Pharmacists' scope of practice is rapidly evolving to include more sophisticated patient assessment, including physical examination. This page includes important links, cheat sheets, and references useful for pharmacists wishing to practice to their full scope.

Videos & Pictures

  • TED Talk: A Doctor's Touch A video about the importance of physical examination to the physician-patient relationship, which is equally applicable to the pharmacist-patient relationship.

Findings on exam

Gen / Derm



  • JVP: Cannon A waves [1], [2] (due to AVNRT, with subsequent resolution following carotid sinus massage)
    • MoA: Right atrium contracts against a closed tricuspid valve.
    • DDx: 1o AVB with marked prolonged PR interval, arrhythmias (3o AVB, SVT/APC, VT/PVC), severe TS.
  • JVP: Monomorphic venous pulsation (Lancisi's sign) [1] , [2]
    • MoA: Blood flows retrograde into right atrium via regurgitant tricuspid valve during ventricular systole, obliterating the x descent of the typical jugular venous pulsation.
    • DDx: Severe TR (functional changes 2o to volume/pressure overload vs endocarditis, rheumatic fever, congenital, etc)
  • JVP: Kussmaul's sign
    • MoA: The right ventricle is unable to accommodate the increased venous return on inspiration, leading to a rise (or no change) in the JVP rather than the typical lowering.
    • DDx: Severe LV/RV dysfunction, RV infarct, PE, TS, constrictive pericarditis, restrictive cardiomyopathy.




  1. Oxford Handbook of Clinical Examination and Practical Skills The most pertinent and succinct how-to guide for physical examination.
  2. The Rational Clinical Examination A collection of systematic reviews evaluating the physical examination diagnosis of common and important condition.
  3. Mechanisms of Clinical Signs Brief mechanistic explanation and differential diagnosis for key physical examination findings.
  4. Bates' Guide to Physical Examination and History-Taking



  • Diagnose A collection of key physical exam findings that change the likelihood of a diagnosis (based mainly on the JAMA Rational Clinical Examination series)