What I’ve learned so far about the physical exam

♦  My partner for Physical Diagnosis has no lymph nodes.  After checking twice, I’ve determined that the only thing standing between her and life-threatening edema is magic.

♦  There’s only 1 immediately identifiable thyroid in our small group, and it’s on the left half of my neck.  This means that either the right half of my thyroid is wherever my left ovary went, or I have a legitimate problem.  (Either with my health, or with my ability to palpate thyroids.  You choose!)

♦  Cautionary advice:  If you ever discover that you have an enlarged thyroid, you should avoid making said discovery in a room full of med students – because you will get an impromptu differential diagnosis, and it will be based entirely on House.*

Anyway, it didn’t matter because I had no symptoms whatsoever.  But just to make sure (<– mistake), I figured “Hey, since it clearly won’t be as bad as necrotizing fasciitis, why don’t I just look up “thyroid cancer”?  There should be a whole list of pretty crazy symptoms that would rule it out!  Let’s see!”

…  DAMN YOU, MAYO CLINIC.  (Okay, I should have seen that coming.)

Anyway, then we went through the rest of the head & neck exam, where I discovered I also have a cavity in one of my molars, an earwax problem, and absolutely no talent for finding optic disks.

On the bright side:  I went home and condensed 2 hours of lecture into a colorful valvular murmur chart.

(… a chart which had better be awesome enough to make up for the time I’m about to waste on dental appointments + the time Boyfriend is about to waste convincing me that I don’t have cancer.)

*  Okay, that’s only if they’re 1st years like me, and even then – to be fair – one possibility was actually from Law & Order: SVU.
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4 thoughts on “What I’ve learned so far about the physical exam

  1. Trust me, that’s better than when your preceptor (who is an oncologist) palpates your lymph nodes, and goes, “Hmmm…. how old are you again? Well, I’m sure it’s nothing.”

  2. >> because you will get an impromptu differential diagnosis, and it will be based entirely on House.*

    At least you will know that it’s not Lupus.

  3. Worse than having a large thyroid, is having a large thyroid and two parents with a history of thyroid cancer 🙂

    I was definitely the most popular kid in my HEENT exam group, because of my ability to:
    1) Open my mouth really wide
    2) Have normal ears
    3) Have oddly large pupils
    4) Have recurrent strep throat as a child, thus causing the lymph nodes in my head and neck to basically swell up and stand out like a braille map of the lymphatic system.

  4. I realize this is an old entry, but it struck a chord with me. I’m a second year med student who was diagnosed with thyroid cancer (papillary thyroid carcinoma) during a physical diagnosis section, and it saved my life.

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