
OSTEOMALACIA
PERIPHERAL NEUROPATHY
PBC
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ANTI-MITOCHONDRIAL ABS
CURE IS TRANSPLANTATION
SPLENOMEGALY
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DIFF FROM KIDNEY
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KIDNEY BALLOTABLE
NOTCH
CAN’T GET ABOVE
DULL TO PERCUSSION
MOVES WITH RESP
LOOK FOR
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LYMPH NODES
ANAEMIA
JAUNDICE
PLETHORIC (PRV)
SPLINTER HAEMORRAGES
RHEUMATOID
CAUSES
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CML
MALARIA
KALA-AZAR
PRV
MYELOFIBROSIS
PORTAL HTN
SARCOID
AMYLOID
ENDOCARDITIS
INFECTIOUS MONONUCLEOSIS
FELTYS
CLL
ITP
KIDNEYS
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LOOK FOR AV FISTULA
LOOK FOR TRANSPLANTED KIDNEY
3RD NERVE PALSY ASSOC WITH
POLYCYSTIC KIDNEY (BERRY)
BP
FHX
ANAEMIA
ABDOMINAL MASSES
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EPIGASRTIC -CA STOMACH
-CA PANCREAS
-AAA
-RETROPERITONEAL
LYMPHADENOPATHY
ABDOMINAL MASSES

RT ILIAC FOSSA-
CROHNS
CA CAECUM
LYMPH NODES
TRANSPLANTED KID
APPENDIX ABSCESS
OVARIAN NG
CARCINOID
AMOEBIAS
CAUSES OF PTOSIS
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UNILATERAL
3RD NERVE PALSY
HORNERS
MYASTHENIA
CONGENITAL
IDIOPATHIC
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BILATERAL
MYASTHENIA
DYSTROPHIA
OCULAR MYOPATHY
SYPHILIS
CONGENITAL
BILATERAL
HORNERS IN
SYRINGOMYELIA
HORNERS
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MIOSIS
PARTIAL PTOSIS
ENOPTHALMOS
ANHYDROSIS
CAUSES
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PANCOAST TUMOUR
CERVICAL SYMPATHECTOMY
CAROTID ANERUYSMS
SYRINGOMYELIA
LESION OF BRAINSTEM
TRAUMA
HOLMES- ADIE
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YOUNG WOMAN
DILATED PUPIL
PUPIL REACTS SLOWLY
DECREASED REFLEXES
BENIGN
DILATED PUPIL
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EYE DROPS
3RD NERVE
HOLMES – ADIE
LENS IMPLANT
DEATH
SYMPATHETIC OVERACTIVITY
SMALL PUPIL
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OLD AGE
EYE DROPS
HORNERS
ARGYLL ROB
PONTINE
NARCOTICS
DIABETIC EYES
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BACKGROUND RETINOPATHY
PREPROLIFERATIVE
PROLIFERATIVE
PAPILLOEDEMA
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SOL
HTN RETINOPATHY
BIH
INCREASED ICP
HEAD INJURY CAUSING CEREBRAL OEDEMA
CO RETENTION
THYROID
VIT A INTOXICATION
CENTRAL RETINAL VEIN THRMBOSIS
MUTIPLE MYELOMA
OPTIC ATROPHY
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
MS
OPTIC NERVE COMPRESSION
GLAUCOMA
TOXINS
ISCHAEMIA
HEREDITARY
PAGETS
VIT B12 DEF
LOWER 7TH
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LOOK IN THE YEARS
PAROTID GLAND ENLARGEMENT
TASTE (INVOLVING CHORDA TYMPANI)
HEARING (HYPERACUUSIS DUE TO
STAPEDIUS)
URINE - DIABETES
CAUSES OF BILATERAL
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GUILLAN BARRE
SARCOIDOSIS
MYASTHENIA MAY MIMIC
UNILATERAL PALSY
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LLS
HERPES
CEREBELLOPONTINE TUMOURS
POLIO
OTITIS MEDIA
SKULL FRACTURE
DYSTROPHICA MYOTONICA
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SHAKING HANDS
FRONTAL BALDNESS
PTOSIS
CATARACTS
EXPRESSIONLESS
DYSTROP MYOTON
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TEST POWER
DECREASED REFLEXES
ASK ABOUT SWALLOWING
URINE - GLUCOSE
LOW IQ
GYNAECOMASTIA
TESTICULAR ATROPHY
DYSTROP MYOTONICA
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AD
CARDIOMYOPATHY
CHEST INFECTION
PROXIMAL MYOPATHY
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DIABETES
CUSHINGS
THYROID
POLYMYOSITIS
DRUG
CARCINOMA
OSTEOMALACIA
HEREDITARY
WASTING SMALL MUSCLES
OF THE HAND
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RHEUMATOID
OLD AGE
CERVICAL SPONDYLOSIS
BILATERAL CERVICAL RIBS
MND
SYRINGOMYELIA
CHARCOT
GUILLAN
NERVE PALSIES
NEUROFIBROMATOSIS
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AXILLA FOR FRECKLES
VISUAL ACUITY - GLIOMA
ACOSTIS NEUROMA
IRIS FOR LISCH NODULES
KYPOSCOLIOSIS
