Tuesday, November 1, 2011


Tropical round exam---à 10marks

5 stations/ question:

1. 1 picture of spot diagnosis

2. 2 stations fo clinical skills eg: LL ex,palpation,percussion(eg: ascitis),auscultation(liver)

3. 2 written clinical skills eg: cause of splenomegally,cause of large tender liver


For clinical skil

-Inspection of abdomen

-Palpation of spleen

-percussion of abdomen

-shifting dullness

-examine both LL

-examine both UL

-examine for complexion


-GIT cause for clubbing

-premature ascitis

-cause of enlarged tender liver

-cause of hepatomegaly/ cause of huge splenomegally

-cause of post operative jaundice

-cause of LL edema( unilateral,bilateral)

-surface anatomy of liver

-value of abdominal examination

Eg of Q:

1. How to palpate splenomegaly?

Ask the patient to take a deep breath.Palpation with ulnar border of the hand till the level of below costal margin... comment on:

-Size of enlargement( by fingers; enlarged by 1,2,3 fingers)

-consistency; firm ,tender

-pulsating or not

2. LL examination; Edema, comment on:

Edema; comment on:

-unilateral or bilateral

-pitting or not

-extent/grade-àgrade1: localized at the middle maleolus, 2:calf area, 3:skin of the thigh, 4: abdomen

-pulsation(dorsalis pedis artery) felt btwn 1st & 2nd metacarpal bones

-LN enlargement


-petechiae,chemosis,scar,ulcer etc..

3. UL examination

-shape of the hand( deformity,trauma)

-tremor(fine or coarse)


-ms wasting

-nails( color,shape,atrophic change)

-LN enlargement( epitrochlear,axillary)

-radial pulse


* gmbr untuk spot diagnosis write protected..dr x bagi ambik..tp ade je kwn2 yg dpt tangkap sebahagian gmbr2 tue..maybe akan diupload( insyaAllah)

Yg attend kuliah da tgk gmbr tue 2 kali.. ingat kot..tp xtau la lps raye haji ni camne..

Chest examination-à 20MARKS

-5 stations

-1 or 2 xray: what is the pathology or the lesion,what is the cause related to the lesion

-3 or 4 cases( patient)..the question will be related to the clinical case or examination

Eg: patient with clubbing of finger. question that maybe asked:

-grade of clubbing

-2 chest causes of clubbing

Clinical skill l: percussion,auscultation..

-dahsyatkan potensi dirimu, raih prestasi luar biasa-