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Haem Exam
 
 
Haem Exam
When examining a patient's haematologic system, remember the three key cell lines and the major manifestations that can result from their derangement: anaemia, infection and bleeding / bruising. The haematology exam is also used to identify signs of malignancy, such as lymphadenopathy and splenomegaly.
 

Oropharyngeal Examination

 
 

Oropharyngeal Inspection

    • How to Perform

    • Ask the patient to open their mouth and make an ‘ahh' sound, in order to contract the palate and uvula. Depress the tongue if required in order to visualise the posterior pharynx.
    • Look For

    • Erythema
    • Swelling of tonsils
    • Exudate
    • Ulcers - viral infection, neoplasm
    • Petechiae on soft palate - pathognomonic for bacterial infection

Pharyngeal Erythema

    • Look For

    • Redness of the posterior pharynx.
    • Causes of Pharyngeal Erythema

    • Infection - common cold, influenza, bacterial pharyngitis, tonsillitis
    • Irritation - postnasal drip, reflux, chemical ingestion
    • Malignancy

Tonsillar Swelling

    • Look For

    • Enlarged, inwardly displaced tonsils. Look for erythema and pus.
    • Causes of Tonsillar Swelling

    • Tonsillitis
    • Peritonsillar abscess (quinsy)
    • Lymphoma
    • Nasopharyngeal cancer
    • Interpretation

    • Asymmetric swelling - may be associated with uvular deviationPeritonsilar abscess (quinsy), malignancy
    • Symmetric swellingTonsillitis

Pharyngeal Exudate

    • Look For

    • Pus or mucus on the posterior wall of the pharynx.
    • Causes of Pharyngeal Exudate

    • Bacterial Pharyngitis
    • Acute nasopharyngitis
    • Influenza
    • Candidiasis
    • Diptheria
    • Interpretation

    • Pus - bacterial pharyngitis, acute nasopharyngitis, influenza
    • White patches - candidiasis
    • Grey, membranous exudate - diphtheria
Last updated on January 1st, 2017
 
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Associated Diseases
BETA

Lymphoma
Head & Neck Cancers
Infections
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