BLOOD PRESSURE
LOOK FOR
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6 OR MORE CAFÉ AU LAIT
2 OR MORE NEUROFIBROMAS
AXILLA FRECKLING
OPTIC GLIOMA
SPEECH
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COMPREHENSION
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PUT OUT TONGUE
SHUT YOUR EYES
ORIENTATION
TIME , DATE
SPEECH
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NAME FAMILIAR OBJECTS
ARTICULATION
MENTAL SCORE
EXPRESSIVE - BROCA
FRONTOPARIETAL
RECEPTIVE - WERNICKE’S SUPERIOR
TEMPORAL
PARKINSONS
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EXPRESSIONLESS- HYPERMYMIA
DROOLING
PILL ROLLING
BRADYKINESIA
TONE- COG WHEEL
GLABELLAR TAP - CONTINUE
MYERSON’S SIGN
WALK
MICRGRAPHIA
RHEUMATOID
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SUBLUXATION OF MCP
SWAN NECK
BOUTONNIERES
Z DEFORMITY
SUBLUX AT WRIST
NAIL FOLD INFARCTS
PALMAR ERYTHEMA
RHEUMATOID ARTHRITIS
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MUST CHECK FOR NODULES
SEROPOSITIVE AGGRESSIVE
PERFORM SIMPLE TASKS
EXAMINE OTHER JOINTS
ANAEMIA
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CHRONIC DISEASE
PERNICIOUS ANAEMIA
FELTYS
NSAIDS
PULMONARY
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NODULES
EFFUSION
FIBROSIS
CAPLANS
BRONCHIOLITIS OBLITERANS
EYES
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EPISCLERITIS
SCLERITIS
SCLEROMALACIA
SICCA
SJOGRENS
ANK SPOND
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? MARK POSTURE
PROTUBERANT ABDOMEN
ASK HIM TO TURN WHOLE BODY
TURNS
STAND AGAINST A WALL
SCHOBERS TEST
LOOK FOR
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IRITIS
ANTERIOR UVEITIS
AORTIC REGURG
APICAL FIBROSIS
ACHILLES TENDINITIS
GENETIC
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HLA-B27
40% SEVERE DISEASE
SCLERODERMA
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TIGHTENING OF HANDS
TELANGICTASIA
PSEUDOCLUBBING
VITILIGO
JOINT FOR ARTHRITIS
PINCHED NOSE
DIFF OPENING MOUTH
ASK ABOUT
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DYSPHAGIA
RAYNAUDS
DRY EYES
SWALLOWING
BREATHING - FIBROSIS
GOUT
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ASYMMETRICAL
LOOK AT 1ST MTP , HELICES,
OLECRANON, ACHILLES
NEGATIVE BIFRINGENT
DISORDER OF PURINE METABOLISM
THYROID
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HANDS - SWEATING, TREMOR, WARM
SCARS
PALMAR ERYTHEMA
PULSE
NODES
GOITRE
SEAT UPRIGHT
EXOPTHALMOS
PALPATE ,WATER
EXAMINE FOR
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SIZE
MOBILITY
TEXTURE
TENDERNESS
PEMBERTONS SIGN - RAISE ARMS FOR
COMPRESSION
PERCUSS FOR RETROSTERNAL
BRUITS - GRAVES
EYES
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LID LAG VON GRAEF’ SIGN
EXOPTHALMOS
LID RETRACTION DALRYMPLES SIGN
EXTRAOCCULAR MOVEMENTS
CORNEAL INVOLVEMENT
PROXIMAL MUSCLES
SKIN PRETIB MYXOEDEMA
CUSHINGS
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MOON FACE
BRUISES
HIRSUTISM
PLETHORIC
BUFFALO HUMP
STRIAE
PROXIMAL MUSCLE WEAKNESS
ASK ABOUT
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STEROIDS
DIABETES
BP
LOOK FOR RA , ASTHMA
VISUAL FIELDS
CAUSES
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STEROIDS
PITUITARY ADENOMA- PIT DISEASE
ADRENAL CA
ADRENAL ADENOMA
ECTOPIC CA
ACROMEGALY
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FACE
SWEATING
LARGE HANDS
CARPAL TUNNEL
PROM SUPRAORBITAL RIDGES
LARGE NOSE AND LIPS
PROTRUSION OF LOWER JAW
WIDE TEETH
LOOK FOR
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MACROGLOSSIA
VISUAL FIELDS
ACANTOSIS NIGRICANS
ORGANOMEGALY
JOINTS- CHONDROCALCINOSIS
KYPHOSIS
BP
DIABETES
OLD PHOTOGRAPHS
HYPERTENSIVE FUNDUS
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GRADE 1 – SILVER WIRING
GRADE 2 – AV NIPPING
GRADE 3 – HAEMORRAGES (FLAME)
+EXUDATES
GRADE 4 - PAPILLOEDEMA
DIABETIC EYES
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BACKGROUND/PREPROLIFERATIVE –
HAEMORRAGES (MICROANEURYSMS) +
EXUDATES
PROLIFERATIVE – MALIGNANT
RETINOPHATY
NEOVASCULARISATION – NEW
VESSELS
GOOD LUCK !