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Question

Difficulty: EasyPhysical Examination Findings

Match each of the following classic physical examination maneuvers or signs with its most strongly associated clinical condition or diagnosis.

  • Arrest of inspiration upon deep palpation of the right upper quadrant (Murphy sign)Acute cholecystitis
  • Resistance and pain upon extension of the knee while the hip is flexed at 90 degrees (Kernig sign)Meningeal inflammation
  • Tingling sensation radiating into the first three digits upon percussion of the volar wrist (Tinel sign)Median nerve compression
  • Carpal spasm elicited by inflating a sphygmomanometer cuff above systolic pressure for 3 minutes (Trousseau sign)Hypocalcemia

Answer

Murphy sign indicates acute cholecystitis; Kernig sign indicates meningeal inflammation; Tinel sign indicates median nerve compression; Trousseau sign indicates hypocalcemia.
The correct matches reflect standard medical knowledge where specific provocative maneuvers yield findings pathognomonic or highly suspicious for particular conditions.

Step-by-Step Solution

1
Analyze the description of inspiratory arrest on right upper quadrant palpation.
Identified as Murphy sign, which strongly correlates with acute cholecystitis.
During inspiration, the diaphragm lowers the inflamed gallbladder to meet the examiner's fingers.
2
Analyze the description of pain with knee extension while the hip is flexed.
Identified as Kernig sign, which is indicative of meningeal inflammation.
This maneuver stretches the inflamed spinal nerve roots, causing pain and resistance.
3
Analyze the description of tingling upon percussion of the volar wrist.
Identified as Tinel sign, which is associated with median nerve compression.
Percussion directly irritates the already compressed nerve within the carpal tunnel.
4
Analyze the description of carpal spasm following blood pressure cuff inflation.
Identified as Trousseau sign, a classic indicator of hypocalcemia.
The ischemia induced by the cuff exacerbates underlying neuromuscular excitability from low calcium levels.

Key Concept

Correlation of classic physical examination signs with specific pathophysiological states and diagnoses.
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Topics

Physical Examination Findings

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